Lareina (F/14), Linden’s sis came for eye examination, with complaint of slightly blurry far vision with existing glasses since after MCO.
Vision without glasses
R: 6/15-
L: 6/12+
Vision with existing glasses of 3years
R: +1.50/-3.75×165 (6/7.5-)
L: +0.75/-3.00×10 (6/7.5-)
Examination shows:
R: +1.75/-4.50×165 (6/6-) N5@40cm
L: +0.25/-3.50×180 (6/6) (+1.00 blur lens test 6/12) N5@40cm [L: left dominant eye] L>R
Near: L>R
Other assessments show:
3D Vision (Random Dot 3S)
25″ (missed the last 3)
(normal value: 12.5″)
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 – 2 XP (blue part)
Near: 2 – 4 XP (blue part)
+1.00 Near: 4 – 6 – 8 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
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
5/7cm, 5/7cm, 5/8cm, 6/8cm, 6/8cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
AA (Accommodation/Focusing – eye stamina/ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 23 YO, 23 YO, 24 YO
L: 14 YO, 14 YO, 14 YO
(normal value: AA goes according to age)
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
-1.50
(normal value: -1.37 to -3.37)
MEM (Accommodation lag – to measure accommodation response seeing near target)
R: +0.75
L: +0.25
(normal value: +0.25 to +0.75)
Facility (Accommodation facility – ability to change focus: far to near or near to far) by Flipper +/-2.00
BE: 10 cycle per minit(cpm), difficult with plus lens (1st lens)
R: 14 cycle per minit(cpm), difficult with minus lens(2nd lens)
L: 14 cycle per minit(cpm), difficult with plus lens(1st lens)
(normal value: 1 cycle = 2 words read
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)
Lareina’s vision is still okay but her 3D vision is slightly not optimum. She has higher astigmatism & longsightedness in right eye. In all children, we would want to optimise their 3D vision first & foremost.. unless if the child has strabismus/squint eye in which 3D vision will certainly be reduced. Uncorrected longsightedness & astigmatism will cause eye stamina to reduce, as eye uses the eye stamina to drive focusing in order to compensate for the uncorrected power, like in Lareina’s right eye.
We cannot emphasize enough proper visual hygiene to all children.. we always nag (we shower love lah) to remind to take regular break in between near work(hp/computer/book) by following 20-20-20 rule: after 20minutes of near work, to look at 20feet away/far far way for 20seconds to relax back our eyes. This is very3 important in this era of digital-dependent lifestyle. Together with proper posture, adequate lighting & healthy elbow distance in holding your phone, we can all do this easily in caring for our eyes. Jommm we practise proper visual hygiene.. so easy peasy like kacang putih only kan.. lets do this together! Kita mesti boleh!