FP21

Perfect Vision  Not Enough: Hidden Binocular Vision Disorders Impairing Microsurgical Performance in Ophthalmology Trainees -2 case series

Purpose: To highlight hidden binocular vision anomalies affecting microsurgical performance despite normal visual acuity in ophthalmology trainees.

Methods: Two ophthalmology trainees with persistent difficulty using the operating microscope despite BCVA 6/6 OU underwent binocular vision assessment including cover test, Maddox Wing, NPC, PFV/NFV, stereopsis and cycloplegic refraction. Appropriate orthoptic therapy was instituted.

Results: Both had normal ocular examination and BCVA 6/6 OU. One had convergence insufficiency (12 PD near exophoria, NPC 12 cm, reduced PFV) causing poor depth perception, fusion difficulty and visual fatigue, improving with pencil push-ups and Brock string exercises. The other had divergence insufficiency with reduced NFV and esophoria, improving after synoptophore therapy.

Conclusion:  Binocular vision screening may identify treatable disorders that improve comfort and performance in ophthalmology trainees struggling while operating with normal vision