Subjective Refraction- Binocular Balance

Question 1

What is the purpose of binocular balancing?

Answer 1

useful in young myopes to ensure that their prescription is not too minus (overcorrected) and is an alternative to the +1.00 blur back test

Question 2

How to do binocular balancing?

Answer 2

Check the binocular acuity (remove any fogging or occluding lenses).
Now ask the patient to fixate on a letter on the lowest line that they can see.
Then place a +1.00 sphere over the left eye and a +0.25 sphere over the right eye and ask: Is the letter better, worse, or about the same?

Question 3

What to do if the letter is better or about the same?

Answer 3

add the +0.25 sphere to the right eye and repeat. Do not give the plus lens if the letter appears worse (blurred).

Repeat the process with the +1.00 sphere over the right eye and the +0.25 sphere over the left eye.

Question 4

What to do if the VA has fallen after binocular balancing?

Answer 4

remove the plus lens