21/3/2022
XE (F/10) came for eye examination, with complaints of slightly blurry far vision with existing glasses of 1 year. We notice that she likes to hold very close to see near.
Vision without glasses
R: 6/24
L: 6/24-
Vision with current glasses
R: -1.75/-1.25×180 (6/7.5-)
L: -1.75/-1.50×5 (6/9-)
Add: +1.50
Examination shows:
R: -2.25/-0.75×180 (6/6) (+1.00 blur lens test 6/12-) [R: right dominant eye] R>L
L: -2.25/-0.75×5 (6/6) (+1.00 blur lens test 6/12-)
Near: L>R
Other assessments show:
Cover Test, CT
Distance: NMD
Near: NMD (ACT: upon covering left eye, patient reported target “go left”.. when covering right eye, target “go right at middle”)
Howell Card (6BD on OD)
Distance: 0
Near: 0 – 2 XP
+1.00 Near: 2 – 4 XP
-1.00 Near: 1 – 3 EP
NPC (RAF rule)
7/9cm, 7/9cm, 7/9cm, 8/10cm, 8/10cm, 8/10cm
NRA
+2.50
PRA
-1.00
MEM
R: +1.00
L: +1.00
AA (RAF rule)
R: 8 YO, 8 YO, 8 YO
L: 8 YO, 8 YO, 8 YO
Accommodation Facility (Flipper +/-2.00)
BE: 14 cpm, difficult minus lens
R: 13 cpm, difficult minus lens [BE see better than with RE]
L: 13 cpm, difficult minus lens [BE see better than with LE]
Fusional Reserves (Prism Bar)
Near, PFV: 10/18/16
Near, NFV: 6/18/16
Distance, NFV: x/6/4
Distance, PFV: x/10/8
Vergence Facility (Prism Flipper of 12Base Out & 3Base In)
Near: 6 cpm (slow BI)
Distance: 5 cpm (slow BO)
3D Vision (Random Dot 3S)
12.5″
(normal value: 12.5″)
Modified
R: -2.00/-0.75×180
L: -2.00/-0.75×5
Vision with both eyes, BE: 6/6
Interpupillary Distance = 5.6cm
*UpdatedA 3/10/2022
XE came for follow up.
Existing glasses
R: -2.00/-0.75×180 (6/7.5)
L: -2.00/-0.75×5 (6/7.5) NRA
Pt reported better vision removing DC seeing near.
Other assessments show:
Cover Test, CT
Distance: NMD
Near: small XP, fast recovery
Howell Card (6BD on OD)
Distance: 0 – 1 EP
Near: 2 – 4 XP
+1.00 Near: 4 XP
-1.00 Near: 2 XP
+2.00 Near: 6 XP
-2.00 Near: 0
NPC (RAF rule)
7/9cm, 7/9cm, 7/9cm, 7/9cm, 7/9cm, 7/9cm
NRA
+2.75
PRA
-1.50
AA (RAF rule)
R: 8 YO, 8 YO, 8 YO
L: 8 YO, 8 YO, 8 YO
Accommodation Facility (Flipper +/-2.00) [target 20/30 words]
BE: 17 cpm, difficult minus lens
R: 17 cpm, difficult minus lens
L: 18 cpm, difficult minus lens
MEM
R: +0.50
L: +0.50
Fusional Reserves (Prism Bar)
Near, PFV: x/10/8
Near, NFV: x/14/12
Distance, NFV: x/10/8
Distance, PFV: 12/20/16 (above 12 blur pt, double then single)
Vergence Facility (Prism Flipper of 12BO & 3BI)
Near: 12 cpm
Distance: 4 cpm (slow BO)
Fusional Reserves (Prism Bar) [with Add +0.50]
Near, PFV: x/8/6
Near, NFV: 10/20/10 (above 10 blur pt, double then single)
XE continues with existing glasses.
*UpdatedAB 11/12/2022
XE came for follow up.
Existing glasses
R: -2.00/-0.75×180 (6/9+2)
L: -2.00/-0.75×5 (6/9+2)
Examination shows:
R: -2.25/-0.75×180 (6/6) (+1.00 blur lens test 6/12-) [R: right dominant eye] R>L
L: -2.25/-0.75×5 (6/6) (+1.00 blur lens test 6/12-)
Near: L>R
Other assessments show:
Cover Test, CT
Distance: NMD
Near: small XP, fast recovery
Howell Card (6BD on OD)
Distance: 0 – 1 EP
Near: 2 – 4 XP
+1.00 Near: 4 XP
-1.00 Near: 2 XP
+2.00 Near: 6 XP
-2.00 Near: 0
NPC (RAF rule)
7/9cm, 7/9cm, 7/9cm, 7/9cm, 7/9cm, 7/9cm
NRA
+2.75 (mono occlusion: OD blur, OS blur)
PRA
-1.75 (mono occlusion: OD blur, OS blur)
AA (RAF rule)
R: 8 YO, 8 YO, 8 YO
L: 8 YO, 8 YO, 8 YO
Accommodation Facility (Flipper +/-2.00) [target 20/40 words]
BE: 20 cpm, difficult minus lens
R: 19 cpm, difficult minus lens
L: 20 cpm, difficult minus lens
MEM
R: +0.50
L: +0.50
Fusional Reserves (Prism Bar)
Near, PFV: x/10/8
Near, NFV: x/12/8
Distance, NFV: x/8/4
Distance, PFV: 12/18/16 (above 12 blur pt, double then single)
Vergence Facility (Prism Flipper of 12BO & 3BI)
Near: 15 cpm
Distance: 11 cpm (slow BO & BI)
Fusional Reserves (Prism Bar) [with Add +0.50]
Near, PFV: x/6/4
Near, NFV: 20/25/12
We prescribe Dot Card to improve PFV @Near.
