A 3-year-old boy was referred to an ophthalmologist for evaluation by his pediatrician after failing his Enfant™ Pediatric VEP Vision Test.

On examination, the patient read 20/30 in the right eye and 20/125 in the left eye. His cycloplegic refraction revealed 2 ½ diopters of hyperopia in his right eye and 5 ½ diopters in his left eye. His external, pupil, anterior segment, and fundus exams were normal in both eyes, and his motility exam showed a microstrabismus in the left eye. Sensory testing revealed suppression with the absent strereopsis.

Diagnosis and Treatment

The boy has microstrabismus associated with a large amount of anisometropia and moderately severe amblyopia in his left eye. He was prescribed spectacles for full-time wear. He has some chance of improving spontaneously but, more likely, he will need either patching or Atropine penalization.

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