Ann (F/31) came, her glasses were broken 2months ago. She is full-time contact lens wearer for the past 10years, wearing -4.00 in both eyes. Vision with contact lens is fine seeing far & near. She sometimes has headache at both sides of her head.. about once in 2weeks.. not specifically arising from near work.
Vision without glasses
R: 6/30
L: 6/45+
Examination shows:
R: -4.25/-0.25×175 (6/6) [+1.00 blur test: 6/15+] [R: right dominant eye] R>L
L: -4.25/-0.25×180 (6/6) [+1.00 blur test: 6/15+]
Near: L>R
Other assessments show:
Cover Test
Distance: NMD
Near: NMD
Howell Card (6BD on OD)
Distance: 0
Near: 3 – 5 EP
+1.00 Near: 0
-1.00 Near: 5 EP
+2.00 Near: 0
-2.00 Near: 5 EP
NRA
+3.00
PRA
-1.25 (mono occlusion: OD blurry, OS blurry)
NPC (RAF rule)
8/10cm, 8/10cm, 8/10cm, 8/10cm, 8/10cm, 8/10cm
AA (RAF rule)
R: 30yo, 30yo, 30yo
L: 30yo, 30yo, 30yo
Accommodation Facility (+/- 2.00)
BE: 16 cpm, difficult minus lens
R: 16 cpm, difficulty minus lens
L: 16 cpm, difficult minus lens
MEM
R: +1.25
L: +1.00
Fusional Reserves (Prism Bar)
Near, NFV: 10/20/14 (above blur point 10, double then single)
Near, PFV: 20/35/30
Distance, NFV: x/12/8
Distance, PFV: x/18/16
Vergence Facility (Prism Flipper 12BO/3BI)
Near: 12 cpm
Distance: 13 cpm
We repeated
Fusional Reserves (Prism Bar) with Add +0.50
Near, NFV: 12/18/12
Near, NFV: x/30/25
Fluorescein
R: -ve staining
L: -ve staining
Cornea Neovas
R: grade 1 trace
L: grade 1 trace
Interpupillary distance, IPD = 6.0cm
Modified
R: -4.25/-0.25×175
L: -4.25/-0.25×180
Add: +0.75
