Question
I dont think I have a problem yet but here is my situation. I failed a stereoacuity examination during an application for employment, I was upset and thought my vision was good. So I went to see the eye doctor and explained the problem he immedi! Ately referd me to a feind and even told his friend doctor I need strabimsmus surgery. The tests I failed were the fly, the animals and circles, i.e wich of four circles stands out. I was clueless. > my op notes say I have 20/30 vision in the right eye and 20/20 visoin in the left. Ocular motility examination, with correction in place revealed evidence of an alternating estropia measuring twelve prisim diopters at distance and eighteen prisim diopters! With near dixaton. Ocular rotations were full, pupillary examination, slit-lamp examination, funduscopic examination, and manifest refraction were enremarkable. The surgury im told I am to have is described as bi medial rectus recession of the right eye wi! Th adjustable suture(s). Im not sure if this means one or two adjustable sutures. >i'm 27 years old and have had glasses, no prisms, since about 6 months of age, and as an infant wore a patch over the left eye. >the place I am presently employed is closing 4th quater this year and I really wanted the new job I applied for, in production work. I never knew I had a vision problem and this was a big dissapointment to me. I feel as if I see fine but am told differentl! Y. I would just rather just memorize the eye test for stereoacuity, and get the whole mess over with and be done with it. >well since I am concerned about my eyesight I've been trying to learn everything I can as quickly as possible. I found out that my insurance compayn considers this type of surgery to be " potentialy cosmetic," however the doctor faxed them a studie in whic! H the conclusion was surgury in a patient with similar circumstances such as myself Not only have eliminated the ocular alignment deformity but cand counter the funcional benifits of fusion and increase the field of bnocular vision. What is alarming is the! Number of people with whom I've spoken that had either undercorrections and overcorrections. Is this a type of surgery that takes 10 tries to get it right, if the doc gets it wrong can he just readjust the adjustable suture to fix it. I was told the distan! Ce fix or whatever is 3mm. Is that bad, will I be able to see a whole new world. Will I really throw up alot. Will I need new glasses, I will eventually ask my doctor for an opinion, but what if he just wants to do the su! >rgy because he has a car payment due.
>if I memorize this stero test and get the job will I be in any danger of cuttng off my hand, because I cant see depth, >any information you can provide would be greately appreciated.
(Paul John Steinbock)
Answer:
Dear Paul,
As I understand it, you have an esotropia of 12 prism diopters with a slight convergence excess: the near angle is 18 diopters. One eye seems slightly amblyopic with a visual acuity of 20/30. You would have the surgery done to pass a stereotest (for seeing depth with two eyes) to get a job.
First, please make sure a hypermetropia has not been overlooked: In that case wearing plus glasse could help a lot.
Secondly, I would consider the chance to pass the stereotest after surgery less than 50 %. If they will take you for the job when just passing the Fly test, the chance may be better, but you are likely to fail at the circles after surgery.
Under these conditions, I would not advise a patient to have surgery, especially as you are not disturbed by double vision or cosmetically.
(Herb Simonsz, MD, PhD)
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