Elizabeth (F/26) came for eye examination, with complaint slight blurry far vision with existing glasses of 1+ year. She uses computer for long hours every day.
Vision without glasses
R: 6/45
L: 6/45+2
Vision with existing glasses
R: -2.00/-0.75×10 (6/7.5+)
L: -2.00/-0.50×175 (6/6)
Examination shows:
R: -2.00/-1.00×10 (6/6) R>L [R: dominant right eye]
L: -1.75/-0.50×175 (6/6)
Add: +0.75
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/Posture (Howell Card) by 6^ Base Down on Right eye
Distance: 0
Near: 4 –> 2 XP –> 0 <–> 1 EP (yellow 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
Elizabeth shows esophoria at near posture.. and we observe that she holds her phone at 30cm or even nearer. The closer you hold your phone, the more our eyes need to converge/come in to focus & see clearly on your hp. For all patients with esophoria at near, we will prescribe added plus lens especially for those who use computer on long hours every day. After wearing added plus lens for a few months, we will reassess your eye posture & check for accommodation & convergence. Sometimes, eyes may be too tired/strenuous that shows findings suggestive of insufficiency at first visit. Added plus lens gives the support our eyes need on near vision and it allows eye system to relax & reveal its true status. Should subsequent follow up show accommodation insufficiency, we will prescribe vision therapy, VT to strengthen & improve eye stamina.
Vision therapy, VT is a series of eye exercises that you can do at home or in-office.. in improving convergence or accommodation & etc depending on your condition. But we prescribe home VT only for now. You do the eye exercise homework and we do the checking chores.. deal or not? As you may have seen/tested for all the tests, it will take some time.. and we need to repeat doing those tests to check for improvement. Manyak kerja ni.. therefore, we do a collab for the wellbeing of your eyes.. we may sometimes also need to do a crossover with ophthalmologists or orthoptists too. Many Cs and many Os hahaha
One can only do so much.. but together with your motivation & compliance in doing the VT, we surely will be able to achieve our goal in eliminating & solving your visual complaint eventually. No string attached.. just heart.. but I dont need your heart ya hehe.. we settle it together!?
Elizabeth, contact lens so far okay mou?