A clinical case

Discussion in 'Off-Topic' started by Optoseeker, Mar 22, 2023.

  1. Optoseeker

    Optoseeker

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    An 8 - year old child was reffered for visual examination because of reading difficulty at school lesson class.
    His phonic and vocabulary level is good, but tests of comprehension are low.
    Results of examination :
    - V A without correction far : 1.0/1.o
    - V A with correction near : 1.0/1.o
    - NPC : 2.5/5cm ( accommodative Chart) 5/7.5cm ( penlight).
    - CT far : Ortho
    - CT near : 2XP.
    MEM retinoscopy : +1.25 both eyes.
    - Subjective : RE +.25 and LE neutral
    - Lateral phoria far : Ortho
    - Base in vergence(far) : X/6/5
    - Base out vergence(far) : X/16/12
    - Lateral phoria(near) : 3XP
    - AC/A 5/1
    - Base in vergence(near) : 8/16/10
    - Base out vergence(near) : 10/15/9
    - NRA : +2.50
    - PRA : -!.00.
    - Amplitude of accommodation : RE 9D/LE 9D
    - Monocular accommodative flexibility : RE 0 cpm fails at -2.00 / LE 0cpm fails at -2.00
    - Binocular accommodative flexibility ; 0 cpm fails at -2.00
    - EOM :
    - Saccadic : 1+ , frequent losses of fixation. Hypometric.
    - Tracking : Frequent losses of fixation.
    - Pupils : PERRLA -MG.
    - The visual health tests were normal.
    What could be the diagnosis according to these data and the history of the case?
    What will be the plan of the treatment?
     
    Optoseeker, Mar 22, 2023
    #1
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