Dr.Miriam Ankita Clement

Dr.Gayathri Panicker

Abstract

A 32 year old male with history of road traffic accident and traumatic brain injury presented 1 month post trauma with complaints of blurred vision and difficulty in focussing on objects. His unaided visual acuity was 6/6 for distance and N6 at 30-35 cm in both eyes. He had an alternating exotropia measuring 25 prism dioptres(PD) at distance and 35-40 PD at near. Stereopsis was 100 seconds of arc and alternate suppression noted on worth 4 dot test. There was absent convergence on testing his near point of convergence while his near point of accommodation was 17 cm. Orthoptic evaluation revealed reduced positive relative accommodation, high lag of accommodation, reduced accommodative facility and low positive fusional vergence. Rest of the eye exam was normal.The patient was given bifocals with near addition and convergence and accommodation therapy aided with base out prisms. He is planned for surgical correction of squint as well.