Muhammad Waqas, Shehla Rubab.
Management of a Partially Sighted Patient with Low Vision Aids.
Pak J Ophthalmol Jan ;16(3):117-9.

A 20-year-old college-going man was referred to low vision clinic of AI-Shifa Trust with the complaint of decreased visual acuity in both eyes for distance and near. His main problem was inability to read from blackboard and books. OPHTHALMIC EXAMINATION: The patient had history of bilateral congenital cataracts. His right eye was operated on at the age of 1 year and the left eye at the age of 2 years. Secondary IOL was implanted in the right eye 15 years after cataract extraction. On cover test the patient was an alternating exotrope with right dominant eye along with dissociated vertical divergence (DVD). Jerk nystagmus was present in the left eye on right gaze, which reduced very much with distance optical correction. Extraocular movements were normal. On slit-lamp examination the patient had left updrawn pupil and a small membrane superotemporally in the right eye. On posterior segment examination the patient had bilateral vitreous degeneration. Optic discs and maculae were normal. Concept of mono-vision was applied to improve the vision in this patient. The patient was advised aphakic correction (+10.00) and 4X Galilean telescope (spotting) for distance vision in the left eye. The visual acuity after aphakic correction in the left eye improved from 1/60 to 6/36. Adding 4X Galilean telescope improved the visual acuity to 6/9. In his right pseudophakic eye, he was advised +10.00 DS for near vision (0.8M/N6) at 10 cm. Now the patient uses +10.00 DS for both eyes. Left eye is used most of the time for distance and the telescope in the same eye provides further enhancement of distance vision when required (e.g reading blackboard, signboard etc), while the right pseudophakic eye is used for near vision. Cosmetically his glasses are acceptable. The latest follow-up at the end of six months is very encouraging and the patient is quite comfortable

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