tag:blogger.com,1999:blog-6504496555839203608.post5083021594075117547..comments2023-10-15T22:45:46.451+08:00Comments on Syah's Optometry Blog: Binocular Vision: 9yo/M/MThe Travelerhttp://www.blogger.com/profile/04326376327284497514noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-6504496555839203608.post-24003426798966480962011-02-28T22:12:17.164+08:002011-02-28T22:12:17.164+08:00btw, did patient complain on glaring? It is common...btw, did patient complain on glaring? It is common in XT patient.<br /><br />Conservative treatment such as tinted glasses may be helpful.azuwanmusanoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-46970616389800023232011-02-28T21:27:52.431+08:002011-02-28T21:27:52.431+08:00there are two diagnosis i can give here.
1) high a...there are two diagnosis i can give here.<br />1) high anisometropic amblyopia secondary to ROP.<br />2) Large LE secondary XT.<br /><br />the prgnosis is very poor. the conservative therapy may not be helpful for this kind of case. Other reasn is due t patient age. Too late for any therapy.<br /><br />my suggestion for this patient is strabismus surgery.do you still remember bout the indication of surgery?<br />a)increasing tropic with diminish fusion control.<br />b) poor fusion recovery on cover / uncover test.<br />XT is manifest >50% of waking hours.<br />c) XT >20PD.<br /><br />If we wish to preserve the sereopsis, i would recommend this patient for surgery first. the undergo anti-suppression therapy. For anisometropic patient, cntact lens is the best option for visin correction. it will also improve the stereopsis since the effect of aniseikonia is reduced.azuwanmusanoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-86142170977152537862011-02-28T15:10:22.414+08:002011-02-28T15:10:22.414+08:00sorry sir, the anonymous person is actually me...h...sorry sir, the anonymous person is actually me...hehehe...tersilap tekan tadi... :)Nurul Atikahnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-88426329313845766912011-02-28T15:08:51.172+08:002011-02-28T15:08:51.172+08:00Hurm,as you all can see the deviation is very larg...Hurm,as you all can see the deviation is very large >20PD. Therefore vision therapy will not be one of the treatment in option. Surgery is actually the best method to correct the XT. I think the prognosis for the surgery would be good since pt have LE suppression and no stereopsis.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-82703356071083448262011-02-27T21:50:02.370+08:002011-02-27T21:50:02.370+08:00@aiDaMaDiHa
tq for such an informative discussion ...@<a href="#c1754990866604124840" rel="nofollow">aiDaMaDiHa</a><br />tq for such an informative discussion guys..<br />but before performing anti-suppression therapy, dont we think we should follow step by step guide in orthoptics training?<br />1.normalize n equalize VA (patching)<br />2.normalize accomodation<br />3.bv training (antisupression, overminus etc)<br />maybe we can discuss further on this, specifically for this pt<br />-should we proceed with amblyopia therapy<br />-or just give in since he is already 9 y.o<br /> =)nazarynanoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-34656936658234387132011-02-25T13:13:02.264+08:002011-02-25T13:13:02.264+08:00anti suppression therapy:
1) physiological diplo...anti suppression therapy: <br /><br />1) physiological diplopia- exercise involved: aperture rule, brock string, dot card<br /><br />2) after patient is able to see diplopia, whats's next?? hurryyy!! tell me heenurlizzznoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-15658180240808646682011-02-25T01:38:26.110+08:002011-02-25T01:38:26.110+08:00@eli aimi
p/s to sir...please correct me if I'...@<a href="#c4584241227334212423" rel="nofollow">eli aimi</a><br />p/s to sir...please correct me if I'm wrong....HANNANnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-54357565297537129522011-02-25T01:35:17.497+08:002011-02-25T01:35:17.497+08:00@eli aimi
eli: I think for this case, though the ...@<a href="#c4584241227334212423" rel="nofollow">eli aimi</a><br /><br />eli: I think for this case, though the deviation is > 20PD surgery is not indicated as it may leads to intractable diplopia (horror fusionis)...<br /><br />thus, for this case, since the pt has peripheral suppression, before anything, we should first treat the peripheral suppression....HANNANnoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-17549908666041248402011-02-24T06:05:10.594+08:002011-02-24T06:05:10.594+08:00@nurlizzz
gud responds guys..:)
