- Prescription from last visit:
- RE: -6.00DS/-1.00DCX174 (6/15)
- LE: -6.00DS/-1.00DCX15 (6/15)
- mother complained that his performance is better after wearing the glasses
Test | RE | LE |
VA with LEA Symbols (aided) | 6/15 | 6/15 |
Hirschberg | Center and symmetrical | |
Cover test | Dist: cannot be obtained Near: moderate esotropia with fast recovery | |
OMT | Nystagmus intensity increase upon abduction | |
Worth Four Dot | Dist: seen 5 light Near: seen 4 light (2R,2G) | |
Stereopsis (Frisby) | 300” | |
PCT | Dist: cannot be obtained Near: 25∆ BO | |
from the examination, we found that he is;
- BE amblyopia
- Nystagmus intensity increase upon abduction
- Nystagmus obvious at distance than near
- Cover test at near reveal esotropia
- Esotropia nystagmus blockage syndrome
- Alternate patching at least 2 hours/ day with near task
- wear correction full time
By: Group 1
can the hirschberg be central and symmetricaleven if the pt is esotropia????? eh????
ReplyDeleteit's probably because he's having nystagmus..since the eyes keep oscillating we got the reflex at central even with several trials..
ReplyDeletebtul tu, with pct u got around 25prism diopter, significant gak tu, and u said esotropia not phoria, normally hirchberg kita buat kat dekat kan, about same distance at pct near,
ReplyDeleteand i think a few tentatif dx is
v pattern or convergen exsess
sorry kl my opian ni tak btul....or tak tetap
kita blajaq sama2 kan
yep..supposedly it shud not be central & symmetry la kn..tp this is what we got..may be anyone could suggest the appropriate way to do hirschberg on nystagmus eyes?hee..i think it's hard to track the reflex when the eyes keeps moving.. ~x(
ReplyDeleteOpps sorry... there was a typo error... the hirschberg is actually 25 degree to temporal..now it make sense that this patient has esotropia...
ReplyDeleteizzah, maybe we can try to fit the pt with CL as it can reduce the nystagmus then we do the hirshberg (hehehe). there is a website stated that nystagmus pt, usually have some position where the nystagmus is decrease, mybe when he's at the position where the nystagmus decrease we can do the hirshberg http://www.lowvision.org/nystagmus.htm
ReplyDelete