ZHim (M/9), non spectacles wearer, came for eye examination, vision is fine seeing far & near. He sometimes will rub his eyes after seeing phone for an hour.
Vision without glasses
R: 6/6
L: 6/6
Examination shows:
R: PL (6/6) [+1.00 blur lens test: 6/6-2]
L: PL (6/6) [+1.00 blur lens test: 6/6-1] [L: left dominant eye]
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test, CT)
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: 1 EP (yellow part)
Near: 0 – 2 XP (blue part)
+1.00 Near: 4 – 6 XP (blue part)
-1.00 Near: 0 – 1 EP (yellow part)
(normal value: 0-1 EP (yellow part) or 0-3 XP (blue part) @Distance; and 0-6 XP (blue part) @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
+1.50
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-1.75
(normal value: -1.37 to -3.37)
MEM – Monocular Estimation Method (Accommodation lag – to measure accommodation response seeing near target)
R: +1.00
L: +1.00
(normal value: +0.25 to +0.75)
MEM – Monocular Estimation Method (Accommodation lag – to measure accommodation response seeing near target) (with +0.50 OU)
R: +0.75
L: +0.75
(normal value: +0.25 to +0.75)
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
RE deviates out at around 10cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
AA (Amplitude Accommodation/Focusing – eye stamina/ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 8 YO, 8 YO, 8 YO
L: 8 YO, 8 YO, 8 YO
(normal value: AA goes according to age; YO=years old)
Facility (Accommodation facility – ability to change focus: far to near or near to far) by Flipper +/- 2.00
BE: 14 cycle per minit(cpm), difficult with plus lens(1st lens)
R: 20 cycle per minit(cpm)
L: 20 cycle per minit(cpm)
(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/18/16
Distance, Base-In/Divergent, NFV: x/8/6
Distance, Base-Out/Convergent, PFV: x/12/10
(normal value: Blur/Break/Recovery)
Near, PFV: 10-28/7-21
Near, NFV: 7-19/5-15
Distance, PFV: 4-18/5-9
Distance, NFV: 4-10/2-6
[Scheiman et al – Adult Data]
Vergence Facility – ability to make rapid repetitive vergence changes (by Prism Flipper of 12Base Out & 3Base In)
Near: 3 cpm (double with Base Out)
Distance: 0 cpm (double with Base Out)
(normal value: 1 cycle = 2 times clearing target
Distance: 12-18 cpm
Near: 12-18 cpm)
Interpupillary distance, IPD = 6.0cm
ZHim has slight long-sightedness/hyperopia.. but children of this age are expected to have slight hyperopia too.
We advise on visual hygiene:
- take regular break 20-20-20 rule [after 20minutes of near work, to look at 20feet away(or far2 away) for 20seconds to relax back eyes]
- hold phone at an elbow distance
- good lighting
- proper posture