WYee (F/38) came with complaints of headache with existing glasses recently, no headache with contact lens wear. She is full-time contact lens wearer.
Unaided Vision
R: 6/45
L: 6/60- 6/45-
Existing glasses of >5years
R: -5.25/-0.50×150 (6/6)
L: -5.00/-0.50×180 (6/6)
Examination shows:
R: -4.75/-0.25×160 (6/6) (+1.00 blur lens test 6/12)
L: -4.75/-0.25×180 (6/6) (+1.00 blur lens test 6/7.5-) [L: left dominant eye]
Other assessments show:
Cover Test, CT
Distance: NMD
Near: small EP, fast recovery
Howell Card (6BD on OD)
Distance: 1 – 3 EP
Near: 0 – 1 EP
+1.00 Near: 0 – 1 EP
-1.00 Near: 9 EP
+2.00 Near: 2 XP
-2.00 Near: 17 EP
Modified
R: -4.50/-0.25×160
L: -4.50/-0.25×180
Howell Card (6BD on OD)
Distance: 0 – 1 EP
Near: 1 – 3 EP
NPC (RAF rule)
TTN, TTN, 6/8cm, 6/8cm, 6/8cm, 6/8cm
NRA
+3.75 (mono occlusion: OD blur, OS blur)
PRA
-2.25 (mono occlusion: OD clear, OS blur)
AA (RAF rule)
R: 30 YO, 30 YO, 30 YO
L: 33 YO, 35 YO, 36 YO
Accommodation Facility (Flipper +/-1.50) [target 20/40 words]
BE: 16 cpm, difficult minus lens
R: 15 cpm, difficult minus lens
L: 15 cpm, difficult minus lens
MEM
R: +0.50
L: +1.00
Fusional Reserves (Prism Bar)
Near, NFV: x/16/14
Near, PFV: x/35/20
Distance, NFV: x/12/10
Distance, PFV: x/30/20
Vergence Facility (Prism Flipper of 12BO & 3BI)
Near: 8 cpm (slow BO & BI)
Distance: 9 cpm (slow BO & BI)
Trial framing
R: -4.50/-0.25×160
L: -4.50/-0.25×180
