The IT technician with optic atrophy
Case report | Optic atrophy and multiple retinal detachments
Patient
A 58-year-old male, employed as an IT technician.
Diagnosis
The patient presents with optic atrophy and a history of multiple retinal detachments in both eyes. Following the detachments, the left eye was treated with silicone oil, which was subsequently removed.
Solution
A trifocal ML Optio solution was prescribed to optimise visual function.
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Background
Due to multiple episodes of retinal detachment and the use of silicone oil in the left eye, the patient’s spectacle prescription had been unstable. For an extended period, the patient therefore relied on ML Binova reading glasses in several different powers: +8.00, +10.00, +12.00 and +16.00.
The patient experienced a positive effect from the ML Binova glasses, but grew tired of constantly having to put them on and take them off.
By May 2024, the ocular condition had stabilised sufficiently to allow for a more permanent solution.
Patient story
Due to retinal swelling in the left eye, the patient experiences diplopia. The eye clinic attempted treatment with a corticosteroid implant, but he has not noticed any improvement during the past three months.
It is not a case of monocular diplopia.
Varied working days
The patient also reports that his working days are highly variable.
At work, the patient carries out many practical tasks within electronics, such as software installation, hardware installation, repair of various electronic equipment, monitors, printers and other devices with small components, as well as repair or replacement of circuit boards and motherboards. At times, he needs to stand or turn his head to see inside machines with confined spaces.
Renovation work
The patient also repairs and works with various types of electronics at home. He has recently purchased a summer house, where he is carrying out renovations himself — including windows, doors, frames, plumbing and the replacement of household appliances.
Distance spectacles
The patient has already obtained a pair of single-vision distance spectacles with the following prescription:
Refraction
Right: –2.00 D
Left: –1.00 D / –0.75 D × 63°
Visual acuity with spectacles
Right: 0.2 +2
Left: 0.08 +1
Binocular: 0.25
Examination
The examination confirmed that the prescription of the distance spectacles is correct. The patient’s primary working distance is approximately 30 cm for practical tasks. When detailed vision is required, objects are held very close. This strategy had worked previously, as he was myopic at around -6.00 D in both eyes.
Intermediate distance
For intermediate distance, approximately 30 cm, the optimal addition was +2.50. The following were trialled: +1.50 | +2.00 | +2.50 | +3.00.
Near distance
For near distance, approximately 10 cm, the optimal addition was +10.00. The following were trialled: +8.00 | +10.00 | +12.00.
Given the patient’s primary working distance, the intermediate segment was designed to be as large as possible in order to accommodate his occupational needs and versatility.
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Final spectacle prescription
Right eye
Distance: -2.00 D, 2 prism dioptres base up
Intermediate addition: +2.50 D
Near addition: +10.00 D, 10 prism dioptres base in
Left eye
Distance: -1.00 D / -0.75 D × 63°, 2 prism dioptres base down
Intermediate addition: +2.50 D
Near addition: +10.00 D, 10 prism dioptres base in
The spectacles address the patient’s two primary issues:
Diplopia at distance
The need to achieve detailed vision/clarity at several working distances
With thanks to OnsightVision in Denmark for the case description.
Published 7 october 2025