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This six-year-old boy presents with visual acuity of OD 20/20 and OS 20/200. There is no shift on the alternate cover test. When a four diopter prism is introduced base out in front of the right eye, both eyes move to the left. When the same prism is introduced in front of the left eye there is no movement. Examination of fixation with the visuscope reveals foveal fixation with the right eye, but in the left the patient fixates slightly nasal to the fovea. Refraction is OD +.75 and OS +3.00 + 1.00 x 85.

1.	The diagnosis in this case is:
	b -- anisometropic amblyopia This is an example of anisometropic amblyopia. The eyes accommodate equally in spite of the difference in refractive error. This means that while the right eye enjoys a clear retinal image, exerting .75 diopters of accommodation, well within the comfort range for a yioung child, the left eye is subjected to blur. This in turn leads to deprivation and also suppression because of the blurred image.
2.	Initial treatment should be:
	d -- prescription of glasses as follows: OD plano and OS +2.00 + 1.00 x 85 The best initial treatment for this patient is the prescription of glasses which treat the difference in the refractive error. Since he is already comfortable with the small amount of accommodation required in the right eye, this boy will accept the glasses readily. The glasses will present an in focus image to both retinas which will in most cases begin the process of reversing the amblyopia. In cases like this, normal vision can be reestablished over a period of several months. Patching may be undertaken if after several months reduced vision in the left eye remains. Cases like this should never have patching as the initial treatment. This can lead to strabismus.
3.	This is an example of a condition that has been called:
	d -- all of the above This condition has been called all of the terms listed here. The unique feature of this type of amblyopia is that the amblyopic eye develops eccentric fixation with the displacement equal to the angle of anomalous retinal correspondence. The eccentric point (area) in the amblyopic eye is used for fixation and also share a common visual direction with the normal eye.