Mr Chong (F/55) came for eye examination, with complaint of tired eyes despite spending very little time on phone. He uses a pair of reading glasses.
Vision without glasses
R: 6/12
L: 6/6-
Examination shows: (Delay Fogging)
R: +1.25/-0.50×75 (6/6) [+1.00 blur lens test: 6/7.5+]
L: +0.25 (6/6) [+1.00 blur lens test: 6/9] (L: left dominant eye) L>R
Add: +2.00
Adding +0.25 in right eye, patient feels uncomfortable
No further hyperopia/long-sightedness is accepted binocularly
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test, CT)
NMD @Distance
(alternating CT: upon covering left eye, patient reported the target goes to his right.. when covering right eye, the target goes to his left)
small XP, fast recovery @Near
(alternating CT: upon covering left eye, patient reported the target goes to his left.. when covering right eye, the target goes to his right)
(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: 3 – 5 EP (yellow part)
Near: 2 – 4 XP (blue part)
+1.00 Near: 4 – 6 XP (blue part)
(normal value: 0-1 EP (yellow part) or 0-3 XP (blue part) @Distance; and 0-6 XP (blue part) @Near)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
NRA (Accommodation analysis – ability to relax accommodation) by plus lens
+0.50
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-1.00
(normal value: -1.37 to -3.37)
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
8/12cm, 10/12cm, 12/16cm, 14/16cm, 12/16cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Distance, Base-Out/Convergent, PFV: x/x/x
Distance, Base-In/Divergent, NFV: x/12/10
Near, Base-In/Divergent, NFV: x/6/4
Near, Base-Out/Convergent, PFV: x/20/18
(normal value: Blur/Break/Recovery)
Near, PFV: 10-28/7-21
Near, NFV: 7-19/5-15
Distance, PFV: 4-18/5-9
Distance, NFV: 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: 2 cpm (double with Base-Out.. then double with Base-In too)
Distance: 2 cpm (double with Base-In)
(normal value: 1 cycle = 2 times clearing target
Distance: 12-18 cpm
Near: 12-18 cpm)
Mr Chong has quite some esophoria at far. He also has significant hyperopia/long-sightedness in right eye. We asked if his eye fatigue comes after near task or far task, he said that he feels very tired especially after a long drive. On whether or not he sees any double vision when driving, he reported no double vision seen.
Wearing optimum power is all you need to put your eyes at rest, keeping your eyes sparklingly fresh.. simply by having your power corrected.. be it by glasses or contact lens. Or take a rest intermittently after feeling tired. You decide what is best for you & your lifestyle.