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Ophthalmology & Optometry/rapid inconsistent focus/sporadic vision

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Question
My daughter, now 14, had an eye exam last year. Her eye doctor was not able to determine her eyesight. ?Retinoscopy? was inconsistent with measurements ranging widely nor was she able to focus on the letter board close up or far away.

He described her condition as "frozen" or "stuck" focus. He stated that her frozen focus my have been caused from texting on a cell phone. My daughter does not text. He said that this condition is common in teenagers, but I searched online and have yet to find anything remotely close.

Her focus is jumping +high & -low dramatically within seconds and inconsistent. He suggested bifocals and eye exercises with an eye specialist.

Last month, I took her back for an exam to see if her vision had improved. I was told that the condition is worse after a year of bifocals and eye therapy.

What is the name and cause for this type of condition? What type of treatment will help her?

Answer
Kelly.    It sounds from your description, that your daughter may be suffering from accommodative spasm and / or accommodative infacility .  An auto refraction should be performed as well as a dry and wet refraction, that is a cycloplegic refraction which should give the doctor a lot if useful information as to her focusing status.  A positive and negative relative accommodation needs to be determined as well as the positive and negative fusional reserves.  The amplitude of accommodation and the lag all needs to be ascertained as well.  Nearpoint and distance Phorias will give the doctor more info  to put the whole refractive puzzle together and devise a proper treatment plan. I know these terms are probably foreign to you but a visit  to a functional optometrist or ophthalmologist or pediatric vision speciialist might be the way to go. . Good luck aNd please let me know how she makes out.  Dr. Ken

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DR. KENNETH BERGER

Expertise

Any and all questions with regard to ocular ailments, eye diseases as cataracts, glaucoma, macular degeneration, diabetic retinopathy, etc , eye and visual sympomatology, eyeglasses, contact lenses, low or subnormal vision, pediatric vision conditions,and special and unique ailments will be discussed.

Experience

36 years of clinical experience in opticianry and therapeutic optometry. Still in private practice with special interests in vision conditions, diagnosing and treating ocular ailments, prescibing treatment plans which include medicine, eyeglasses, and contact lenses primarily. Although surgery is not within the realm of my area of expertise, I co-manage many pre and post -op surgical cases which include Lasik and PRK procedures.

Organizations
New Jersey Society of Optometric Physicians American Optometric Association

Education/Credentials
B.A.,1968, Hunter College of the City University of New York B.S.,1970, Pennsylvania College of Optometry O.D.,1973, Pennsylvania College of Optometry Therapeutic Pharmaceutical Administration Certification, New Jersey 1992

Awards and Honors
Clinical Efficiency Award, 1973, Pennsylvaania College of Optometry

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