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Sepit Eka Sari

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Eka (F/35) datang untuk pemeriksaan mata, mengadu kabur tengok jauh dengan speknya.. beliau hanya pakai spek bila tengok jauh saja.. lain masa beliau tak pakai spek.. tengok hp okay tapi kena pegang hp dekat. Beliau kata ini spek pertamanya, dulu2 memang tak rasa kabur tengok jauh hmmm.. bila kita semak power spek, power 500 aiyooo kalau power ini, kita mestilah pakai spek setiap masa.

Vision without glasses
R: xguess 6/120
L: xguess 6/120

Existing glasses of 3years
R: -5.50/-2.00×165 (6/12-)
L: -5.00/-1.75×20 (6/12-) 0.5BD

Subjective Refraction & Retinoscopy
R: -6.00/-1.25×165 (6/12) PHNI
L: -5.75/-0.75×10 (6/7.5) PHNI

Other assessments show:

Random Dot 3S
40″

Cover Test
Distance: NMD
Near: small XP, fast recovery

Howell Card (10^BD @OD)
Distance: 1 EP
Near: 8 XP
+1.00 Near: 12 XP
-1.00 Near: 2 – 4 XP
+2.00 Near: 14 XP
-2.00 Near: 0 – 2 XP

NRA
+2.00

PRA
-0.50

MEM
R: +1.25
L: +1.50

Modified
R: -6.00/-1.25×165
L: -5.75/-0.75×10
Add: +0.75 (Add is preferred by pt)

NPC (with Add)
TTN, TTN, TTN, TTN, TTN, TTN, TTN

MEM (with Add)
R: +0.50
L: +0.50

Fusional Reserves (with Add for near)
Near, PFV: x/25/14
Near, NFV: x/x/x
Distance, PFV: x/x/x
Distance, PFV: x/x/x

Vergence Facility
Near: no double reported (no eye movement seen)
Distance: no double reported (no eye movement seen)

Interpupillary distance, IPD = 7.1cm

Rabun jauh Eka tinggi, beliau mesti pakai spek sepenuh masa. Selepas 2bulan pemakaian spek sepenuh masa, kita pantau balik penglihatan terutamanya mata kanan.

NOTES

Vision without glasses
6/6 – smallest testing line
6/7.5 – 2nd smallest line
6/9 – 3rd smallest line
6/12 – 4th smallest line
6/15 – 5th
6/18 – 6th
6/21 – 7th
6/24 – 8th

Examination of Eye Alignment
Cover Test, CT @ Distance & Near
– NMD(No Movement Detected) or
– small XP, fast recovery
EP = Esophoria is misalignment of eye, eye is deviated inwards
XP = Exophoria is misalignment of eye, eye is deviated outwards
ACT: alternating CT

Examination of Eye Alignment
(Maddox Rod) placed on RE 

Examination of Eye Posture
(Howell Card) by 6^ BD OD
Distance:
– 0-3 XP (blue part) or
– 0-1 EP (yellow part)
Near:
– 0-6 XP (blue part)

Accommodation/Focusing analysis – ability to relax
NRA
+1.50 to +2.50

Accommodation/Focusing analysis – ability to focus
PRA
-1.37 to -3.37

Convergence, NPC – ability of eye to maintain a single clear near image (RAF rule)
Break/Recovery – within 10cm or TTN(to the nose)

AA(Amplitude Accommodation) – eye stamina (Dioptre, D) (RAF rule)
6yo – 16.5D | 6cm
9yo – 15.5D | 6.5cm
12yo – 14.5D | 7cm
15yo – 13.5D | 7.5cm
18yo – 12.5D | 8cm
21yo – 11.5D | 9cm
24yo – 10.5D | 10cm
27yo – 9.5D | 11cm
30yo – 8.5D | 12cm

MEM(Monocular Estimation Method) – measure accommodation response seeing near target
+0.25 to +0.75 (with movement)

Accommodation Facility – ability to change focus: far to near or near to far) by Flipper +/- 2.00
Monocular: 6cpm – 16cpm
Binocular: 4cpm – 14cpm
(1 cycle per minute, cpm = 2 words)

Fusional Reserves –
Convergent/Divergent reserve stamina (Prism Bar)
Blur/Break/Recovery
Children 7-12yo
Near, BO/PFV: x/15-31/10-22
Near, BI/NFV: x/7-17/3-11
Adult
Near, BO/PFV: x/10-28/7-21
Near, BI/NFV: x/7-19/5-15
Distance, BO/PFV: x/4-18/5-9
Distance, BI/NFV: x/4-10/2-6

Vergence Facility  – ability to make rapid repetitive vergence changes (Prism Flipper 12BO & 3BI)
Distance: 12-18 cpm
Near: 12-18 cpm)
(1 cycle = 2 times clearing target)

Random Dot 3S – 3D Vision/Stereopsis 
12.5″

Worth 4 Dots – Binocular Perception
4 dots/lights