Case 9

A 9 year old boy presents whose parents ask that you determine if their child has dyslexia. The child has been in Title I reading programs at their school for the past year. The parents report that their son reverses letters. You are able to determine that there is no outstanding medical history, including peri-natal. The child received an annual eye examination the previous two years, and passed a school screening several months ago.

What additional history information to explore?

Clinical findings:

Unaided distance visual acuity	20/20-2 O.D. / 20/20 O.S.
Unaided near visual acuity	20/25 O.D. / O.S.
Cover test	ortho / +kinetic cover test
Stereopsis	50 sec
NPC	15 cms / diplopia at break
EOMs	2 losses of fixation on 1 rotation
Refraction (O.D./O.S.)	O.D. +0.50 / O.S. +1.00
Distance phoria (H/V)	1 eso / 1 O.D. hyper
Near phoria	1 exo
Near BI/BO fusional vergences	BI: x/12/4 BO: 10/16/6
MEM (unaided)	O.D. +0.75 - 0.50 x90 / O.S. +1.00 - 0.75 x90
Accommodative facility (cpm)	O.D. 6 / O.S. 4

Additional testing?

Management?