Guna (F/20) came for eye examination, complaining of persistent headache on one side for quite some time already.
Vision without glasses:
R: 6/6-
L: 6/6-
Examination showed:
R: PL/-0.25×135 (6/6)
L: PL/-0.25×45 (6/6)
(PL is plano, it means no shortsighted power)
Guna has mild astigmatism in both eyes, her far vision is fine without glasses but with astigmatism correction, she can see the smallest line on testing chart sharp & clear. The orientation of her astigmatism is of oblique axis(between 30 to 60 or 120 to 150) – right eye astigmatism axis is 135 and left eye astigmatism axis is 45. Oblique axis should be corrected as it normally does improve vision.. even though astigmatism power is as low as 025, such as in Guna’s vision. Comparatively, if astigmatism is of with-the-rule axis(between 0 to 30 or 150 to 180) or against-the-rule axis(between 60 to 120), sometimes, it makes no difference wearing or not wearing lenses. We will let you compare and see the difference yourself.
Other assessments showed:
Cover Test (examination of Eye Alignment)
Orthophoria (normal) @ distance & near
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
8cm, 8cm, 8cm
(normal value: less than 10cm)
AA (Accommodation/eye stamina – ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 14cm, 16cm, 18cm
L: 9cm, 9cm, 9cm
(normal value: 9cm for a 20year old)
NRA (Accommodation analysis – ability to relax accommodation)
+1.50
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation)
-1.25
(normal value: -1.37 to -3.37)
MEM (to measure Accommodation response seeing near target)
R: +1.00
L: +0.75
(normal value: +0.25 to +0.75)
Guna has Accommodation Insufficiency (AI) in Right eye.
Our eyes have two systems – Accommodation & Convergence to help us seeing near print clearly. She can maintain a single clear image within 10cm from eye, her Convergence is normal. On Accommodation, her Left eye is fine but her Right eye shows reduced eye stamina.. there is no enough eye stamina to sustain seeing near print clearly. Continuous demand in exerting accommodation/focusing leads to stress or muscle pull in her Right eye, so this may be the cause of headache on one side.
Guna is 20yo, and she has AI in only one eye. We will work on vision therapy to train/strengthen Accommodation in her Right eye. She will wear her glasses for 2-4weeks and we prescribe Hart Chart Rock eye exercise for her to do at home for another 2-4weeks. Also, proper visual hygiene is of paramount importance, ensuring regular break in between near task or golden rule 20-20-20 rule. We will see her again in 4weeks.
Guna likes the transparent peach frame of Flexi for an absolutely vibrant look fitted with Kodak UVBlue lenses.
Thank you Guna & mummy Naga for your trust & support!? and thank you kak Mugu for your referral?
- Thank you my Binocular Vision lecturers Ms Prema & Mr Stanley for all the BV gems!?