Binocular Balance

Question 1

Why would you do binocular balance?

Answer 1

Monocular subjective can cause proximal accommodation (from occlusion)
Ensures balanced accommodation

Question 2

Who can’t you do binocular balance on?

Answer 2

Over 60s
Pseudophakic pxs with IOL
Pxs with one eye
Amblyopes?

Question 3

When is a binocular addition necessary?

Answer 3

Pxs requiring max plus

Question 4

Who is binocular subjective refraction good for?

Answer 4

Hyperopes
Pseudomyopia
Antimetropia (one plus, one minus)

Question 5

What does binocular subjective refraction do that monocular subjective doesn’t?

Answer 5

Keeps accommodation relaxed and balanced throughout subjective

Question 6

What can occlusion cause?

Answer 6

Pupil dilation - refractive changes due to spherical aberrations
Manifests latent nystagmus - makes subjective difficult
Manifests cyclophoria - incorrect astigmatism assessment

Question 7

Who can binocular subjective be difficult on?

Answer 7

Pxs with highly dominant eyes - px aware of vision in dominant eye even if fogged