logo
Question of the Week
Video Library
Ophthalmology Books & Manuals
Cybersight Atlas of Eye Diseases
The Ophthalmology Minute
Nursing Education
Eye Care Equipment
Orbis Program Features
Free Online Journals
Ophthalmology Links
Frequently Asked Questions (FAQ)
Print ViewPrint this Page
Strabismus -  Use of executive bifocal in accommodative esotropia Lecture 43 of 54  NEXT»

"I want to know... why we prescribe executive bifocal type in accommodative esotropia [and] why not other type of bifocal." 

The executive bifocal has a flat top across the entire lens. If placed high so that it bisects the pupil, or nearly so, it is more difficult for the child to avoid looking through it. It is the purpose of this bifocal to force the child to use it in order to reduce accommodative effort and, we hope, eliminate the esodeviation at near. Bifocals for presbyopia are there to allow the patient to use the add for near work, if it helps. There is a big difference in the reason for use of a bifocal in these two cases. However, any bifocal that the child uses is okay. There is nothing "magic" about the executive bifocal.  A rare indication for bifocal in a child is hypoaccommodation in which case it is likely that any suitable bifocal could be used.


Eugene M. Helveston, M.D.


Lecture 43 of 54 «Previous Lecture   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54    Next»