the stage of ROP...@<a href="#c4835450561566304393" rel="nofollow">nurlizzz</a><br /><br />gud responds guys..:)<br /><br />the stage of ROP is not mention. but according to his mother, the patient had undergone laser therapy..<br /><br />recent studies suggest that argon laser and diode laser photocoagulation for treatment ROP with stage 3+..with diode laser therapy, 81% successful.<br /><br />on 22nd Feb, ophthalmic delivery and fundus photo assessment done on him.<br />VA: RE:6/9+2 <br /> LE:5/60<br /> it improves a lot..:)<br /><br />fundus: laser scar presents on posterior pole of LE. others finding normals.<br /><br />actually, before we normalize VA, should eliminate any abnormalities first. for this case, we should eliminate amblyopia first. eventhough the LE suppress, we should try on anti-suppression therapy.<br /><br />so, can u guys explain how to do anti-suppression therapy for this patient?aiDaMaDiHanoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-9534922089949046652011-02-23T10:03:43.048+08:002011-02-23T10:03:43.048+08:00@rohaila
should we normalize the vision first? us...@<a href="#c7149449141243712865" rel="nofollow">rohaila</a><br /><br />should we normalize the vision first? using CL perhaps?nurlizzznoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-48354505615663043932011-02-23T10:01:59.371+08:002011-02-23T10:01:59.371+08:00a) diagnosis: Bilateral anisometropic amblyopia
a...a) diagnosis: Bilateral anisometropic amblyopia<br /><br />according to W4D test, LE is supress at distance. LE supressed due to the high anisometropic which produce aniseikonia. <br /><br />b)prognosis is bad since he has no streopsis. He has no binocular vision as his LE supressed. <br /><br /><br />c)Complication of ROP: As known, retinal detachment in stage 4 and 5. What stage is he? <br /><br />Since he has history of laser, for case of ROP, ophthal usually laser the blood vessels right? Can someone explain? i forgot oledy..heenurlizzznoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-71494491412437128652011-02-23T05:30:24.693+08:002011-02-23T05:30:24.693+08:00good from eli and dayah~
ok, i have a question. c...good from eli and dayah~<br /><br />ok, i have a question. can we perform anti-suppression therapy for him?rohailanoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-4675081577764234492011-02-23T00:59:43.250+08:002011-02-23T00:59:43.250+08:00aslmkm..
for this case, he is probably having anis...aslmkm..<br />for this case, he is probably having anisometropic amblyopia secondary to ROP.<br /><br />the prognosis is poor since the binocularity is poor - finding from W4D test and stereopsis.<br /><br />among the complications of ROP are retinal detachment, higher risk of developing strabismus and myopia (Kanski, 2007)hidayahhttps://www.blogger.com/profile/02300092466810813045noreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-59761154396275052332011-02-21T10:07:23.662+08:002011-02-21T10:07:23.662+08:00besides, i would like to suggest to prescribe this...besides, i would like to suggest to prescribe this patient with polycarbonate lenses. why?? because protection of the remaining functional eye is important. Patients who have only one functional eye should wear adequate protective eyewear fulltime. polycarbonate lenses are preferred due to their high impact resistance. Additionally, physical education in school and other recreational activities must be limited to safe, non-traumatic activities due to increased risks for retinal detachment.eli aiminoreply@blogger.comtag:blogger.com,1999:blog-6504496555839203608.post-45842412273342124232011-02-21T10:04:03.973+08:002011-02-21T10:04:03.973+08:001.anisometropia with bilateral amblyopia. amblyopi...1.anisometropia with bilateral amblyopia. amblyopia is an organic type.<br /><br />2.the prognosis for BV is poor since the deviation is large. maybe surgery can be done for cosmetic purposes because the deviation is more than 20 pd.<br /><br />3. a. The retina may become stretched and pulled by the contraction of the scars in the eye. This may physically pull the macula, the most sensitive part of the retina, causing abnormal vision. <br /><br />b. It may also cause folds in the retina and lead to retinal detachment.<br /><br />c. Strabismus is another complication and it is the crossing in or turning out of an eye. This may occur from the loss of vision in one eye or be related to the large refractive differences between the eyes. <br /><br />d. Both cataract and corneal problems can develop. Severe damage may lead to Phthisis bulbi, a shrinking of the severely damaged eyes. Glaucoma may develop either early or as a later in life complication of ROP. <br /><br />e. Nystagmus is common in all patients whose vision loss occurs at an early age.eli aiminoreply@blogger.com