WQi (F/14) came for eye examination, with complaint of slight blurry far vision with existing glasses of 2years.
Vision without glasses
R: 6/60
L: 6/60 (L>R)
Vision with existing glasses
R: -2.75/-0.25×180 (6/7.5)
L: -2.75/-0.50×170 (6/12)
Examination shows:
R: -3.00/-0.50×180 (6/6)
L: -2.75/-1.00×170 (6/6) [L: dominant left eye]
Improper LE PD by 5mm causing new power does not tally with power/vision with existing glasses?
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @ Distance
small XP, 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: 2 – 4 XP (blue part)
+1.00 Near: 2 – 4 XP (blue part)
(normal value: 0-1 EP or 0-3 XP @Distance and 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
NRA (Accommodation analysis – ability to relax accommodation) by plus lens
+2.00
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-2.50
(normal value: -1.37 to -3.37)
Facility (Accommodation facility – ability to change focus: far to near or near to far) by Flipper +/- 2.00
R: 13 cycle per minit(cpm)
L: 13 cycle per minit(cpm)
BE: 14 cycle per minit(cpm)
(normal value:
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)
WQi has a little of power increment only. Considering her focusing is going strong, we hardly see such nice findings these days.. it is happy & comforting to see that the status of your eyes is great! We are much less worried about myopia progression, but of course the possibility is still there.. on top of the fact that her power is on the higher side.
We seldom allow ourselves to prescribe Single Vision, SV spectacles for children/adolescents with progressing myopia.. knowing – to allow that we are only allowing their power to increase just like that in a matter of time. Unless if the child has been on atropine eye drop, then we may go with SV spectacles first & monitor.
A child with shortsightedness/myopia should be on myopia management, what more progressing myopia. There are 2 approaches to this: 1) wait and see for progression, then only we start myopia management 2) start as soon as myopia is diagnosed. We present the eye findings, and the call is yours.
WQi, we have trust in you to continue caring for your eyes.. aunty will see you in 6 months.