Elaine L (F/18) came for eye examination, complaining of sometimes blurry near vision and headache with near work. She has not worn any glasses before.
Unaided VA (Vision without glasses)
R: 6/6 (+1.00 blur lens test 6/6-)
L: 6/6 (+1.00 blur lens test 6/6-)
Examination shows: (Delay Fogging)
R: +1.00/-0.25×160 (6/6)
L: +1.00 (6/6)
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance & 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)
-1.25 (normal value: -1.37 to -3.37)
Elaine has longsighted power/hyperopia, power that can be autocorrected by our eye’s focusing system, so her vision is still good achieving vision 6/6. With a blur lens test, she can still see the 6/6 smallest line on testing chart, this indicates that she has uncorrected longsighted power/hyperopia.
Not only her eyes need to autocorrect her hyperopia in order to see far clearly, her eyes also work to autofocus in seeing near. This means eyes need to do double the work. Normally, we are able to autofocus at near effortlessly for everyone below the age of 40. Near vision complaints typically arises when we spend very long hours looking at near without break or a very upclose distance in seeing near continuously (like our previous featured story about Silan), these two are big no no!
Naturally, our eyes have the ability to stimulate focusing and relax focusing same like a camera.. to zoom in and zoom out. We measure these abilities during examination, that we call NRA & PRA like stated above. The normal value tells us how our eyes are supposed to be doing, the examination data gives us a clue how our eyes are really doing that we can use to relate to your complaint.
Some people may have strong accommodation that can withstand the long hours while others start to experience near vision complaints like tired eye, burning eye, blurry near vision, headache. Everyone’s threshold is different, so we troubleshoot based on complaints & history. We will then investigate by carrying out necessary tests to know the issue behind the visual complaint.