Borish delayed refraction test (modified fogging technique) provides alternative method of measuring refractive error, where accommodation is controlled by adding positive lenses in front of the eyes to relax accommodation.
In this technique, first the patient is made to relax their accommodation wearing a plus lens with a magnitude slightly higher than the expected average NRA value (+2.50 DS) for a prolonged duration.
Then vertical prism is used to dissociate the image. This helps examiner to understand the status of accommodation. The eye with residual accommodation will see better than the other eye. The eye with clear vision is fogged further till image of both eyes are nearly equal. This method is known as prism dissociation method of balancing the accommodation.
Once accommodation is balanced the prisms are removed and NRA values are slowly defogged till patient just start seeing 6/6 or 20/20
Note: Do not try to give over minus as patient may feel better with more minus.
This Borish delayed method is alternative test for cycloplegic refraction. It is highly effective in cases of accommodative spasm.
The binocular balancing helps to balance the accommodation between the eyes.
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7 сен 2024
