Case Analysis Presentation
This document was uploaded by user and they confirmed that they have the permission to share it. If you are author or own the copyright of this book, please report to us by using this DMCA report form. Report DMCA
Overview
Download & View Case Analysis Presentation as PDF for free.
More details
- Words: 494
- Pages: 10
Case Analysis Presentation: accomodation spasm Mohd Abdul Latif Bin Abdul Rahman
Case Hx
Mr H.Y a 221 years old student with complain of headache and having asthenopia. Usually in the class, he always complain of diplopia. He never wear spect. His brother has keratoconus and on treatment with ophthalmologist. His father side has diabetic history. MrH.Y general health problem is good and she had no allergies and not under medication. Patient hobby is to play computer game.
Entrance Test OD UNAIDED VA 6/6 +1.00DS 6/12 NEAR VA N 5 @40 CM COVER TEST EP WITH FAST PUPIL RESPONSE PERRLA RECOVERY OCULAR SAFE STEREOPSIS 30”OF ARC MOTILITY COLOR VISION PASS (SPP1) CONFRANTATION FULL NPA 7/8 NPC 12/8 HIRCBERGH SYMMETRY
OS 6/6 6/12 N5 @40 CM EP WITH FAST RECOVERY
9/8
RERACTION OD RET
+0.25/-0.25X160 (6/6) MONOCULAR END +0.25/-0.25X160 POINT (6/6) BINOCULAR END +0.25/-0.25X160 POINT (6/6) AA 12
OS +0.25 (6/6) +0.25 (6/6) +0.25 (6/6) 12
BINOCULAR EVALUATION HETEROPH DICTANCE H: 3XP ORIA NEAR H: 3EP AC/A 3:1
V: 0 V: 0
MADDOX ROD
ACCOMMODATION EVALUATION RELATIVE B+ ACCOMMODATIO +0.50 DS N
B-
MAF
FAIL
FAIL
BAF
FAIL WITH PLUS LENS
-1.50
PATIENT REPORT OF SEEING DOUBLE DURING THE ASSESSMENT OF ACCOMODATION, THUS MEM RET CAN’T BE DONE
SLIT LAMP EXAMINATION DOES NOT DETECT ANY ABNORMALITY OPHTALMOSCOPY TEST UNDER NORMAL CONDITION
DIAGNOSIS
This pt has low simple astigmatic hyperope. He loves to play computer game and and he has symptoms of having asthenopia and complain of diplopia. Patient fail with +ve lens, and reporting of seeing double during the assessment. This means that patient can’t relax his accomodation. This patient is suspected to has accommodation spasm or accommodation excess. But patient with accommodation excess usually developed a high exophoria, contradict with this patient that has esophoria. Thus due to the symptoms above this patient might has accommodation spasm
Management
Need to make another follow up with patient for cycloplegic refraction. Then need to compare the result of cycloplegic and post cycloplegic refraction to find the best power that suite her. Correct the refractive error with minimum minus with best distance VA. Advice patient to reduce his time spend for playing computer game. Ask patient to see distance or green panoramic to relax the accommodation. Patient also need to be refer to special binocular vision clinic for therapy session. He might need to undergo therapy to relax his accommodation and to increase the MAF and BAF using plus minus lens (flipper lens) with word rock card.
The flipper use for the first session is +/0.50 then the power will be increase gradually according to patient achievement until it reach the goal of having around 7 cycle per minute using +/2.00 D flipper. He also need to undergo corneal topography, just to confirm that he does not has any corneal irregularity that could developed to keratoconus (his brother has keratoconus).
Case Hx
Mr H.Y a 221 years old student with complain of headache and having asthenopia. Usually in the class, he always complain of diplopia. He never wear spect. His brother has keratoconus and on treatment with ophthalmologist. His father side has diabetic history. MrH.Y general health problem is good and she had no allergies and not under medication. Patient hobby is to play computer game.
Entrance Test OD UNAIDED VA 6/6 +1.00DS 6/12 NEAR VA N 5 @40 CM COVER TEST EP WITH FAST PUPIL RESPONSE PERRLA RECOVERY OCULAR SAFE STEREOPSIS 30”OF ARC MOTILITY COLOR VISION PASS (SPP1) CONFRANTATION FULL NPA 7/8 NPC 12/8 HIRCBERGH SYMMETRY
OS 6/6 6/12 N5 @40 CM EP WITH FAST RECOVERY
9/8
RERACTION OD RET
+0.25/-0.25X160 (6/6) MONOCULAR END +0.25/-0.25X160 POINT (6/6) BINOCULAR END +0.25/-0.25X160 POINT (6/6) AA 12
OS +0.25 (6/6) +0.25 (6/6) +0.25 (6/6) 12
BINOCULAR EVALUATION HETEROPH DICTANCE H: 3XP ORIA NEAR H: 3EP AC/A 3:1
V: 0 V: 0
MADDOX ROD
ACCOMMODATION EVALUATION RELATIVE B+ ACCOMMODATIO +0.50 DS N
B-
MAF
FAIL
FAIL
BAF
FAIL WITH PLUS LENS
-1.50
PATIENT REPORT OF SEEING DOUBLE DURING THE ASSESSMENT OF ACCOMODATION, THUS MEM RET CAN’T BE DONE
SLIT LAMP EXAMINATION DOES NOT DETECT ANY ABNORMALITY OPHTALMOSCOPY TEST UNDER NORMAL CONDITION
DIAGNOSIS
This pt has low simple astigmatic hyperope. He loves to play computer game and and he has symptoms of having asthenopia and complain of diplopia. Patient fail with +ve lens, and reporting of seeing double during the assessment. This means that patient can’t relax his accomodation. This patient is suspected to has accommodation spasm or accommodation excess. But patient with accommodation excess usually developed a high exophoria, contradict with this patient that has esophoria. Thus due to the symptoms above this patient might has accommodation spasm
Management
Need to make another follow up with patient for cycloplegic refraction. Then need to compare the result of cycloplegic and post cycloplegic refraction to find the best power that suite her. Correct the refractive error with minimum minus with best distance VA. Advice patient to reduce his time spend for playing computer game. Ask patient to see distance or green panoramic to relax the accommodation. Patient also need to be refer to special binocular vision clinic for therapy session. He might need to undergo therapy to relax his accommodation and to increase the MAF and BAF using plus minus lens (flipper lens) with word rock card.
The flipper use for the first session is +/0.50 then the power will be increase gradually according to patient achievement until it reach the goal of having around 7 cycle per minute using +/2.00 D flipper. He also need to undergo corneal topography, just to confirm that he does not has any corneal irregularity that could developed to keratoconus (his brother has keratoconus).
Related Documents
Case Analysis Presentation
June 2020 1
Presentation Analysis
June 2020 5
Case Presentation
November 2019 21
Case Analysis
May 2020 21
Case Presentation
June 2020 21