The College of Optometrists

Hello, I was just enquiring when doing subjective on ambylopic px would you do a modified binocular routine or would you just leave out all binocular tests? and also when doing binocular balancing on a binocular px, do you offer both positive & negative lenses or just positive only. Thank you.

Not sure why you would not do binocular tests in an amblyopic patient. Amblyopes may suppress but you need to assess the elevel of suppression and see if they have a phoria or tropia or if their amblyopia is purely refractive.

You would use both positive & negative lenses as you are balancing accommodation and may have either over plussed or underplussed the patient in one eye.

Some bino tests may have to be modified if there is deep suppression. An easy minimal test would be to try to elicit diplopia with a 5 dioptre prism base out - or a 2 diopte prism base down one eye = and work from there.