YFei (F/8) came with complaint of blurry seeing whiteboard at school after recess onwards, vision is fine early in the morning. She does not wear any glasses.
Vision without glasses
R: 6/6-
L: 6/6
Examination shows:
R: PL (6/6) [R: right dominant eye]
L: PL (6/6) L>R
Near: L>R
Other assessments show:
Random Dot 3S
12.5″
Cover Test
Distance: NMD
Near: small XP, fast recovery
Howell Card (6BD on OD)
Distance: 1 EP (pt reported arrow would be missing sometimes)
Near: 4 – 6 XP
+1.00 Near: 6 XP
-1.00 Near: 0 – 1 EP
+2.00 Near: 6 XP
-2.00 Near: 13 – 15 EP
NRA
+3.50
PRA
-2.00 (mono occlusion: OD blurry, OS clear)
NPC (RAF rule)
TTN, TTN, 5/8cm, 5/8cm, 5/8cm, 5/8cm
AA (RAF rule)
R: 16D, 15.5D, 14.5D (blur @end of RAF rule, clear @34cm)
L: 16D, 15.5D, 14D (blur @end of RAF rule, clear @26, 24, 22cm)
Accommodation Facility (+/- 2.00)
BE: 11 cpm, difficult minus lens
R: 14 cpm, difficulty minus lens
L: 14 cpm, difficult minus lens
MEM
R: +0.50
L: +0.50
Fusional Reserves (Prism Bar)
Near, NFV: x/8/4
Near, PFV: x/18/10
Distance, NFV: x/12/6
Distance, PFV: x/18/12
Vergence Facility (Prism Flipper 12BO/3BI)
Near: 4 cpm (slow BO & BI)
Distance: 3 cpm (slow BO)
We repeated
Fusional Reserves (Prism Bar) with Add +0.50
Near, NFV: x/8/6
Near, PFV: x/20/12
Interpupillary distance, IPD = 5.7cm