I have a gentleman that has diplopia for years. He had an eye trauma at 17, a retinal detachment and lens rupture at 19 (with no IOL) and had cataract surgery in Summer of last year. He used to wear RGPs but doesn't want to go that route.
His RX when we first saw him in May 05 was:
OD +12.75 -0.25 x 017 V:70
OS +0.75 -0.50 x 090 V:20 +1
+2.00 ADD
At that time we referred him to an OMD to have Cat Surgery and possible IOL.
He came in for 1st follow up with us in Sept 05. His rx at time was:
OD -2.25 -4.25 x 025 5BU V:25 -4 (when pushed)
OS +0.75 -0.50 x 090 5BD V:20 +1
+2.00 Add
He held off on filling RX to give more time to heal per OMD.
In Dec he presented the rx was:
OD pl -2.00 x 180 6BU 4BI V:20 -2
OS +1.00 -0.75 x 114 6BD V:20 +1
+2.25
Patient was pleased with vision out of both eyes, but while diplopia was better than in past, he still wasn't able to get a fused image.
Remade in Feb with altered prism of
OD 3BU 4BI
OS 3BD 4BI
with a notation made that there still will be some diplopia but less.
Patient said this is much better, and when he uses just one of his eyes, he gets a great crisp picture. The problem is if he tries to ues both eyes at same time, the right image is still up about 15 degrees of the left.
The gentleman is getting frustrated because now that he can see out of right eye, he wants to be able to use it. It isn't as easy to ignore now :)
Any ideas on what can be done to help fuse these images together? He doesn't notice a difference in the placement of the images when using distance or reading.
He just doesn't want to give up on that hope we created for a clear image from both eyes.
Many Thanks!
Cassandra
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