A man with convergent squint in one eye vision is 6/60 and another eye no squint with vision 6/60. Next step
**Core Concept**
The question describes a patient with convergent squint (esotropia) in one eye and a vision of 6/60 in both eyes. The key concept here is the assessment of binocular vision, specifically the evaluation of the potential for binocular single vision (BSV) in a patient with strabismus.
**Why the Correct Answer is Right**
In this scenario, the patient has esotropia in one eye, which suggests that the eye is deviated inward. The vision in both eyes is poor, with a visual acuity of 6/60. The next step is to assess the potential for binocular single vision, which requires the alignment of the eyes and the presence of fusion. The correct answer involves a detailed assessment of binocular vision, including the measurement of the near point of convergence (NPC) and the cover-uncover test. This evaluation will help determine if the patient can achieve BSV and if any surgical or non-surgical interventions are necessary.
**Why Each Wrong Option is Incorrect**
* **Option A:**
This option is incorrect because it does not address the underlying issue of esotropia and the potential for binocular single vision.
* **Option B:**
This option is incorrect because it does not provide a clear plan for assessing binocular vision and determining the best course of treatment.
* **Option C:**
This option is incorrect because it does not consider the patient's poor vision in both eyes, which may impact the potential for binocular single vision.
**Clinical Pearl / High-Yield Fact**
In patients with strabismus, the near point of convergence (NPC) is often abnormal. The NPC is the closest point at which an individual can fuse two images, and it is an essential component of binocular vision assessment.
**Correct Answer: B. Comprehensive binocular vision assessment, including measurement of near point of convergence (NPC) and cover-uncover test.**