Abi (F/20) came for eye examination complaining headache at back of head & pulling sensation in left eye after near work since recently. She uses a lot of laptop. Her mother is worried for the constant headache on her daughter as Abi will go back to college in October.
* History taking / complaint asked during the beginning of eye examination is very important as we will conduct certain necessary eye tests to investigate your complaint
Vision with own glasses
R: -2.00/-1.25×5 (6/6)
L: PL/-3.50×175 (6/6-)
Examination shows:
R: -2.00/-1.25×5 (6/6) [+1.00 test: 6/12+1] (R: dominant right eye)
L: PL/-3.50×175 (6/6-), [+1.00 test: 6/12]
Left non-dominant eye sees far better
Relax add is not favoured
Near power
R: -1.50/-1.25×5
L: +0.25/-3.50×175
Left non-dominant eye sees near better
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance
NMD @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
NRA (accommodation analysis – ability to relax accommodation)
+1.25
(normal value: +1.50 to +2.50)
PRA (accommodation analysis – ability to stimulate accommodation)
-3.25
(normal value: -1.37 to -3.37)
Examination of Eye Alignment (Howell Card)
Distance: 0
Near: 0
(normal value: 1 EP-0 or 0-3 XP @Distance & 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
One eye is in charge of our far vision, namely the dominant eye. Another eye is in charge of our near vision, namely the non-dominant eye. Generally, we will want the dominant eye to see far vision better while the non-dominant eye to see near vision better. However, in event if an eye has any pathological condition/eye disease, this eye dominancy does not apply.
On top of that, Abi has anisometropia(difference power of 200 between two eyes) with very high astigmatism in one eye.
Normally, we use digital devices for prolonged period of time and for those who experience headache with near work, we will ascertain:
- power of glasses is optimum
- we will let you compare with & without relax power – whether it is more comfortable in seeing near – if so, Relax glasses can be prescribed
- alternatively, we may prescribe relax reading glasses specifically just for your near work.. it will help to regulate & stabilise your accommodation/focusing in supporting seeing near.. to see if your headache subsides
- if relax add is not favoured & relax reading power does not work, we will refer you to eye specialist centre to do a cycloplegic refraction (to put eye drop to temporarily paralyse/relax your eye muscles)
- if all else fail & you may visit a doctor to have further examination
You may choose the option that you are comfortable.
Some people are fine using digital devices for long time, while some people present with symptoms of headache, blurry near vision.. as the status of our eyes are different from one another. Some may have very good eye stamina/focusing & convergence that they can withstand very long hours seeing near with no symptoms at all.. and vice versa.
Abi reported that she feels better without relax add. So, we have prescribed a pair relax reading glasses of near power for Abi.. we will see her in 1month.