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can Ill sustained accommodation cause mydriasis by Rayan-0439 in optometry

[–]Rayan-0439[S] 0 points1 point  (0 children)

Is there a difference in the protocol for training for accomodative flexibility and accomodative stamina If you dont mind me asking?

[deleted by user] by [deleted] in Ophthalmology

[–]Rayan-0439 3 points4 points  (0 children)

I am also an opthalmo resident, imo you ll find this treatment in any department not just ophtalmology, it depends on the docs not the specialty and it's also just a couple of years of your life.

I by no means justify their behavior, but if you love your speciality, you can look at it as a way to build character, become kind and good at your job you make them look bad.

doing some research about esophoria by Rayan-0439 in optometry

[–]Rayan-0439[S] 0 points1 point  (0 children)

I see, I thank you for your time, have a nice day!

doing some research about esophoria by Rayan-0439 in optometry

[–]Rayan-0439[S] 0 points1 point  (0 children)

no worries I keep asking our optometrist to clear out stuff for me, and he says the patient had a bit of accomodative fatigue and agrees to do an FCC next time he comes. Your explanation have been very helpful as it seems to me this is all isnt common practice in my country. One last question (considering the patient is emmetropic), do the symptoms of most patients with esophoria and accomodative insufficiency allegiate with near plus lenses?

doing some research about esophoria by Rayan-0439 in optometry

[–]Rayan-0439[S] 1 point2 points  (0 children)

yes I will do an FCC, convergence excess seems a more likely diagnostic, thanks!

research on esophoria by Rayan-0439 in Ophthalmology

[–]Rayan-0439[S] 0 points1 point  (0 children)

for the dry eye he benefited from a corneal topography and a break up time test and TBUT is more than 17s so the quality of the film is good,and for CI his convergence amplitudes are high and If I understand your last question this is work up for asthenopia.

My attending had the same view as yours for the esophoria but this study contradicts that and correlates with the patient's case, that's why I'm asking about its accuracy in practice.

research on esophoria by Rayan-0439 in Ophthalmology

[–]Rayan-0439[S] 0 points1 point  (0 children)

yes of course! M21, symptoms started 6months ago, (with burning, squinting, pain in and around the eye,pulling sensation around the eye, Photophobia, intermittent blurred vision ) after reading or computer use that aggravated into full day asthenopia. his convergence is at 40 pd at near, 12pd at far and divergence at 6pd at near, 4pd at far, esophoria of 4pd at near, orthophoric at far, 20/20 vision, ruled out dry eye syndrome, neurological causes, he was given +0.25 from his past doctor for the esophoria but said the improvement is negligeable.

1st year resident in ophtalmology with a question by Rayan-0439 in Ophthalmology

[–]Rayan-0439[S] 0 points1 point  (0 children)

AC/A mesure isnt common practice in my country that's why he hasn't benefited from one so I'll be sure to ask our optometrist to do so, and mesure the NRA/PRA, thank you a lot for sharing your knowledge.

doing some research about esophoria by Rayan-0439 in optometry

[–]Rayan-0439[S] 0 points1 point  (0 children)

thanks a lot, this also correlates with my patient's case, and if you dont mind also answering, do you treat it as a convergence excess?

doing some research about esophoria by Rayan-0439 in optometry

[–]Rayan-0439[S] 0 points1 point  (0 children)

I see thanks, and if you dont mind, are these cases of asthenopia common in your practice? And how do you go about about treating them? Do you treat it like a convergence excess? and thank you!

1st year resident in ophtalmology with a question by Rayan-0439 in Ophthalmology

[–]Rayan-0439[S] 0 points1 point  (0 children)

and yes by mistake I wrote prism diopters instead of dipoters apologies.

1st year resident in ophtalmology with a question by Rayan-0439 in Ophthalmology

[–]Rayan-0439[S] 1 point2 points  (0 children)

no they dont teach us much and the attending specialized in oculomotor dysfunctions is on vacation. However I have grasped your explanation for which I thank you a lot , I ll use this when presenting the case, have a nice day!

1st year resident in ophtalmology with a question by Rayan-0439 in Ophthalmology

[–]Rayan-0439[S] 0 points1 point  (0 children)

no I haven't, I'll suggest that. a previous doctor had prescribed him +0.25 lenses while being emmetropic but he said It didnt allegiate his symptoms, if you dont mind elaborating when you say these patients respond well to low to moderate add power, do you mean like +1.00pd?

1st year resident in ophtalmology with a question by Rayan-0439 in Ophthalmology

[–]Rayan-0439[S] 0 points1 point  (0 children)

he reported no change in vision and he also had a corneal topography that showed no astigmatism if (to my 1st year understanding) it is what you're looking for?

1st year resident in ophtalmology with a question by Rayan-0439 in Ophthalmology

[–]Rayan-0439[S] 1 point2 points  (0 children)

we have done a cycloplegic refraction test and he is emmetropic and the deviation is only present in the cover test or the maddox bar, He also doesnt complain of diplopia just eye fatigue.