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Child Having Blurry Near Vision?

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Ugendran (M/14) came for eye examination, glasses made with us last 2years during eye screening were missing quite some time ago. He complained of blurry far vision, when prompted he also complained of sometimes blurry near vision after near work.

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

Examination shows:
R: -0.75 (6/6)
L: -0.75 (6/6)
Add: +1.25 (N5@40cm)

Other assessments show:

Examination of Eye Alignment/Vergence (Cover Test)
orthophoria @Distance
small EP fast recovery @Near
(normal value: orthophoria/NMD-No Movement Detected or small XP small recovery)
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
16cm, 18cm, 20cm
(normal value: less than 7.5cm)

NPC with Relax Add (Convergence – ability of eye to maintain a single clear near image) by RAF rule
9cm, 9cm, 10cm
(normal value: less than 7.5cm)

AA (Accommodation/eye stamina – ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 9cm, 9cm, 10cm
L: 9cm, 9cm, 10cm
(normal value: 8cm for a 14year old)

NRA (Accommodation analysis – ability to relax accommodation)
+1.50
(normal value: +1.50 to +2.50)

PRA (Accommodation analysis – ability to stimulate accommodation)
-0.50
(normal value: -1.37 to -3.37)

MEM (to measure Accommodation response seeing near target)
R: +1.00
L: +1.00
(normal value: +0.25 to +0.75)

From the result, we know that Ugendran has:

  1. PRA is very low – he has difficulty in stimulating focusing/accommodation
  2. Receded NPC as NPC decreases gradually with repeated testing or repeated near work
  3. Reduced Eye Stamina/AA – he is expected to see up to 8cm before he reports blurry but he reported blurry at 9 or 10cm already
  4. Reduced accommodation & convergence causes high lag/MEM +1.00

Ugendran has shortsighted power of 075 in both eyes. With his disabling near task and on top of his focusing reserve/threshold is low, he is prescribed Relax Add to help support seeing near, otherwise he will have blurry near vision or headache when he starts online learning classes.

Our management for Ugendran:

  1. to wear the glasses full-time for 4-6weeks
  2. to repeat assessments for Accommodation & Convergence
  3. to strengthen/improve his accommodation/focusing or convergence ability by vision therapy/eye exercises

Ugendran likes all-black plastic flexible frame of Penada to pair with Kodak Kids for him to have clear & comfortable vision seeing far to seeing near.

Happy to know that Ugendran is wearing his glasses now, Wendy?

Thank you Wendy & Ugendran for your trust & support!?