Hi,
I was hoping with some help on this as it's thrown my entire practice.
We have a patient who, like the title says, has a prescription that is constantly fluctuating after starting some medication.
They first tested at R: -1.75 L: -4.25/-0.50 x 70 but after starting their meds came back with headaches and felt their specs weren't correct after about two months and at that time tested at R: -1.00 L: -3.75/-0.25 x 70
The meds don't have any reports of causing changes in vision before now that we can find.
Specs were made to this rx and px could see perfectly. However they ended up having to go back to the original specs. All in all they have had six tests with five different opticians and the prescription is somewhere different between the above values each time.
They can see perfectly with one prescription in the test, and then mins five later be unable to read even two lines on the chart.
When administered cycloplegic drops the patient could see almost perfectly without any correction.
As you can see the patient has gross anisometropia, and previously we have given them differing lens indices between each eye to balance out the retinal image size (px said it was best depth perception they've ever had). The left eye only has a low rx but the px doesn't get much vision from it, not fully amblyopic but definitely around there. The px was patched as a child rigorously (px family worked in optics for two generations) and px has started patching again to keep left eye active with some result, saying that eye feels more aware.
But every optician that looks at their record goes "oh wow" which is not helpful as you can imagine. They are currently bouncing between the first specs and the second pair daily, neither of them feeling 100% now.
If anybody has any ideas I know we'd all be grateful. My director has decided the patient is a 'medical oddity'
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