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Head Tilt?

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Mr Tan (M/47) came for eye examination complaining blurry far & near vision and he said he notices that he sees double vision on left superotemporally.

Examination showed:
R: +0.50/-0.50×20 (6/6)
L: +0.25/-1.00×20 (6/6)
Add: +1.50 (N5@40cm)

Mr Tan reported that 6/6 line of distance vision is not sharply clear. And he is observed to have slight head tilt.

Examination of eye alignment (by Prism Cover Test)
Far vision : Left eye 1-2 Base Out

Examination of eye alignment (by Howell Card)
Far vision : 1-3 EP
Near vision: Orthophoria

EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
The normal magnitude of misalignment for far vision (within normal range) is 0-2XP and for near vision is 0-6XP.

For his far vision, he does have slight misalignment that is out of normal range, hence having adopted a slight head tilt in order to naturally compensate the misalignment of his eye, to avoid seeing double vision.

Mr Tan has not worn any glasses before, so he has opted for a pair of reading glasses, and he has no issue on his near vision.

We will continue to monitor on his far vision.

Thank you Mr Tan for your trust & support!?