Cyrus (M/27) Eris’s brother came for eye examination to change a new pair of glasses.
Vision without glasses
R: 6/9+
L: 6/45-
Vision with existing glasses of few years
R: -1.50/-0.25×20 (6/6)
L: -3.50 (6/6-)
Examination shows:
R: -0.75 (6/6) [R: dominant right eye]
L: -2.75/-0.25×180 (6/6)
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: 2 XP (blue part)
Near: 4 – 6 XP (blue part)
+1.00 Near: 8 – 10 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
NRA (Accommodation analysis – ability to relax accommodation) by plus lens
+1.50
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-0.50
(normal value: -1.37 to -3.37)
Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Distance, Base-In/Divergent, NFV: 10/x/x
Distance, Base-Out/Convergent, PFV: 6/8/2
(normal value: Blur/Break/Recovery)
Distance, PFV: x/4-18/5-9
Distance, NFV: x/4-10/2-6
Near, PFV: 16/10-28/7-21
Near, NFV: 13/7-19/5-15
[Scheiman – Adult Data]
Cyrus has anisometropia, a condition in which there is a power difference of 200 between both eyes. The power of his own glasses is much higher. Most of us may tolerate some over power as the lens inside our eyes can exert & relax focusing like the focusing of a camera. However, higher power may cause our vision to be uncomfortably sharp & bright.. on top of easily causing eye fatigue during near work.. not to mention on prolonged near work. It can also exhaust our eye stamina unnecessarily with the higher power. Thus, we see his PRA is very low.
Increasing visual needs on near task has placed a profound emphasis, more than ever.. in having a comfortable near power while using our digital devices. It is far from only being able to see, but it ultimately extends to the comfort…… whether or not it can last us til the end of the day… every day.
Hearing about Zoom fatigue is not a new thing anymore. Therefore, it is certainly the right time to address the issue.. are you comfortable looking at your laptop/computer? Only we know ourselves best.
Normally, we would want you to wear optimum power for at least a few months for eyes to regulate back accommodation & convergence.. this is the first step. Based on your chief complaint (the most important thing that kick starts & guides our detective checking), should initial result show defective findings & if binocular vision anomaly is suspected, we will do a full binocular vision(BV) workout again. We need to match your complaint with our findings.. and they must tally in order to determine the root cause of your complaint:
- visual complaint @ far or near?
- accommodation or convergence? being in excess or insufficiency?
- some conditions may present in combination.. as they are the two pillars in support of each other
- esophoria or exophoria?
We will need to test only we can tell and subsequently address them accordingly. Follow-up assessments & feedback, compliance in doing the vision therapy(VT) & motivation are the important factors to a successful management in alleviating to solving your complaint.
We let him wear the optimum power and we will see him in 6 months.