Mr Yeong (M/42) has been having persistent headache for a long time. He has a pair of glasses with shortsighted power of 075 to be used when driving only. He holds phone slightly further away to see near better.
Unaided VA (Vision without glasses)
R: 6/9-
L: 6/6
Examination shows:
R: -0.50/-0.75×180 (6/6)
L: PL (6/6)
Add: +1.25
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance & small EP fast recovery @Near
(normal value: orthophoria/NMD-No Movement Detected or small XP fast recovery)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
Examination of Eye Alignment (Howell Card)
Distance: 0 – 1 EP
Near: 5 – 7 EP
+1.25 Near: 0
(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
Mr Yeong has esophoria at near. Without glasses, eyes are turned in more when he looks at near. Sometimes, uncorrected astigmatism may also give near visual complaint like headache. When he wears Add +1.25, alignment is normalised back.
We advise him to always wear reading glasses for near and we see how it goes.