Dinesh (M/23) came for eye examination, vision with existing glasses is still okay and he complains of headache after prolonged computer work sometimes.
Vision with own glasses:
R: -2.50/-0.50×160 (6/6-)
L: -3.75/-0.25×60 (6/6)
Examination showed:
R: -2.25/-1.00×160 (6/6)
L: -3.50/-0.50×145 (6/6)
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: 10cm, 11cm, 12cm
L: 10cm, 10cm, 10cm
(normal value: 10cm for a 23year 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: +0.75
L: +0.75
(normal value: +0.25 to +0.75)
Dinesh’s power is almost the same with his existing glasses. Astigmatism power has increased 050, in which we did Duochrome test, the Red-Green test (to ensure number in green is seen clearer or both numbers in red & green are about the same) before we get optimum astigmatism power.
From the assessments, we know that his eye stamina is reduced in Right eye, or it may be possibly reduced due to suboptimal astigmatism power.
His ability to stimulate accommodation/focusing, PRA is slightly lower. When we do near work, we need to stimulate focusing in order to see near. With slight reduced ability to stimulate focusing, on top of also slight reduced eye stamina, and so when we exert our eyes to focus seeing computer for long hours hence his complaint of headache with computer work. Headache is when demand exceeds supply.
Our management for Dinesh is that:
1. Astigmatism power must be fully corrected
– as astigmatism will interfere with the space between your reading target and your eyes when you are focusing
2. Shortsighted power is lowered, maintaining a satisfactory 6/6 vision with both eyes
– if we lower 025 shortsighted power, it will add up to his PRA value in regulating his ability to stimulate accommodation to normal value
– for eg.
Old power:
R: -2.50/-0.50×160 (6/6-)
L: -3.75/-0.25×60 (6/6)
PRA: -1.00
New power:
R: -2.25/-1.00×160 (6/6)
L: -3.50/-0.50×145 (6/6)
PRA: -1.25
– therefore, over power of spectacles power can create near work fatigue
3. Proper visual hygiene is reinforced
– the importance of 20-20-20 or regular break and to blink your eyes enough in between near work are essential
4. To follow up with eye stamina of Right eye in 4-6weeks
Dinesh has opted for big squarish, transparent black of Flexi with good versatility, to pair with Kodak EvoBlue lenses that change to dark colour upon exposure to sun/UV as well as blue light protection.. that comes with an accessory clip-on to be used when driving.
Thank you Dinesh for your trust & support!?