Dchainee (F/19) came for eye examination, with complaint of headache with laptop work, especially worse recently.. it gets better after taking a nap. Seeing hp/paperwork is fine though. She has not worn any glasses before.
Vision without glasses
R: 6/6 (+1.75 blur lens test 6/9+)
L: 6/6 (+1.50 blur lens test 6/9+)
Examination shows: Retinoscopy & WD lens Delay Fogging
R: +1.00/-0.50×60 (6/6) (+1.00 blur lens test 6/9+)
L: +0.75/-0.25×45 (6/6) (+1.00 blur lens test 6/9+) [L: left dominant eye] L>R
Near: R>L
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 8^ Base Down on Right eye
Distance: 0 – 2 XP (blue part)
Near: 4 – 6 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
+1.75
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-1.75
(normal value: -1.37 to -3.37)
MEM (Accommodation lag – to measure accommodation response seeing near target)
R: +0.25
L: +0.25
(normal value: +0.25 to +0.75)
Facility (Accommodation facility – ability to change focus: far to near or near to far) by Flipper +/- 1.50
BE: 16 cycle per minit(cpm), difficult with minus lens (2nd lens)
R: 12 cycle per minit(cpm), difficult with minus lens(2nd lens)
L: 16 cycle per minit(cpm), difficult with minus lens(2nd lens)
* cannot clear +2.00 flipper
(normal value: 1 cycle = 2 words read
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)
Examination of Eye Muscles (Motility, EOM)
– pain reported on dextro depression (7 o’clock)
Dchainee has some longsightedness/hyperopia/plus power.. upon +1.00 blur lens test, she can still see 6/6 smallest line. This indicates that she has hyperopia.. normally uncorrected hyperopia will cause you to have tired eyes on prolonged near work. She also has oblique astigmatism in which Axis of astigmatism lies between 30-60 or 120-150.. and her right eye is on Axis 60, left eye is on Axis 45. Any amount of oblique astigmatism needs to be corrected for comfortable vision, especially on computer/laptop.. hence her complaint.
We prescribe her glasses for full-time wear.. for comfortable vision all day long. If you are just out jalan2 cari makan or shopping, probably you can do without your glasses.. when no near visual task is required on you. Otherwise, give the little support our eyes need (by wearing your glasses as advised), our eyes do not ask much from us & they will in turn give all out when we need them the most during our last min deadline? we all had that hehe
Our eyes deserve more than that, and they never ask. Let us all sayang our eyes more & more each day!