WYan (F/16) came for eye examination, vision with existing glasses of 2+years is fine seeing far & near. No headache is reported. She wants to wear contact lens for her gymnastics classes.
Vision without glasses
R: 6/30-
L: 6/45-
Vision with existing glasses
R: -3.25/-0.25×70 1BU (6/6-)
L: -3.00 (6/6-)
Examination shows:
R: -3.00(6/6) [+1.00 blur lens test: 6/9]
L: -3.00 (6/6) [+1.00 blur lens test: 6/9-] (L: left dominant eye) L>R
Near: R>L
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test, CT)
small XP, fast recovery @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: 2 XP (blue part)
Near: 2 – 4 XP (blue part)
+1.00 Near: 6 – 8 XP (blue part)
-1.00 Near: 0 – 2 XP (blue 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
+2.00
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-2.25
(normal value: -1.37 to -3.37)
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
8/10cm, 8/10cm, 8/10cm, 8/10cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
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: 13 cycle per minit(cpm), difficult with minus lens(2nd lens) (both eyes see better than with right eye)
L: 12 cycle per minit(cpm), difficult with minus lens(2nd 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)
MEM – Monocular Estimation Method (Accommodation lag – to measure accommodation response seeing near target)
R: +0.25
L: +0.50
(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, 20 YO, 16 YO (target is clear @end of RAF rule)
L: 16 YO, 16 YO, 16 YO (target is clear @end of RAF rule)
(normal value: AA goes according to age; YO=years old)
Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Near, Base-Out/Convergent, PFV: 18/25/14
Near, Base-In/Divergent, NFV: 16/18/14
Distance, Base-Out/Convergent, PFV: x/20/16
Distance, Base-In/Divergent, NFV: x/12/8
(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: 14 cpm
Distance: 14 cpm
(normal value: 1 cycle = 2 times clearing target
Distance: 12-18 cpm
Near: 12-18 cpm)
Interpupillary distance, IPD = 5.9cm
Prescribe daily disposable contact lens
R: -3.00
L: -3.00
If WYan would like to wear contact lens every day, we will shift her to monthly disposable the next round.