Since I started prescribing prism in greater numbers, (I’ve prescribed more prism in the last 7 months than during any of my nine years of practice) I’ve seen all sorts of interesting things happen during the exam.
There was the 12 year old girl who our technician couldn’t refract to anything better than 20/200. After a few binocular tests and the proper prism put in front of her, she coasted easily to 20/20 with each eye. I’d never seen anything like it. But then again, I’d never looked at that as the potential problem. And I have to admit, it’s a little embarrassing considering I’ve practiced for almost 10 years.
And I see this almost every day. People of all ages who fall asleep driving, can’t read for more than 20 minutes, high school seniors who can’t make it all the way through their SAT testing and I wonder how many I missed over the years. Patients we would just call amblyopic because there was no other explanation. All because their eye muscles don’t want to efficiently aim their eyes at whatever they’re trying to concentrate on.
Now, for my OD friends…I do not consider myself a binocular guru. I’m not planning on writing a book or opening up a specialty practice. I’m just looking at an aspect of their vision and checking their response to holding a prism in front of the eyes. I’ve been shocked at how many times my patients say that things look clearer as well.
And the tricky part of all this is how well most of us can compensate when our eyes start fighting each other. But compensating usually means slowing down, stopping, or avoiding any kind of comprehensive reading. Those of us who are halfway intelligent can be fairly successful in life despite this.
So maybe I’m just behind the times and Dr. Chung and Dr. Espiritu (my friends and classmates), they probably discovered all this years ago. I know Dr. Nate did! I like to think that the busy-ness of my prior practice in Texas did not afford me the time to delve in to these things. But that’s not much of an excuse.
So if you experience fatigue around the eyes that occurs regularly, quit blaming your sinuses if you haven’t had a good binocular work up during your eye exam. If your eye doc didn’t make you see double at some point during your last exam AND didn’t solve all your vision problems, then mention this article to them next time.