Melissa Valdellon

Patient case for September 29, 2023

What would you do for this patient?

A 66 year old Asian female came in for her first eye exam in the states. She reports blurred distance vision though it’s generally okay at all distances. Her last eye exam was a year ago in China, where they “measured something about 600”, but she said it caused her eyes to hurt so they reduced her current prescription.

Medically, she is taking pravastatin for her hyperlipidemia but has no other systemic conditions or medical allergies.

All confrontation testing (pupils, EOMs, visual fields) are normal.

Incoming visual acuities with her SV glasses are:

OD: -4.50 DS  20/70, pinhole 20/30, NVA 0.4/0.6M
OS: -4.50 DS  20/70, pinhole 20/30, NVA 0.4/0.6M

Refraction results were:

OD: -6.50 DS  20/30-
OS: -6.75 DS  20/40+

She has some moderate cataracts in both eyes, but her ocular health is otherwise unremarkable.

The patient is not ready to have cataract surgery done. In this case, what glasses prescription would you prescribe? How would you modify her glasses for better adaptation? How would you counsel her about her vision in regards to her daily activities?

A discussion is much appreciated.

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