Chloe L (F/11) came for eye examination, with complaint of blurry seeing whiteboard at school & near vision is fine. No headache reported. She likes to chin down. We previously referred her to see ophthalmologist 2yrs ago.. but they did not go.
Vision without glasses
R: xguess 6/60 (with squinting: 6/24)
L: 6/60 (with squinting: 6/24)
Vision with existing glasses
R: -2.00 (with squinting: 6/12)
L: -2.00 (with squinting: 6/12-)
Examination shows:
R: -2.50 (6/6) [+1.00 blur test: 6/15-] (ret shows OD <-1.75) N5@35cm
L: -2.75 (6/6) [+1.00 blur test: 6/12-] (L: left dominant eye) N5@35cm
Near: L>R (adding +0.75 in OD: R>L)
Other assessments show:
Random Dot 3S
20″
Cover Test
Distance: NMD
Near: small XP, fast recovery
Howell Card
Distance: 2 XP
Near: 12 XP
+1.00 Near: 14 – 16 XP
-1.00 Near: 8 XP
+2.00 Near: 18 XP
-2.00 Near: 2 XP
Maddox Rod
Distance: 2 BI, R 1 BD
Near: 7 BI, R 2 BD
NRA
+0.25
PRA
-0.50
NPC (RAF rule)
RE deviates @12cm, RE deviates @10cm, 6/8cm, RE deviates @8cm, RE deviates @10cm, 6/8cm
AA (RAF rule)
R: 14D, 13.5D, 12D (blurry @end of RAF rule, clear @36cm, 24cm, 28cm)
L: 13.5D, 12.5D, 13.5D (blurry @end of RAF rule, clear @34cm, 28cm, 26cm)
MEM
R: PL
L: +0.50
Accommodation Facility +/-2.00
BE: 11 cpm, difficult plus lens
R: 13 cpm, difficult plus lens
L: 13 cpm, difficult plus lens
Fusional Reserves (Prism Bar)
Near, PFV: 8/16/10
Near, NFV: 12/16/14
Distance, NFV: x/8/6
Distance, PFV: 12/16/12 (above blur point 12: double then single)
Vergence Facility (Prism Flipper 12BO/3BI)
Near: 4 cpm (slow BO)
Distance: 5 cpm (slow BO)
Motility
@LaevoElevation: slight overaction +1 RIO with accompanying Left eye pain @this gaze
Assessing Control of IXT
Subjective
Clinic Control
Distance: score 1 (fair control)
Near: score 1 (fair control)
Objective
Binocular VA
Distance: 6/9
Interpupillary distance, IPD = 5.6cm
+gradient = 6:1/12:1, -gradient = 15:1/9:1
We ask Natalie whether or not she realises that her eyes will turn out.. she said her right eye will turn out & she is able to pull back her eye. When we ask about her left eye, she said no.
We prescribe Dot card eye exercise.