17/1/2022
Mrs Yeoh (F/47) came for eye examination, existing glasses of 3years were rolled over by car & spoilt last month. She has a history of migraine since about 8-9 years ago. Her migraine will occur every month around her menstrual, it is not particularly after laptop work/phone that triggers the migraine. She can know that she will get the migraine attack.. in which she needs to rest & to completely stay away from phone & laptop work as well as light source too.. she termed as “hibernate”. Otherwise, her migraine will be worse & she ends up needing a few longer days to feel better. She has consulted eye specialist doctors/ophthalmologists and was cleared of all eye pathology few years ago. Examination with ENT turned out fine too. Numerous scans/MRI were negative. She reported having “swollen eyes/water puffy eyes” when she is awake.. and it takes a bit of time for it to subside.. and to be able to open her eyes slowly every day. She feels her eyes are heavy & dry, difficult to open as day wears on.
Vision without glasses
R: 6/9- slow
L: 6/6
Power of own reading glasses > 7-8 years
R: +1.75/-0.50×160
L: +1.25/-0.25×20
Examination shows:
R: +1.00/-0.25×180 (6/6) (+1.00 blur lens test 6/7.5-)
L: +0.25/-0.25×180 (6/6) (+1.25 blur lens test 6/7.5-) [L: left dominant eye] L=R
Add: +2.00/+1.75 R>L
Adding longsightedness/hyperopia +0.25 in left eye (L>R) is not preferred
No further longsightedness/hyperopia accepted binocularly
Other assessments show:
Cover Test
Distance: NMD
Near: NMD
Howell Card (6BD on OD)
Distance: 0 – 1 EP
Near: 0 – 2 XP
NRA
+0.75
PRA
-0.25
Power of spoilt glasses (sent to us after eye examination)
R: +0.50
L: PL
Add: +1.50
Mrs Yeoh has longstanding migraine, started after the birth of her youngest son 10years ago. Migraine attack coincidently happens around her monthly menstrual.
*UpdatedA 5/4/2022
Mrs Yeoh came back for follow up.
Assessments with her existing new glasses:
Howell Card
Distance: 0 – 1 EP
Near: 0 – 2 XP [when spec sits lower: 0 – 1 EP]
NRA
+1.25
PRA
-0.25
Fusional Reserves (Prism Bar)
Near, NFV: x/2/1
Near, PFV: x/25/20
Distance, NFV: x/8/6
Distance, PFV: x/18/14
Vergence Facility (Prism Flipper of 12BO & 3BI)
Near: 10 cpm
Distance: 5 cpm (slow BI)
*UpdatedB 14/7/2022
Mrs Yeoh came back for follow up. She sometimes feels that her vision is blurry & smoky all around.. and her eyes are very tired due to the blurriness. She let us know that her sister has glaucoma.
Existing glasses
R: +1.00/-0.25×160 (6/6)
L: +0.25/-0.25×20 (6/6)
Add: +2.00/+1.75 (N5@40cm)
Other assessments show: (on trial frame)
NRA
+0.75
PRA
-0.25
MEM
R: +0.25
L: +0.25
Fusional Reserves (Prism Bar)
Near, NFV: x/4/2
Distance, NFV: x/8/6
Vergence Facility (Prism Flipper of 12BO & 3BI)
Near: 10 cpm (slow BO & BI)
Distance: 12 cpm
Fusional Reserves (with Add + 1 BO OU)
Near, Base-In/Divergent, NFV: x/6/4
Fusional Reserves (with Add + 2 BO OU)
Near, Base-In/Divergent, NFV: x/6/4
Fluorescein
R: negative staining
L: negative staining
– All near tests are done with Add.
*UpdatedC 26/10/2022
We prescribe a separate pair of exercise glasses to be worn when she is seeing computer on extended hours.
Exercise reading glasses
R: +2.75/-0.25×180 1BO
L: +1.75/-0.25×180 1BO
*UpdatedD 15/1/2023
Mrs Yeoh came for follow up. She still feels that her vision is blurry & smoky all around seeing far & near. She did not really wear the exercise glasses.
Unaided Vision
R: 6/7.5-
L: 6/6
Vision with existing glasses of 1 year
R: +1.00/-0.25×180 (6/6)
L: +0.25/-0.25×5 (6/6)
Add: +2.00/+1.75
Examination shows:
R: +0.75/-0.50×180 (6/6) (+1.00 blur lens test: 6/7.5)
L: +0.25/-0.50×180 (6/6) (+1.00 blur lens test: 6/9) L>R
Add: +1.75 (L>R)
Other assessments show:
Cover Test
Distance: NMD
Near: NMD
Howell Card (6BD on OD)
Distance: 0-1 EP
Near: 2 XP
+1.00 Near: 4 XP
-1.00 Near: 0-2 XP
NRA
+0.50
NRA
-0.50
NPC (RAF rule)
10/22cm, 10/22cm, 10/22cm, 12/24cm, 12/24cm
AA (RAF rule)
R: 47yo, 47yo, 47yo
L: 46yo, 46yo, 46yo
Accommodation Facility (Flipper +/- 0.50)
BE: 20 cpm, difficult minus lens
R: 20 cpm, difficult minus lens
L: 20 cpm, difficult minus lens
MEM
R: +0.50
L: +0.50
Fusional Reserves (Prism Bar)
Near, NFV: x/4/2
Near, PFV: x/20/18
Distance, NFV: 6/8/6
Distance, PFV: x/25/20
Vergence Facility (Prism Flipper of 12BO & 3BI)
Near: 8 cpm [slower BI & slow BO]
Distance: 4 cpm (slower BO & slow BI)
Interpupillary distance, IPD = 6.4cm