Mr Lai (M/34) came for eye examination, with complaint blurry far vision & glaring riding bike especially during rainy days. He has had laser in both eyes due to inherited diabetes.
Vision without glasses
R: 6/15+2 slow
L: 6/12- slow
Examination shows:
R: -0.25/-0.50×180 (6/12) PHNI [R: right dominant eye]
L: -0.25/-0.50×180 (6/7.5-) PHNI
Add: -0.50
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance
small XP, fast recovery @Near
(normal value: orthophoria/NMD-No Movement Detected or small XP, fast recovery)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
Examination of Eye Alignment/Posture (Howell Card) by 6^ Base Down on Right eye
Distance: 0 – 2 XP (blue part)
Near: 10 – 12 XP (blue part)
-1.00 Near: 2 – 4 XP (blue part)
+1.00 Near: 10 – 12 XP (blue part)
(normal value: 0-1 EP or 0-3 XP @Distance; and 0-6 XP @Near)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
8/10cm, 8/10cm, 10/12cm, 12/14cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Near, Base-Out/Convergent, PFV: 8/10/4
Near, Base-In/Divergent, NFV: x/18/14
(normal value: Blur/Break/Recovery)
Near, PFV: x/10-28/7-21
Near, NFV: x/7-19/5-15
Distance, PFV: x/4-18/5-9
Distance, NFV: x/4-10/2-6
[Scheiman – Adult Data]
Vergence Facility – ability to make rapid repetitive vergence changes (by Prism Flipper of 12Base Out & 3Base In)
Near: 7 cpm (difficulty with Base-Out)
Distance: 3 cpm (cannot fuse Base-Out)
(normal value: 1 cycle = 2 times clearing target
Distance: 12-18 cpm
Near: 12-18 cpm)
Interpupillary Distance = 6.7cm