25/5/2022
ZhHye (M/10) came for eye examination, with complaint of blurry far vision with existing glasses of 3years. His near vision is fine with no headache. We observe that he likes to chin up.
Vision without glasses
R: cannot guess 6/120 (better)
L: cannot guess 6/120
Vision with existing glasses
R: -5.50/-0.75×180 (6/12-)
L:-5.50/-1.00×160 (6/18-)
Examination shows:
R: -6.50 (6/9+) [PH 6/9+], N5
L: -7.00/-0.50×160 (6/9-) [PH 6/9-], N5
BCVA OU 6/7.5- (R>L)
(adding up to +0.75 in OD: still R>L)
Other assessments show:
Random Dot 3S
100″
Modified
R: -6.50/-0.25×180
L: -7.00/-0.50×160
Random Dot 3S
40″ (with Add +0.75)
Cover Test
Distance: NMD
Near: NMD
Howell Card (6BD on OD)
Distance: 1 – 3 EP
Near: 1 – 3 EP
+1.00 Near: 0 – 2 XP
-1.00 Near: 1 – 3 EP
Maddox Rod
Distance: 2.5 BO, R 1 BU
Near: R 2 BU
NRA
+0.75
PRA
-0.25
MEM
R: +1.00
L: +1.00
Accommodation Facility (+/-1.00) [xclear +/- 2.00 & 1.50]
BE: 7 cpm, difficult minus lens
R: 8 cpm, difficult minus lens
L: 10 cpm, difficult plus lens
AA (RAF rule)
R: 20 YO, 25 YO, 30 YO (blur @end of RAF rule, clear @22cm)
L: no blur reported x3 (blur @end of RAF rule, clear @15cm)
NPC (RAF rule)
TTN, TTN, TTN, TTN, TTN, TTN
Fusional Reserves (Prism Bar)
(Add +0.75) Near, PFV: x/6/4
(Add +0.75) Near, NFV: x/2/1
Distance, NFV: x/4/2
Distance, PFV: x/12/8 (above break point 4, double then single)
Vergence Facility (Prism Flipper 12BO/3BI)
Near: 9 cpm (double BI.. blink few times then single)
Distance: 3 cpm (double BI.. blink many2 times then single)
Modified
R: -6.50/-0.25×180 2BD
L: -7.00/-0.50×160 2BD
Add: +0.25
Prescribe
R: -6.25/-0.25×180 2BD
L: -6.75/-0.50×160 2BD
He reported seeing far & near vision better with 2BD.
Interpupillary distance, IPD = 6.2cm
We will do fusional reserves at far & near with new glasses soon.
After obtaining these findings, we asked if ZhHye sees blurry near vision on hp/computer after some time.. he admitted seeing blurry after an hour+ on phone.. in which he will blink3 eyes.. that will extend for another hour before seeing blurry again.
*Updated
New glasses
R: -6.25/-0.25×180 2BD
L: -6.75/-0.50×160 2BD
BCVA OU 6/7.5-
Howell Card (6BD on OD)
Distance: 0 – 1 EP
Near: 0 – 2 XP
Fusional Reserves (Prism Bar)
Near, PFV: x/20/18
Near, NFV: x/14/12
Distance, NFV: x/16/14
Distance, PFV: x/30/25
Random Dot 3S
12.5″
*UpdatedA
5/11/2022
ZhHye (M/10) came for follow up. He said that his near vision is fine now.
Existing glasses
R: -6.25/-0.25×180 2BD
L: -6.75/-0.50×160 2BD
BCVA OU 6/7.5+
Other assessments show:
Cover Test
Distance: NMD
Near: NMD
Howell Card (6BD on OD)
Distance: 1 – 3 EP
Near: 0 – 2 XP
+1.00 Near: 2 XP
-1.00 Near: 1 EP
+2.00 Near: 2 XP
-2.00 Near: 3 EP
NRA
+1.25 (mono occlusion: OD better, OS blurry)
PRA
-1.25 (mono occlusion: OD better, OS blurry)
NPC (RAF rule)
14/20cm, 14/20cm, 14/20cm, 14/20cm, 14/20cm, 14/20cm
AA (RAF rule)
R: 13.5D, 13.5D, 13.5D (blur @end of RAF rule, clear @28cm)
L: 12.5D, 12.5D, 12.5D (blur @end of RAF rule, clear @26cm)
Accommodation Facility (+/- 2.00)
BE: 15 cpm, difficult minus lens
R: 15 cpm, difficult minus lens
L: 15 cpm, difficult minus lens
MEM
R: +0.50
L: +0.50
Fusional Reserves (Prism Bar)
Near, NFV: x/16/12
Near, PFV: 20/30/25
Distance, NFV: x/10/8
Distance, PFV: x/25/20
Vergence Facility (Prism Flipper 12BO, 3BI)
Near: 9 cpm (slow BI)
Distance: 9 cpm (slow BI)
Interpupillary distance, IPD = 6.3cm
+gradient AC/A = 2:1, -gradient AC/A = 1:1
