Asyiqatul

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Syiqa (F/19) datang untuk pemeriksaan mata, mengadu kabur tengok jauh kebelakangan ini.. tengok dekat okay. Beliau tak pernah pakai cermin mata.

Vision without glasses
R: 6/12
L: 6/12

Examination shows:
R: -0.75 (6/6)
L: -0.50 (6/6) L>R [L: dominant left eye]
Near: L>R (adding +0.25 in OD: R=L)

Other assessments show:

Cover Test
Distance: NMD
Near: NMD

Howell Card
Distance: 0 – 2 XP 
Near: 2 XP 
+1.00 Near: 6 XP
-1.00 Near: 2 XP
+2.00 Near: 6 XP
-2.00 Near: 2 XP 

NRA
+1.75 

PRA
-4.75

NPC
LE deviates @7cm x3

AA
R: 15.5D, 15.5D, 15.5D (blur @end of RAF rule, clear @30cm)
L: 15.5D, 14.5D, 14D  (blur @end of RAF rule, clear @30cm)

Accommodation Facility (+/- 2.00) 
BE: 9 cpm, difficult plus lens
R: 12 cpm, difficult plus lens
L: 11 cpm, difficult minus lens

MEM
R: PL
L: +0.50

Modified
R: -0.50
L: -0.50

Fusional Reserves
Near, NFV: x/12/8
Near, PFV: x/25/16
Distance, NFV: x/12/8
Distance, PFV: x/20/16

Vergence Facility
Near: 2 cpm (double BO)
Distance: 5 cpm (slow BO)

NPC (with L: -0.25, R: -0.50)
LE deviates @7cm x3

NPC (with L: PL, R: -0.50)
8/10cm, 8/10cm, 10/12cm, 10/12cm, 12/14cm, 12/14cm

Interpupillary distance, IPD = 6.3cm

Prescribe Rx? To be worn during class – only if necessary? VT?
We reinforce proper visual hygiene.

Adalah amat penting untuk kita ambil rehat antara kerja dekat – jom ikut peraturan 20-20-20 (setiap 20minit tengok dekat, alihkan pandangan tengok jauh jauh 20kaki.. selama 20saat) untuk relekkan mata.

NOTES

Vision without glasses
6/6 – smallest testing line
6/7.5 – 2nd smallest line
6/9 – 3rd smallest line
6/12 – 4th smallest line
6/15 – 5th
6/18 – 6th
6/21 – 7th
6/24 – 8th

Examination of Eye Alignment
Cover Test, CT @ Distance & Near
– NMD(No Movement Detected) or
– small XP, fast recovery
EP = Esophoria is misalignment of eye, eye is deviated inwards
XP = Exophoria is misalignment of eye, eye is deviated outwards
ACT: alternating CT

Examination of Eye Alignment
(Maddox Rod) placed on RE

Examination of Eye Posture
(Howell Card) by 6^ BD OD
Distance:
– 0-3 XP (blue part) or
– 0-1 EP (yellow part)
Near:
– 0-6 XP (blue part)

Accommodation/Focusing analysis – ability to relax
NRA
+1.50 to +2.50

Accommodation/Focusing analysis – ability to focus
PRA
-1.37 to -3.37

Convergence, NPC – ability of eye to maintain a single clear near image (RAF rule)
Break/Recovery – within 10cm or TTN(to the nose)

AA(Amplitude Accommodation) – eye stamina (Dioptre, D) (RAF rule)
6yo – 16.5D | 6cm
9yo – 15.5D | 6.5cm
12yo – 14.5D | 7cm
15yo – 13.5D | 7.5cm
18yo – 12.5D | 8cm
21yo – 11.5D | 9cm
24yo – 10.5D | 10cm
27yo – 9.5D | 11cm
30yo – 8.5D | 12cm

MEM(Monocular Estimation Method) – measure accommodation response seeing near target
+0.25 to +0.75 (with movement)

Accommodation Facility – ability to change focus: far to near or near to far) by Flipper +/- 2.00
Monocular: 6cpm – 16cpm
Binocular: 4cpm – 14cpm
(1 cycle per minute, cpm = 2 words)

Fusional Reserves –
Convergent/Divergent reserve stamina (Prism Bar)
Blur/Break/Recovery
Children 7-12yo
Near, BO/PFV: x/15-31/10-22
Near, BI/NFV: x/7-17/3-11
Adult
Near, BO/PFV: x/10-28/7-21
Near, BI/NFV: x/7-19/5-15
Distance, BO/PFV: x/4-18/5-9
Distance, BI/NFV: x/4-10/2-6

Vergence Facility  – ability to make rapid repetitive vergence changes (Prism Flipper 12BO & 3BI)
Distance: 12-18 cpm
Near: 12-18 cpm)
(1 cycle = 2 times clearing target)

Random Dot 3S – 3D Vision/Stereopsis 
12.5″

Worth 4 Dots – Binocular Perception
4 dots/lights