Scribd Logo
Upload

Welcome to Scribd!

  • 15 views

    Clinical Case - Atheer Alharby

    Uploaded by

    atheer
    This document discusses a clinical case of suspected accommodative excess in a patient. Accommodative excess is when the eyes over-focus on near objects, leading to symptoms like eye strain and headaches. Based on the patient's symptoms and exam findings, which showed fluctuating vision, esophoria, and normal accommodation, the optometrist's initial diagnosis is accommodative excess. The document then lists tests that can confirm the diagnosis and treatments that may be recommended, such as reducing near work, prescribing corrective lenses, vision therapy, prismatic lenses, and lifestyle changes. A brief report is provided summarizing the diagnosis and recommended treatment plan for the patient.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Clinical Case - Atheer Alharby

    Uploaded by

    atheer
    15 views3 pages
    This document discusses a clinical case of suspected accommodative excess in a patient. Accommodative excess is when the eyes over-focus on near objects, leading to symptoms like eye strain and headaches. Based on the patient's symptoms and exam findings, which showed fluctuating vision, esophoria, and normal accommodation, the optometrist's initial diagnosis is accommodative excess. The document then lists tests that can confirm the diagnosis and treatments that may be recommended, such as reducing near work, prescribing corrective lenses, vision therapy, prismatic lenses, and lifestyle changes. A brief report is provided summarizing the diagnosis and recommended treatment plan for the patient.

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses a clinical case of suspected accommodative excess in a patient. Accommodative excess is when the eyes over-focus on near objects, leading to symptoms like eye strain and headaches. Based on the patient's symptoms and exam findings, which showed fluctuating vision, esophoria, and normal accommodation, the optometrist's initial diagnosis is accommodative excess. The document then lists tests that can confirm the diagnosis and treatments that may be recommended, such as reducing near work, prescribing corrective lenses, vision therapy, prismatic lenses, and lifestyle changes. A brief report is provided summarizing the diagnosis and recommended treatment plan for the patient.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    15 views3 pages

    Clinical Case - Atheer Alharby

    Uploaded by

    atheer
    This document discusses a clinical case of suspected accommodative excess in a patient. Accommodative excess is when the eyes over-focus on near objects, leading to symptoms like eye strain and headaches. Based on the patient's symptoms and exam findings, which showed fluctuating vision, esophoria, and normal accommodation, the optometrist's initial diagnosis is accommodative excess. The document then lists tests that can confirm the diagnosis and treatments that may be recommended, such as reducing near work, prescribing corrective lenses, vision therapy, prismatic lenses, and lifestyle changes. A brief report is provided summarizing the diagnosis and recommended treatment plan for the patient.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Binocular Vision and Accommodation: Assessment and Treatment

    CLINICAL CASE

    Questions:

    1. Identify the case.


    My initial diagnosis is “Accommodative excess “as there are some signs related to
    it such as:
     fails + Flipper mono and difficulty in bino flippers.
     Esophoria at near and at distance.
     the normal AA.
     Fluctuating of VA.
     fatigue at work as well as itchy eyes.
     High PRA

    2. Which test would you do to confirm the case?


     MEM : its lowered or even negative value.
     Vergence Amplitude test show: BI blur at near may be low
     Cyclo Refraction.
     In the subjective, a vertical negative cylinder may appear due to tensional
    causes.
     Slit lamp exams, to rule out dryness and allergy from SCL.

    3. Is there any test that does not fit with the clinical signs of this case?
     YES, the NRA usually will be reduced in cases of AE.

     Also the Retinoscopy usually has a higher value than subjective. But this may
    happen because the pt is overcorrected ! the cyclo refraction will give us the
    accurate refractive status regardless the excess of accommodation.

     Some myosis can be observed in its performance, and also a fluctuating reflex
    or difficult identification
    Binocular Vision and Accommodation: Assessment and Treatment

    4. Which general recommendations would you indicate to this patient?


    The common treatment options that may be recommended:

    Reducing Near Work: Accommodative excess is often caused by excessive near


    work activities as he is a bank teller he deals with numbers and near work for
    extended periods. Reducing near work activities and taking frequent breaks can
    alleviate symptoms and prevent the condition from worsening. The rule of 20/20/20
    will be helpful.

    Corrective Lenses: Prescription glasses or contact lenses of accurate refraction


    (least minus more plus) can help to reduce the demand on the eyes to focus. Bifocals
    or progressive lenses may also be prescribed to help the patient see clearly at
    different distances.

    Vision Therapy: to improve the patient's visual function and reduce symptoms. This
    may include exercises to improve eye tracking, convergence, and accommodative
    function. Such as hart chart and flippers.

    Prism Lenses: Base IN Prism can be prescribed to help correct any underlying
    binocular vision issues, such as excessive convergence or esophoria.

    Lifestyle Changes: Practicing good visual hygiene habits such as taking frequent
    breaks, adjusting lighting, and maintaining proper posture can help reduce symptoms
    and prevent the condition from worsening.

    Medications: In rare cases, medications such as atropine or cyclopentolate may be


    prescribed to temporarily paralyze the ciliary muscles and reduce accommodative
    spasm.
    Binocular Vision and Accommodation: Assessment and Treatment

    5. Prepare a brief report for the patient


    Dear
    Thank you for visiting our clinic. Based on your symptoms and exam findings, it
    appears that you may have accommodative excess, a condition where the eyes over-
    focus on near objects, leading to symptoms such as eye strain, headaches, and
    blurred vision.
    The clinical exams showed a fluctuated Visual acuity which is related to your excess
    near work.
    Treatment for accommodative excess depends on the underlying cause and severity
    of the condition. Treatment options may include reducing near work activities,
    prescribing corrective lenses such as reading glasses or bifocals, vision therapy,
    prism lenses, lifestyle changes, and in rare cases, medications.
    We recommend that you take regular breaks from near work, adjust your lighting,
    and maintain good posture when using digital devices. It's also important to follow
    any prescribed treatment plan to alleviate symptoms and prevent the condition from
    worsening.
    If you have any further questions or concerns, please don't hesitate to contact us. We
    are here to help you maintain optimal eye health and visual function.

    Best regards,
    [Atheer Alharby, Optometry Doctor]

    You might also like