Nicole (F/14) came for eye examination, vision with existing glasses of 1.5years is fine seeing far & near. Her frame was slightly senget, as volleyball hit on her face.
Vision without glasses
R: 6/24
L: 6/21
Vision with existing glasses
R: -1.50/-0.25×115 (6/6)
L: -1.50/-0.50×160 (6/6)
Examination shows: (Delay Fogging)
R: -1.50/-0.25×160 (6/6) [+1.00 blur lens test: 6/12+]
L: -1.50/-0.50×160 (6/6) [+1.00 blur lens test: 6/7.5-] [L: left dominant eye]
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test, CT)
NMD @Distance
(alternating CT: upon covering left eye, patient reported the target goes to her left.. when covering right eye, the target goes to her right)
small XP, fast recovery @Near
(alternating CT: upon covering left eye, patient reported the target goes to her left.. when covering right eye, the target goes to her right)
(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 – 6 XP (blue part)
+1.00 Near: 10 XP (blue part)
-1.00 Near: 1 – 3 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
-2.00
(normal value: -1.37 to -3.37)
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
7/14cm, 7/14cm, 7/12cm, 7/12cm, 7/12cm, 7/12cm
(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: 14 YO, 14 YO, 14 YO
L: 14 YO, 14 YO, 14 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: 12 cycle per minit(cpm), difficult with minus lens(2nd lens)
R: 11 cycle per minit(cpm), difficult with minus lens(2nd lens) (right eye sees better than with both eyes)
L: 11 cycle per minit(cpm), difficult with minus lens(2nd lens) (left eye sees better than with both eyes)
(normal value: 1 cycle = 2 words read
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)
MEM – Monocular Estimation Method (Accommodation lag – to measure accommodation response seeing near target)
R: +0.25
L: +0.25
(normal value: +0.25 to +0.75)
Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Near, Base-Out/Convergent, PFV: 12/14/8
Near, Base-In/Divergent, NFV: 12/18/16
Distance, Base-Out/Convergent, PFV: 8/14/12
Distance, Base-In/Divergent, NFV: 8/10/8
(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: 5 cpm (double with Base Out, blink3 eyes then single)
Distance: 9 cpm (double with Base Out, blink eyes then single)
(normal value: 1 cycle = 2 times clearing target
Distance: 12-18 cpm
Near: 12-18 cpm)
Interpupillary distance, IPD = 6.0cm
Nicole can wear daily disposable contact lens for sports purposes.