Ng Wai Boon – 88 Optometry

Mr Ng Wai Boon (M/38) Chee Hee’s dad came for eye examination, with complaint of sometimes tired eyes seeing computer in which he will look far away to relax his eyes & difficulty driving in low light condition/at night. He had lasik about 13years ago.

Vision without glasses
R: 6/6- slow
L: 6/6- (better)

Power of existing glasses
R: -0.75/-0.50×180
L: PL

Subjective Refraction
R: -0.25/-0.25×180 (6/6) [+1.00 blur lens test: 6/9+] R>L
L: PL/-0.25×20 (6/6) [+1.00 blur lens test: 6/9-]
Near: N5@40cm (L>R)

Other assessments show:

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

Howell Card
Distance: 0
Near: 2 – 4 XP
+1.00 Near: 6 XP
-1.00 Near: 0
+2.00 Near: 10 XP
-2.00 Near: 0

NRA
+1.25

PRA
-0.75

NPC
7/10cm, RE deviates @8cm x3, 7/10cm, 7/10cm

AA
R: 38yo, 38yo, 38yo
L: 38yo, 38yo, 38yo

Modified
R: PL/-0.75×180
L: PL/-0.25×20
DC is better @N

NPC
7/10cm, 7/10cm, 7/10cm, 7/10cm

MEM
R: scissors reflex
L: +0.50

Fusional Reserves
Near, PFV: x/25/18
Near, NFV: x/16/14
Distance, NFV: x/8/6
Distance, PFV: x/14/12

Vergence Facility
Near: 12 cpm
Distance: 13 cpm

Interpupillary distance, IPD = 7.0cm

Slit Lamp
R: no cataract
L: no cataract

Fluorescein
R: -ve staining
L: -ve staining

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)

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