Yan (F/17) came for a regular eye examination, vision with existing glasses of 4-5 years is fine seeing far & near. No headache is reported.
Vision without glasses
R: 6/18-
L: 6/18- (better)
Vision with glasses
R: -0.75/-0.25×170 (6/7.5-, 6/6-)
L: -1.25/-0.25×160 (6/7.5-, 6/6-)
Examination shows: (Delay Fogging)
R: -1.00/-0.25×180 (6/6) (+1.00 blur lens test 6/9-)
L: -1.25/-0.25×180 (6/6) (+1.00 blur lens test 6/9-) [L: left dominant eye] R=L
Adding or subtracting 025/050 shortsightedness monocularly/binocularly look the same to her
Noticed that she tends to close right eye that is under occlusion when testing the left eye.. when prompted, she did not realise that she will tend to cover either eye when seeing far
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
moderate XP, moderate recovery @Distance (Distance > Near)
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: 10 XP & beyond (blue part)
-1.00 Distance: 8 – 10 XP & beyond (blue part)
Near: 20 XP & beyond (blue part)
-1.00 Near: 18 – 20 XP & beyond (blue part)
+1.00 Near: beyond blue bar
(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
+0.75 (above +0.75, print becomes blur then clear quickly)
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-0.75
(normal value: -1.37 to -3.37)
MEM (Accommodation lag – to measure accommodation response seeing near target)
R: reflex fluctuation
L: reflex fluctuation
(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: 12 cycle per minit(cpm)
R: 11 cycle per minit(cpm), difficult with plus lens(1st lens) [seeing through plus lens is like zooming in]
L: 12 cycle per minit(cpm)
(normal value: 1 cycle = 2 words read
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)
Examination of Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Near, Base-Out/Convergent, PFV: x/x
Near, Base-In/Divergent, NFV: 30/20 (even before break point 30, double is seen but it can become single)
Distance, Base-Out/Convergent, PFV: 30/20 (above break point 10, target is blur then clear)
Distance, Base-In/Divergent, NFV: 16/10
(normal value: Break/Recovery)
Near, PFV: 10-28/7-21
Near, NFV: 7-19/5-15
Distance, PFV: 4-18/5-9
Distance, NFV: 4-10/2-6
[Scheiman – Adult Data]
3D Vision/Stereopsis (Random Dot 3S)
12.5″
(normal value: 12.5″)
Interpupillary Distance = 6.2cm
Yan has very high divergent fusional reserve, NFV at distance, having break point beyond 9, this suggests Divergence Excess.