Mrs Ng, Tang CY (F/47) came with complaint of slight blurry far & near vision with existing glasses recently.
Vision without glasses
R: xguess 6/60
L: 6/60-
Existing reading glasses of 3years (FH worn higher)
R: -6.50 (6/7.5-)
L: -6.25 (6/9)
Add: +1.75
Examination shows:
R: -6.00 (6/6) [+1.00 blur test: 6/12+]
L: -5.50 (6/6) [+1.00 blur test: 6/12+] [L: left dominant eye] L>R
Add: +1.75 (N5@40cm) R>L
Cover Test
Distance: NMD (ACT: pt reported RE sees target going down, LE sees target going up)
Near: small XP, fast recovery
Howell Card (8BD on OD)
Distance: 0 – 1 EP
Near: 0
+1.00 Near: 4 – 6 XP
-1.00 Near: 2 XP
NRA
+1.25 (mono occlusion: OD blurry, OS blurry)
PRA
-1.00 (mono occlusion: OD blurry, OS blurry)
NPC (RAF rule)
16/28cm, 16/28cm, 16/28cm, 16/28cm
AA (RAF rule)
R: 45yo, 45yo, 45yo (blur @end of RAF rule, clear @34cm)
L: 45yo, 45yo, 45yo (blur @end of RAF rule, clear @40cm)
NPC (RAF rule) with Add +2.25
14/24cm, 14/24cm, 14/24cm
Accommodation Facility (+/- 1.00)
BE: difficult minus lens
R: difficulty plus lens
L: difficult plus lens
MEM
R: PL/+0.25
L: +0.25
Fusional Reserves (Prism Bar)
Near, NFV: 8/16/14
Near, PFV: x/20/18
Distance, NFV: x/10/8
Distance, PFV: x/30/20
Vergence Facility (Prism Flipper 12BO/3BI)
Near: 5 cpm (at the end: double BO)
Distance: 7 cpm (slow BO)
Interpupillary distance, IPD = 6.5cm
Slit Lamp
R: vy mild cataract
L: vy mild cataract
Fluorescein
R: vy mild staining inferiorly
L: vy mild staining inferiorly
