Kelly (F/21) came for eye examination, a full-time contact lens wearer since she started working a few months ago. Her work requires her to use computer the whole day. She complains of blurry vision on computer after long hours of work and she realises that her far vision is also slightly reduced too recently, suspecting that her power may have increased.
Vision without glasses
R: 6/24-
L: 6/12
Vision with existing glasses of 9months
R: -1.50 (6/6)
L: -1.00/-0.50×180 (6/6)
Examination shows:
R: -1.50/-0.50×180 (6/6) (R: dominant right eye)
L: -1.00/-0.50×5 (6/6)
Relax Add: +0.50
Contact lens prescription:
R: -1.75
L: -1.25
Relax Add: +0.75
Other assessments show:
Examination of Eye Alignment/Posture (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/Posture (Howell Card) by 6^ Base Down on Right eye
Distance: 0
Near: 1 EP (yellow part)
+1.00 Near: 1 EP <-> 0 <-> 1 XP
Contact lens Near: 0 – 2 XP (blue part)
(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
MEM (to measure accommodation response seeing near target)
R: +1.00
L: +1.00
(normal value: +0.25 to +0.75)
With esophoria at near, we know that her eyes are prone to turn inwards (to nose) during near work. Excessive near work causes her to have eye fatigue or even sometimes blurry near vision when eyes are overly tired. After she stares at computer for long period of time, she finds that her far vision can sometimes be blurry too. We prescribe Relax contact lens with relax power at near.. to support her near.. in so, it makes her easier to look back at far vision comfortably without having the downtime/blurry far vision.
Contact lens is particularly good for short-sighted/myopic patients with esophoria be it for adults or children. For Kelly, from being esophoric on glasses, it has normalised her near posture to 0 – 2 exophoria being on Relax contact lenses.
We will see whether or not contact lens wear will resolve her symptoms.