Tracy (F/42) came for eye examination, with complaint of tired eyes & headache with computer work after she returns to office after CNY break. She removes glasses at home as she only needs to see near & her phone. We observe that she tends to look through the top part of lens to see near.
Vision without glasses
R: 6/30
L: 6/45+
Vision with existing glasses of 8 years
R: -2.50 (6/12)
L: -3.00 (6/9-)
Examination shows: (Delay Fogging)
R: -2.75/-0.25×95 (6/6) (+1.00 blur lens test 6/9) [R: right dominant eye] L>R
L: -2.75/-0.75×55 (6/6) (+1.00 blur lens test 6/12+)
Add: +1.00 (N5@40cm)
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance
NMD @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: 0
+1.00 Near: 0 – 2 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
+1.25
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-0.25
(normal value: -1.37 to -3.37)
MEM (Accommodation lag – to measure accommodation response seeing near target)
R: reflex very dim
L: with movement (dim reflex)
(normal value: +0.25 to +0.75)
3D Vision (Random Dot 3S) with Distance Power only
40″
Add +0.75 on right eye: 12.5″
(normal value: 12.5″)
Modified Power – better than own glasses
R: -2.00/-0.25×95
L: -2.50/-0.75×55 [VA BE 6/6] L>R
Add: +0.75 (N5@40cm)
Adding +0.50 on left eye, R>L but not favoured
Adding +0.25 monocularly in either eye/binocularly is not favoured
NRA (Accommodation analysis – ability to relax accommodation) by plus lens (with Add)
+0.50
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens (with Add)
-0.75
(normal value: -1.37 to -3.37)
Facility (Accommodation facility – ability to change focus: far to near or near to far) by Flipper +/- 1.00
BE: 8 cycle per minit(cpm), difficult with minus lens(2nd lens)
R: 10 cycle per minit(cpm), difficult with minus lens(2nd lens)
L: 14 cycle per minit(cpm), difficult with minus lens(2nd lens)
* cannot clear -1.50 binocularly
(normal value: 1 cycle = 2 words read
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)
Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar (with Add)
Near, Base-Out/Convergent, PFV: 20/x/x
Near, Base-In/Divergent, NFV: x/20/16
Distance, Base-In/Divergent, NFV: 12/8
Distance, Base-Out/Convergent, PFV: 10/x/x
(normal value: Blur/Break/Recovery)
Near, PFV: x/10-28/7-21
Near, NFV: x/7-19/5-15
Distance, PFV: x/4-18/5-9
Distance, NFV: x/4-10/2-6
[Scheiman – Adult Data]
Interpupillary Distance = 5.4cm
Tracy has some astigmatism & her shortsightedness/myopia is lower now. It is no good to go without eye examination for too long. Eyes won’t simply give us visual complaint, so long as it is still within their capabilities.. as you notice each testing has their own range of normal value. Not-updated power will stress/burden our eye systems, exhausting their limits. When eyes continue to receive no help & their resources/reserves have depleted, will your eyes scream for help.. you having visual complaint like blurry vision/headache/burning, tired eyes/etc. Tracy, after taking a long break & putting eyes to relaxed mode (not doing computer work), the moment she goes back to work, straining the eyes.. eyes give you the complaint.
Regular eye examination is crucial, that is why we want to check your eyes – max every 2years.. we won’t want to simply call you in unnecessarily? but if you have follow up with us, please schedule to come in.. follow up is advised because it is necessary (we understand the worry in the rising cases, do come in for follow up when you feel comfortable ya?)
We hope that by sharing all these with you, you will get to know the importance of having an updated power. Let us all spread the words.. until we are all aware of the importance of regular eye examination.. and by then we are done.