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Category: Volume 07 Issue 09 September 2019
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Title: Optometry mismanagement in Patient with latent hyperopia, misdiagnosed as Pre-Presbyopia (age 30-35 yrs)

Authors: Samir Sutar, Mossab Omaer, Ram Gopal, Dr Pradeep Agrawal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.96

Abstract

  

This study highlights mismanagement in glass prescription in optometry care services and the importance of modified fogging technique (Borish’s delayed subjective refraction) to detect latent hyperopia, especially those patient age group of (30-35 years) associated with prolonged near work followed by asthenopia symptoms and near vision blur. This retrospective case series study was done at a tertiary care eye hospital in Uttar Pradesh, India. Thirty patients, presented with complaints of blurring of vision specially near work and asthenopic symptoms with history of aggravation of symptoms with prolonged near work (ill sustained of accommodation). Refraction was initially showing hyperopic refractive error but it was ignored  view of  vision was 20/20-20/25 for distance  but found to be gross near vision difficulty (N18), simple near  addition was prescribed. To prove mismanagement in Optometry care, a simple / modified fogging technique was introduced and was performed over the same patient. After this technique there was noted latent hyperopia and VA was 20/20 for distance with near vision N6 without any near add found. Diagnosis of latent hyperopia was made. Single glasses for distance were prescribed. Patients were observed after 2 months in which none had recurrence.  The condition resolved and asthenopic symptoms were improved.

Keywords: Latent hyperopia, Boris’s delayed subjective test, Ill sustained of accommodation.

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Corresponding Author

Samir Sutar

Department of Optometry and Vision science, C L Gupta Eye Institute