Yap Siong Lim

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SLim (M/16) came with c/o sometimes blurry far & near vision with existing specs of 1.5yrs made with us. He has headache when he is tired/not enough sleep..

Vision without glasses
R: 6/60-2
L: xguess 6/60

Existing glasses
R: -3.75/-0.50×10 (6/6)
L: -4.00/-0.25×155 (6/6)

Examination shows:
R: -3.75/-0.25×10 (6/6) [+1.00 blur test: 6/12] [R: right dominant eye]
L: -3.75/-0.50×155 (6/6-) [+1.00 blur test: 6/12-] L>R (adding +0.25 in OS: R>L but xfavoured)
Near: L>R (pt likes 025DC higher in OU @seeing N)

Other assessments show:

Cover Test
Distance: NMD
Near: NMD

Howell Card (6BD on OD)
Distance: 1 – 3 EP
Distance: 1 – 3 EP (additional +0.25 OU on top of Rx)
Near: 0 – 1 EP
+1.00 Near: 2 XP
-1.00 Near: 7 – 9EP
+2.00 Near: 4 XP
-2.00 Near: 11 – 13 EP

NRA
+1.50 (occlude monocularly: OD blurrier, OS clearer)

PRA
-1.75 (occlude monocularly: OD clearer, OS clearer)

NPC
6/8cm, 6/8cm, 6/8cm, 6/8cm, 6/8cm, 6/8cm

AA
R: 13.5D, 12D, 10.5D (blur @end of RAF rule, clear @30cm)
L: 13.5D, 12D, 10.5D (blur @end of RAF rule, clear @32cm)

Accommodation Facility (+/- 1.50) double with -2.00
BE: 15 cpm, difficult minus lens
R: 12 cpm, difficult minus lens
L: 15 cpm, difficult minus lens

MEM
R: +0.75
L: +0.75

Fusional Reserves (Prism Bar)
Near, NFV: 6/8/6
Near, PFV: 16/20/18
Distance, NFV: x/10/6
Distance, PFV: 10/14/12

Vergence Facility (Prism Flipper 12BO, 3BI)
Near: 10 cpm (slow BI)
Distance: 7 cpm (slow BI, sometimes slow BO too)

Interpupillary distance, IPD = 6.8cm
-gradient AC/A = 7:1 | +gradient AC/A = 2:1 | calculated AC/A = 6:1

Prescribe
R: -3.75/-0.25×10
L: -3.75/-0.50×155
Add: +0.75
And daily disposable contact lens for event/function.

SLim said that his far vision is sometimes “shaky/vibrate”.. but no double seen. He sometimes sees blurry near too, especially when he is playing games.