23/1/2021
Wei (F/12) came for eye examination, vision with existing single vision glasses of 2years is fine. Mother, Wai Yee reported that she has been on atropine eye drop, prescribed by ophthalmologist to control the progression of short-sightedness for 1year+ & she is still using the eye drop now.
Examination shows:
R: -3.50/-4.25×180 (6/6-)
L: -5.25/-2.25×170 (6/6-)
Other assessments show:
NRA (Accommodation analysis – ability to relax accommodation)
+1.25
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation)
-1.75
(normal value: -1.37 to -3.37)
*Updated
Wei (F/13) came for follow up, vision with existing glasses is fine seeing far & near.
Vision without glasses
R: 6/60-
L: guess 6/120
Vision with existing glasses of 1.5years
R: -3.50/-4.25×180 (6/6-)
L: -5.25/-2.25×175 (6/7.5-)
Examination shows: (Delay Fogging)
R: -3.50/-4.25×180 (6/6-)
L: -5.25/-2.50×175 (6/6) [+1.00 blur lens test: 6/12-] (L: left dominant eye)
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test, CT)
NMD @Distance
(alternating CT: upon covering left eye, patient reported the target goes to her left. when covering right eye, the target goes to her right)
small XP, fast recovery @Near
(alternating CT: upon covering left eye, patient reported the target goes to her left. when covering right eye, the target goes to her right)
(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: 0 – 2 XP (blue part)
Near: 2 – 4 – 6 – 8 XP (blue part)
+1.00 Near: 12 – 14 – 16 XP (blue part)
-1.00 Near: 0 – 2 – 4 XP (blue part)
(normal value: 0-1 EP (yellow part) or 0-3 XP (blue part) @Distance; and 0-6 XP (blue part) @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
+1.25
(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)
MEM – Monocular Estimation Method (Accommodation lag – to measure accommodation response seeing near target)
R: +0.75
L: +0.75 (vertical reflex is seen pointing at 45°, not 90°)
(normal value: +0.25 to +0.75)
AA (Amplitude Accommodation/Focusing – eye stamina/ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 8 YO, 8 YO, 8 YO
L: 8 YO, 8 YO, 8 YO
(normal value: AA goes according to age; YO=years old)
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
TTN, TTN, TTN, TTN, TTN, TTN
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
Accommodation Facility – ability to change focus: far to near or near to far (by Flipper +/-2.00)
BE: 11 cycle per minit(cpm), difficult with minus lens(2nd lens)
R: 10 cycle per minit(cpm), difficult with minus lens(2nd lens) [both eyes see better than with right eye]
L: 13 cycle per minit(cpm), difficult with minus lens(2nd lens) [both eyes see better than with left eye]
(normal value: 1 cycle = 2 words read
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)
Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Near, Base-Out/Convergent, PFV: x/10/6 (break point 12 & 14 – there is another shadow seen on one of the double target)
Near, Base-In/Divergent, NFV: x/14/12
Distance, Base-Out/Convergent, PFV: x/20/18
Distance, Base-In/Divergent, NFV: x/14/12
(normal value: Blur/Break/Recovery)
Near, PFV: 10-28/7-21
Near, NFV: 7-19/5-15
Distance, PFV: 4-18/5-9
Distance, NFV: 4-10/2-6
[Scheiman et al – Adult Data]
Vergence Facility – ability to make rapid repetitive vergence changes (by Prism Flipper of 12Base Out & 3Base In)
Near: 5 cpm (double with Base Out)
Distance: 1 cpm (double with Base Out)
(normal value: 1 cycle = 2 times clearing target
Distance: 12-18 cpm
Near: 12-18 cpm)
Interpupillary distance, IPD = 5.8cm
3D Vision (Random Dot 3S)
12.5″
(normal value: 12.5″)