Kavitha (F/39) came with complaint of headache these few days & it does not go away with sleep. She reported slight blurry near vision & tired eyes using computer at work too.
Vision without glasses
R: 6/45-
L: 6/24
Existing glasses of 3years
R: -1.50/-1.00×180 (6/6)
L: -1.25/-1.00×15 (6/6)
Examination shows:
R: -1.50/-0.50×180 (6/6) [+1.00 blur test: 6/9-]
L: -1.25/-0.50×15 (6/6) [+1.00 blur test: 6/9] [L: left dominant eye]
Cover Test
Distance: small XP, fast recovery
Near: moderate XP, slow recovery
Howell Card (6BD on OD)
Distance: 8 – 10 XP
Near: 18 – 20 XP & beyond the scale
+1.00 Near: 18 – 20 XP & beyond the scale
-1.00 Near: 18 – 20 XP & beyond the scale
+2.00 Near: 18 – 20 XP & beyond the scale
-2.00 Near: 18 – 20 XP & beyond the scale
NRA
+2.50 (mono occlusion: OD clearer, OS clearer)
PRA
-1.50 (mono occlusion: OD blurry, OS blurry)
NPC (RAF rule)
OD deviates @12cm x4
AA (RAF rule)
R: 44yo, 44yo, 45yo (blur @end of RAF rule, clear @38cm)
L: 44yo, 45yo, 46yo (blur @end of RAF rule, clear @36cm)
NPC (RAF rule) with Add +0.75
OS deviates @10cm x3
Accommodation Facility (+/- 1.00) single letter target N8
BE: 19 cpm, difficult minus lens
R: 20 cpm, difficulty minus lens
L: 20 cpm, difficult minus lens
MEM
R: +0.50
L: +0.50
Fusional Reserves (Prism Bar)
Near, PFV: 8/x/x (10 blur pt onwards, OD deviates out)
Near, NFV: x/25/18
Distance, NFV: x/x/x
Distance, PFV: x/14/10
Vergence Facility (Prism Flipper 12BO/3BI)
Near: 19 cpm (no double reported)
Distance: 20 cpm (no double reported)
We repeated
Fusional Reserves (Prism Bar) with Add +0.50
Near, PFV: x/x/x
Random Dot 3S
32″
12.5″ (with Add +0.75)
Kavitha shared that she was told about her eyes moving 20years ago when she went to check her eyes.
