Tammy first came to our office when she was six years old. She had failed a school screening, the first indication she had an eye or vision problem. The prognosis was very guarded with entering acuity of 20/100 in her amblyopic eye. But her mother was a dedicated school nurse and was diligent in corrective eyeglass wear and patching. Vision was improved to 20/20 in each eye and she actually achieved 100% stereo appreciation on the Randot Stereo Test.
But results were not easy and the patching was no fun. So when Carrie was born, a trip to the eye doctor was high on the list in the first year of life.
Initial presentation was normal. Carrie was healthy, held good fixation and maintained eye contact.
Visual acuity tests were normal. Eye muscle tests were normal, and eye alignment tests were normal.
Distance retinoscopy indicated low hyperopia, but there was no change to against motion on nearpoint retinoscopy which gave an indication that we may be sitting on more plus than distance retinoscopy was telling us.
The key was cycloplegic refraction, where the full amount of hyperopia and low anisometropia became evident.
The dilated fundus exam was unremarkable.
With this amount of hyperopia, positive family history of amblyopia, and an anisometropic situation we immediately began a conservative regimen of patching the less hyperopic eye (OS). We rechecked Carrie at 3 month intervals and noted more balanced results.
Carrie maintains close monitoring, but the patching, done at such a young age, was very easily accepted. Prognosis is excellent for full acuity in each eye and full binocular function.