Binocular vision - easier than you think (lecture)

This one hour lecture, delivered to final year optometry students, describes a simplified two-system approach to BV diagnosis and management, with cases, then details easy use of prism correction for vergence disorders; changes to BV in contact lens wear; and why BV matters - for reading and learning in kids, clinical problem solving, and myopia management.
By Dr Kate Gifford, Optometrist from Brisbane, Australia.
www.myopiaprofile.com www.mykidsvision.org

[@dreamerknitter]

Absolutely fantastic presentation to jumpstart binocular vision revision with : ) Thanks for the upload!

[@dantrbI]

This was probably the clearest explanation of BV I’ve ever heard. Would definitely recommend to fellow classmates!

[@reksubbn3961]

As an Optometrist who graduated many years ago and is now studying Children's Vision again this lecture has proved extremely helpful. It logically explains many things that I knew clinically. And explains why some things don't work. Your advice regarding glasses vs VT is what most people have experienced. But good to hear it from an expert. Thank you Kate!

[@sirmohammed9216]

Hi reksubbn, hope you have a good day, I’m a junior Optometrist, next year will be my last at college, what’s your advice as an expert for me?

[@reksubbn3961]

@@sirmohammed9216 great question. Let me have a think on how to answer you. Cheers

[@sirmohammed9216]

@@reksubbn3961 take your time brother ♥️ whenever you’re ready

[@MyopiaProfile]

Thank you so much for your kind comment - I'm really glad this video has helped you.

[@reksubbn3961]

I like the quote ' once he gets back to his normal life of staring at the screen all the time....!'

[@deonhattingh3868]

Wonderful. Thank you! I understand CI, CE, etc much better now.

[@otiebrown9999]

Good presentation, Kate Gifford!

[@RIDEFORFOOD]

Thank you for this upload. Very helpful and informative.

[@karolinaopaczynska7562]

Very useful thing to have. Shaving everything,

[@truptishah9074]

thank u maam your lectures are useful .i am very grateful to u

[@shruthiorange5792]

Amazing lecture Kate, someday in my life wanna meet you.....love from INDIA

[@uttrakhandjobs6377]

Plz take me too with you ..i am also from india

[@celsode-graftarmah7293]

I'm an optometrist in Ghana, I love the lecture very much and would like to get in touch with you

[@MyopiaProfile]

Feel free to join the Myopia Profile Facebook Group and you could contact me through there, or on LinkedIn.

[@thomasbuxton2648]

Hi Kate. Would you say there’s any point in doing a plus one test on refraction being done under cyclo?

[@kategifford9691]

Hi Thomas, I wouldn't think so, as the plus one test is to attempt to control / manage accommodation and this is the point of a cycloplegic.

[@user-zk8ck3my3l]

Can therapy work without prism for VH and BVD? Asking as patient… also, how do you determine if eye strain and weakness in one eye is BVD related vs something like MG?

[@AL-ru3nk]

I need help I think I have binocular vision dysfunction and dont know where to go for help. Im on central coast nsw. Please help

[@otiebrown9999]

Is the goal of myopia research - to help the person get himself out of myopia? Say, from 20/50, to 20/20. A refractive change of from -0.75 Diopters (starting), to +0.5 Diopters, completed, with verified 20/20?

[@ev4611]

No. To reduce its progression.

[@otiebrown9999]

@@ev4611 I need to get back to 20/20.

[@MyopiaProfile]

The first goal of myopia management is to ensure a person has an accurate prescription, for sure. If someone is overcorrected, or has pseudomyopia, this can make their prescription seem stronger than what it really should be and even sometimes fit the example you've described. Manifest myopia, though, occurs when the eye has grown too long and/or the power components of the eye are anatomically too powerful to match the length. The goal then, at least in children, is to try and reduce the progression (worsening) of myopia.

[@thomasbuxton2648]

Hi Kate. I had a 9 year old young boy today who came for an eye test, he had a small alternating xot at near and large XOP with rapid recovery in the distance. His unaided visions were 6/6 each eye. Retinoscopy showed +0.50DS. His father told me that he had recently had strabismus surgery to correct the xot last year, and after the surgery, they had prescribed him -2.50DS apparently to control the strabismus. I checked the prescription from the hospital and they had indeed given him -2.50 lenses, but he has stopped wearing them since last year, and his father wnTed to know if he should continue wearing them. I placed a -2.50 into the trial frame and redid the cover test, the lenses were hardly making any difference. Should this child continue wearing -2.50? I don’t see the point considering his visions are 6/6, he’s past the age where amblyopia could develop, and the lensss aren’t really doing anything to control the near strab

[@MyopiaProfile]

Hi Thomas, if the lenses don't seem to help with his cover test then they may not be needed any longer. An overminus of -2.50DS is a common management for intermittent XOT - here's a paper: pubmed.ncbi.nlm.nih.gov/33662112/ I would want to test and retest the cover test and fusional reserves several times during the exam to check for fatigue. If he fatigues a lot, perhaps he still needs some support at distance. I'd be concerned about a 9 year old child reading through an extra -2.50 at near, though. If it's not needed for fusion it could place excessive demand on accommodation at near. Kind regards, Kate.

[@thomasbuxton2648]

@@MyopiaProfile hi Kate. Thank you so much for your advice. I am intending to purchase your binocular vision course online, I wanted to ask whether the course, or anything else, would allow us to communicate directly with you for support on complex cases..? I am particularly interested In becoming more confident on prescribing guidelines for children, I am in the UK and we usually use Susan Leats 2011 paper as a basis, but I find it confusing tbh.

[@MyopiaProfile]

@@thomasbuxton2648 of course, you can email [e-mail] or message me directly through Facebook or LinkedIn. You will find Susan Leat's 2011 paper translated into prescribing tables in our course Mastering Refraction for Kids!

[@thomasbuxton2648]

@@MyopiaProfile many thanks! I’ve purchased your BV course, very excited to start it! Regarding your mastering refraction course, one of the things that I find particularly difficult re Susan leats paper is that there are no examples.. (of Course there wouldn’t, it’s a research paper :-)) does your course walk you through examples of how to prescribe for hyperopia, myopia, astigmatism, anisometropia, etc according to age norms as outlined in her paper? :/)

[@thomasbuxton2648]

whats PRA and NRA??

[@kategifford9691]

PRA = positive relative accommodation (ability to clear minus) and NRA = negative relative accommodation (ability to clear plus), both measured at near.

[@thomasbuxton2648]

@@kategifford9691 thank you so much!

[@jfilm7466]

Great info, but those sleeves are off-putting 😂