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Case Study: IQ

  1. Type
    1. Occulomotor
  2. History:
    1. Entering complaint: referred by Primary Care OD for EOM dysfunction.
    2. Signs and symptoms: Mother noted during gymnastics, IQ struggles with the balance beam – she tends to move her entire head.
    3. History: 7 year old white female. Born at 32 weeks – twin. Activities include gymnastics and dance. Loves to read, does well in school. FVSC: 19.
  3. Diagnostic Data
    1. Visual Acuity @ Distance: 20/25-2 OD, 20/20-3 OS; @ Near: 0.5m OD, 0.5m OS
    2. King-Devick: p<0.5% level
    3. Ocular Motility: head movement; poor horizontal and vertical pursuits
    4. Refractive status: emmetropia
    5. Analytical: suppresses right eye at distance
    6. Accommodative facility: 3 cycles/minute
    7. COVD Lifestyle checklist: 55 (higher number indicates more challenges)
  4. Diagnoses
    1. Accommodative infacility
    2. Occulomotor dysfunction
  5. Prognosis:
    1. OD Goals: normalize accommodative facility (exceed 6 cycles/minute), normalize occulomotor function (achieve normal King-Devick, free eye movements from head movements).
    2. Patient Goals:
      1. Lean to read better so that I can learn more & learn faster.
      2. Make better grades in school.
  • Finish my homework sooner and have more time to play.
  1. Stop having headaches or blurred vision after doing reading or close work.
  2. Would like to track better with eyes only.
  3. Maximize potential.
  1. Prognosis: excellent
  2. Treatment:
  3. Lens Rx: no lenses prescribed
  4. VT prescribed: VT2 curriculum prescribed
  5. Outcome of Case
  6. Results
  7. King-Devick: within normal range
  8. Ocular Motility: excellent motility; eyes move freely from head

iii. Accommodative facility: 17 cycles/minute

  1. COVD Lifestyle Checklist: COVD Lifestyle checklist: 1
  2. Goals:
    1. OD goals met? Yes
    2. Patient goals met?
    3. Follow-Up Care:
  • 1MO follow up: stable
  • 3MO follow up: stable
  • 6MO follow up: stable
  • Annual follow ups with OD