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Elderly Parents Can See Far Vision Better Without Glasses Now?

Mr Leow (M/82) came for eye examination, with complaint of blurry far vision with existing glasses of many2 years ago.. he realises that he can far better removing his glasses.

Vision without glasses
R: 6/12
L: 6/12

Existing Glasses (lenses have been refitted to new frame previously)
R: +2.50/-1.25×70  
L: +1.50
Add: +2.50

Subjective Refraction
R: +1.00/-0.50×90 (6/7.5-) PHNI
L: +0.75 (6/7.5-) PHNI
Add: +2.50

Other assessments show:

Cover Test
Distance: NMD
Near: small XP, fast recovery

Worth 4 Dots
Distance: 4 dots
Near: 4 dots

Pupil Reflex
R: -RAPD
L: -RAPD

Colour Vision
R: normal
L: normal

Amsler Grid
R: a few crooked lines
L: some crooked lines

Slit Lamp
R: cataract
L: cataract

Fluorescein
R: -ve staining
L: -ve staining

Right eye
Left eye

Elderly parents may tell us that they can see far better & they do not need their glasses for far vision anymore. This is usually a temporary phase due to changes in the lens inside their eyes.

We refer to see eye specialist doctor/ophthalmologist.

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Separately…

Ivin’s mum (F/66) came for eye examination, she also reported seeing far vision better removing her glasses & she does not need glasses for far vision now.

Existing Glasses of 5years
R: +1.25/-0.50×90  
L: +1.00
Add: +2.50

Subjective Refraction
R: +0.50 (6/7.5-) PHNI
L: +0.50 (6/7.5-) PHNI
Add: +2.50

Other assessments show:

Cover Test
Distance: NMD
Near: small XP, fast recovery

Worth 4 Dots
Distance: 4 dots
Near: 4 dots

Pupil Reflex
R: -RAPD
L: -RAPD

Colour Vision
R: normal
L: normal

Slit Lamp
R: cataract
L: cataract

Fluorescein
R: -ve staining
L: -ve staining

Right eye
Left eye

We refer Ivin’s mum to see eye specialist doctor/ophthalmologist for cataract surgery.

Notes

Vision without glasses
6/6 – smallest testing line
6/7.5 – 2nd smallest line
6/9 – 3rd smallest line
6/12 – 4th smallest line
6/15 – 5th
6/18 – 6th
6/21 – 7th
6/24 – 8th

Examination of Eye Alignment
Cover Test, CT @ Distance & Near
– NMD(No Movement Detected) or
– small XP, fast recovery
EP = Esophoria is misalignment of eye, eye is deviated inwards
XP = Exophoria is misalignment of eye, eye is deviated outwards
ACT: alternating CT

Examination of Eye Alignment
(Maddox Rod) placed on RE

Examination of Eye Posture
(Howell Card) by 6^ BD OD
Distance:
– 0-3 XP (blue part) or
– 0-1 EP (yellow part)
Near:
– 0-6 XP (blue part)

Accommodation/Focusing analysis – ability to relax
NRA
+1.50 to +2.50

Accommodation/Focusing analysis – ability to focus
PRA
-1.37 to -3.37

Convergence, NPC – ability of eye to maintain a single clear near image (RAF rule)
Break/Recovery – within 10cm or TTN(to the nose)

AA(Amplitude Accommodation) – eye stamina (Dioptre, D) (RAF rule)
6yo – 16.5D | 6cm
9yo – 15.5D | 6.5cm
12yo – 14.5D | 7cm
15yo – 13.5D | 7.5cm
18yo – 12.5D | 8cm
21yo – 11.5D | 9cm
24yo – 10.5D | 10cm
27yo – 9.5D | 11cm
30yo – 8.5D | 12cm

MEM(Monocular Estimation Method) – measure accommodation response seeing near target
+0.25 to +0.75 (with movement)

Accommodation Facility – ability to change focus: far to near or near to far) by Flipper +/- 2.00
Monocular: 6cpm – 16cpm
Binocular: 4cpm – 14cpm
(1 cycle per minute, cpm = 2 words)

Fusional Reserves –
Convergent/Divergent reserve stamina (Prism Bar)
Blur/Break/Recovery
Children 7-12yo
Near, BO/PFV: x/15-31/10-22
Near, BI/NFV: x/7-17/3-11
Adult
Near, BO/PFV: x/10-28/7-21
Near, BI/NFV: x/7-19/5-15
Distance, BO/PFV: x/4-18/5-9
Distance, BI/NFV: x/4-10/2-6

Vergence Facility  – ability to make rapid repetitive vergence changes (Prism Flipper 12BO & 3BI)
Distance: 12-18 cpm
Near: 12-18 cpm)
(1 cycle = 2 times clearing target)

Random Dot 3S – 3D Vision/Stereopsis 
12.5″

Worth 4 Dots – Binocular Perception 4 dots