Haley (F/12) complains of blurry far vision & she is observed to have head tilt to Left.
Vision with existing power
R: -375/-0.75X175 (6/12)
L: -3.25/-1.50X160 (6/12)
Examination shows:
R: -4.25/-1.25X175 (6/6) N5@38cm
L: -3.75/-2.00X160 (6/6), N5@38cm
Other assessments show:
3D Vision (Random Dot 3S)
12.5″
(normal value: 12.5″)
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance
small XP fast recovery @Near
(normal value: orthophoria/NMD-No Movement Detected or small XP small recovery)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
29/5/2021 Follow Up
Mother reported that head slanting gets better now.
Examination shows:
R: -4.25/-1.25X175 (6/6-) N5@38cm
L: -3.75/-2.00X160 (6/6-), N5@38cm
AA (Accommodation/Focusing – eye stamina/ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 7cm, 7cm, 7cm
L: 7cm, 7cm, 7cm
(normal value: TTN-to the nose or 7cm for a 12year old)
NRA (accommodation analysis – ability to relax accommodation)
+2.25 (normal value: +1.50 to +2.50)
PRA (accommodation analysis – ability to stimulate accommodation)
-0.75 (normal value: -1.37 to -3.37)
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
6cm, 6cm, 6cm
(normal value: less than 7.5cm)
Examination of Eye Alignment (Howell Card)
Distance: 0 -> 1 EP
Near: 4 -> 6 XP
(normal value: 1 EP-0 or 0-3 XP @Distance & 0-6 XP @Near)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
Examination of Fusional Reserves (Convergent/Divergent stamina) by Prism Bar
Near, Base-In/Divergent Fusional Reserves: 30/25
Near, Base-Out/Convergent Fusional Reserves: 16/12
(normal value: Break/Recovery)
Near, Base-In: 7-17/3-11
Near, Base-Out: 15-31/10-22
BHTT (Head Tilt Test)
negative
We will review: Base-Out/Convergent Fusional Reserves first followed by Base-In/Divergent Fusional Reserves.
We will monitor Haley’s head tilt again and we see her in 3months.