19/2/2022
XLing (F/11) came for eye examination, with complaint of blurry far vision (whiteboard or projector screen) with existing glasses since going back to school. She reported that she can see far better squinting her eyes small. Her near vision is fine & no headache. Mother reported that she tends to hold phone very near.
Vision without glasses
R: 6/60
L: 6/45
Vision with existing glasses of 1yr 3mths
R: -3.00/-0.50×165 (6/12)
L: -2.25/-0.50×165 (6/15)
Examination shows:
R: -4.25/-0.50×165 (6/6) (+1.00 blur lens test 6/12) [R: right dominant eye]
L: -3.50/-0.50×165 (6/6) (+1.00 blur lens test 6/9-2)
Other assessments show:
Cover Test
Distance: NMD
Near: small EP, fast recovery
Howell Card (6BD on OD)
Distance: 0 – 1 EP
Near: 0 – 1 EP
+1.00 Near: 2 – 4 XP
NRA
+1.50
PRA
-2.00
AA
R: no blurry reported x4
L: 15.5D, 15.5D, 15.5D
NPC
TTN, TTN, TTN, TTN, TTN, TTN
MEM
R: PL/-0.25
L: +0.50
Accommodation Facility +/- 2.00
BE: 13 cpm, difficult minus lens
R: 13 cpm, difficult plus lens
L: 11 cpm, difficult minus lens
Fusional Reserves
Near, NFV: 16/18/14
Near, PFV: 1/14/12
Distance, NFV: x/10/8
Distance, PFV: x/12/10
*UpdatedA 25/5/2022
XLing has not gone to eye specialist clinic for atropine eye drop treatment yet & she is complaining of blurry vision at school. Mother wants to make glasses for her first.
Our last record (Unaided now R: 6/60- L: 6/60)
R: -4.25/-0.50×165
L: -3.50/-0.50×165 (BCVA OU 6/7.5-)
Examination shows:
R: -4.75/-0.25×165 (6/6) R>L
L: -3.75/-0.25×160 (6/6)
Add: +1.00 (L>R)
Howell Card
Distance: 1 – 3 EP
Near: 1 – 3 EP
+1.00 Near: 2 – 4 XP
Maddox Rod
Distance: 3.5 BO
Near: 3 BI
NRA (with Add +1.00)
+1.25
PRA (with Add +1.00)
-2.75
NPC
TTN, TTN, TTN, TTN, TTN, TTN
AA
R: 8 YO, 15 YO, 20 YO (target only comes into focus starting @18cm)
L: 25 YO, 25 YO, 30 YO (target only comes into focus starting @18cm)
MEM
R: PL (reflex is seen at 110°)
L: PL (reflex is seen at 70°)
Accommodation Facility +/-2.00
BE: 10 cpm, difficult plus lens
R: 14 cpm, difficult plus lens [right eye sees better than with both eyes]
L: 14 cpm, difficult plus lens [left eye sees better than with both eyes]
Fusional Reserves
Near, NFV: x/12/10
Near, PFV: x/10/8
Distance, NFV: x/10/8
Distance, PFV: x/18/16
Vergence Facility
Near: 10 cpm (initially double with Base Out.. blink few times then single)
Distance: 12 cpm
AHP
She likes to chin up
We tried (pt reported seeing far & near vision better with 1BD)
R: -4.50/-0.25×165 1BD
L: -3.50/-0.25×165 1BD
Add: +0.75
Fusional Reserves
Near, PFV: x/14/12
Near, NFV: x/8/6
Distance, NFV: x/10/6
Distance, PFV: x/12/8
Interpupillary distance, IPD = 5.7cm
*UpdatedB
XLing (F/11) came for follow up. Vision with existing glasses is fine seeing far & near.
Existing glasses
R: -4.50/-0.25×165 (6/6)
L: -3.50/-0.25×165 (6/9)
Add: +0.75 (Pt reported more comfortable looking through slightly lower portion of lens, lowest portion no good)
Other assessments show:
Howell Card
Distance: 0 – 1 EP
Near: 4 – 6 XP
+1.00 Near: 8 – 10 XP
-1.00 Near: 4 – 6 XP
+2.00 Near: 10 – 12 XP
-2.00 Near: 0 – 2 XP
NRA
+2.25
PRA
-2.75
NPC
TTN, TTN, TTN, TTN, TTN, TTN
AA
R: 16D, 16D, 16D
L: 16D, 16D, 16D
MEM
R: +0.25
L: PL
Accommodation Facility +/-2.00
BE: 16 cpm, difficult minus lens
R: 15 cpm, difficult plus lens
L: 15 cpm, difficult plus lens
Fusional Reserves
Near, PFV: x/25/20
Near, NFV: x/16/12
Distance, NFV: x/10/8
Distance, PFV: x/18/12
Vergence Facility
Near: 8 cpm (slow Base Out)
Distance: 8 cpm (slow Base Out)
AHP Head Posture
No more chin up
Interpupillary distance, IPD = 5.7cm
+/-1.00 flipper VT?
*UpdatedC (10/2/2023)
Existing glasses
R: -4.50/-0.25×165 (6/6)
L: -3.50/-0.25×165 (6/7.5-)
Add: +0.75 (Pt reported more comfortable seeing near looking through lower portion of lens)
We reinforce proper visual hygiene & the correct usage of the lenses. All’s good.