Originally Posted by
ilanh
Today I saw a 38 year old friend of mine as a patient. He complains of constantly having to close his left eye at distance, computer and near gaze. He cannot quite explain why he closes his left eye.
On exam his BCVA was 20/20 OD and 20/25- OS. His refraction was -1.25 OD, -2.00 OS. When looking through his left eye he complains that the letters "are jumping around" and just not that clear. There is no measurable deviation at either distance or near, uncyclopleged or cyclopleged. The 8 prism base out diopter test is negative for a microtropia. He seems to have a mild exophoria which is elicited with difficulty. When I place a total of 5 diopters of base in prism in front of both eyes the exophoria seems to improve somewhat. Dilated retinal exam in entirely WNL. His main request is that he would love not to have to close his left eye all the time.
Any advice or help would be appreciated. As of now, I've made him spectacles with 2BI prims OD and 3BI prism OS. I can't say that I've ever run into this issue before.
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