30/9/2021
Mr Tam (M/55) came for eye examination, complaining of slightly blurry far vision & he removes glasses to see near with existing glasses of more than 10years. The lens coating has peeled off with many scratches on lenses.
Vision without glasses
R: cannot guess 6/60
L: cannot guess 6/60
Vision with existing glasses
R: -4.50/-2.50×80 (6/15+)
L: -4.00/-1.00×80 (6/15+)
Add: +1.00
Examination shows:
R: -4.50/-2.50×90 (6/12+) PHNI
L: -4.00/-2.00×90 (6/6) (+1.00 blur lens test: 6/9) [L : dominant left eye]
Add: +1.25 (N5@40cm)
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
R Esotropia @Distance
NMD @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 6^ Base Down on Right eye)
Distance: > 9 EP (yellow part)
+1.00 Distance: 7 – 9 EP (yellow part)
Near: 2 – 4 XP (blue part)
(normal value: 0 – 1 EP 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
Eye alignment shows that Mr Tam has Right Esotropia, inwards deviation of right eye. When prompted whether or not he has headache, he said that he has no headache but reported seeing double at far vision especially when eyes are tired since this year. With Eso deviation, we will try to give minimum shortsighted power or max longsighted power while maintaining satisfactory, comfortable vision.
We refine his power:
R: -4.00/-2.50×90
L: -3.50/-2.00×90
He reported seeing small prints even without reading Add power
We let Mr Tam wear the power & have a walk to see if he sees double vision. He reported no double vision is seen. We will monitor & see how it goes after we update his prescription.
It is no good to wear compromised lens coating & to go without eye examination for so many years. You should go to your nearby optometrist at least once in 2years if not once a year.
Our eyes are too precious to not be seeing with an updated eye prescription for optimum, relaxed vision. Our eyes are worth more than anything.. this pair of eyes captures our surroundings thrilling our soul! Let us all sayang our eyes.. and we want to hear all of you say that too!
*UpdatedA
15/3/2022
Mr Tam came back for follow up. He sometimes sees double vision at distance in the evening/low light condition or when eyes are tired.
Vision without glasses
R: 6/120
L: 6/60-2
Vision with existing new SV glasses (6months)
R: -4.00/-2.50×80 (6/15)
L: -3.50/-2.00×80 (6/9+)
Examination shows:
R: -4.50/-2.50×90 (6/12+) PH 6/6- N5
L: -4.00/-2.00×90 (6/6) (+1.00 blur lens test: 6/9) [L : dominant left eye] N5
Add: +1.00 (N5@40cm) more comfortable with Add
Examination of Eye Alignment/Vergence (Cover Test)
R Esotropia @Distance
NMD @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 (Maddox Rod)
Distance: 12 Base Out
Near: Orthophoria
(normal value: 0 – 1 EP or 0 – 3 XP @Distance & 0 – 6 XP @Near)
Base Out/EP = Esophoria is misalignment of the eye, eye is deviated inwards
Base In/XP = Exophoria is misalignment of the eye, eye is deviated outwards
NRA (Accommodation analysis – ability to relax accommodation) by plus lens
+1.00
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-1.75
(normal value: -1.37 to -3.37)
Worth 4 Dots
Distance: 3 dots seen (Right suppression)
Near: 4 dots seen (normal)
(normal value: 4 dots seen = normal, 3 dots seen = Right suppression, 2 dots seen = Left suppression)
Modified
R: -4.50/-2.50×90 3^Base Out
L: -4.00/-2.00×90 2^Base Out
Far vision is better with prism
3D Vision (Random Dot 3S)
25” (with prism)
50” (without prism)
(normal value: 12.5”)
We refer him to see eye specialist doctor/ophthalmologist &/or orthoptist.
*UpdatedB
Mr Tam updated us that ophthalmologist has given him a week of medication & he is scheduled to go back for 1-week follow up tomorrow.