Ythiga (F/16) came for eye examination, with complaints of blurry far vision in left eye.
Vision without glasses
R: 6/6- slow
L: 6/18-
Examination shows: (Delay Fogging)
R: PL/-0.25×70 (6/6) (+1.00 blur lens test 6/18-) [R: right dominant eye] R>L
L: -1.25/-0.25×130 (6/6) (+1.00 blur lens test 6/18-)
Add: +0.75 (L>R)
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance (upon covering left eye, patient reported target “go up”.. when covering right eye, target “go down”)
NMD @Near (upon covering left eye, patient reported target goes “behind”/further.. when covering right eye, target goes “in front”/closer)
(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: 4 –> 2 XP (blue part) –> 0
+1.00 Near: 6 <–> 4 <–> 2 XP (blue part) (no blink 8-10XP, after blink 2-4XP)
(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
Examination of Eye Alignment/Posture (Maddox Rod)
Distance: 2 Base In
Near: Orthophoria
(normal value: 0-1 EP or 0-3 XP @Distance; and 0-6 XP @Near)
Base Out/EP = Esophoria is misalignment of the eye, eye is deviated inwards
Base In/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
TTN, TTN, TTN
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
NRA (Accommodation analysis – ability to relax accommodation) by plus lens
+1.50
(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 – Monocular Estimation Method (Accommodation lag – to measure accommodation response seeing near target)
R: +0.50
L: -0.25
(normal value: +0.25 to +0.75)
AA (Amplitude Accommodation/Focusing – eye stamina/ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 16 YO, 16 YO, 16 YO
L: 8 YO, 10 YO, 10 YO
(normal value: AA goes according to age; YO=years old)
– after repeated testings on left eye, she reported eye pain
Accommodation Facility – ability to change focus: far to near or near to far (by Flipper +/-2.00)
BE: 13 cycle per minit(cpm), difficult with minus lens(2nd lens)
R: 11 cycle per minit(cpm), difficult with plus lens(1st lens) [right eye sees better than with both eyes]
L: 9 cycle per minit(cpm), difficult with plus lens(1st lens) [both eyes see better than with left eye]
(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
Near, Base-Out/Convergent, PFV: x/12/10
Near, Base-In/Divergent, NFV: x/14/12
Distance, Base-Out/Convergent, PFV: 10/16/14
Distance, Base-In/Divergent, NFV: 12/10
(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]
Vergence Facility – ability to make rapid repetitive vergence changes (by Prism Flipper of 12Base Out & 3Base In)
Near: 11 cpm
Distance: 0 cpm (cannot fuse Base-Out)
(normal value: 1 cycle = 2 times clearing target
Distance: 12-18 cpm
Near: 12-18 cpm)
Interpupillary Distance = 6.0cm
When we prompt further whether or not Ythiga sees blurry near vision sometimes or loses focus on near work, she said yes and she has been experiencing it since many years ago.