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Headache & Eye Pain? *UpdatedA

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22/5/2021

Mr Kumaresan (M/51) previously came & complained of headache, dizziness, left eye pain & difficulty sleeping at night since 7-8 months ago. He has hypertension and on medication with no history of trauma reported.

We referred him and he has gone to see eye specialist doctor/ophthalmologist & was warded for a few days last month. He was told that he has a mild eye stroke.

Unaided/vision without glasses:
R: 6/6-
L: 6/15- double

Examination shows:
R: +0.50/-0.50×120 (6/6)
L: +1.50/-0.75×25 (6/6)
Add: +2.00 (N5@40cm)
With both eyes, double vision reported sometimes after eyes are closed & then open

Other assessments show:

Colour Vision
normal

Pupil Reflex
PERRLA, -RAPD

Examination of Eye Alignment (Cover Test)
Distance: alternating exotropia
Near: alternating exotropia
(normal value: Orthophoria/NMD-no movement detected or small movement detected)

Cover Test @Distance

Eye Pain? – 88 Optometry

*UpdatedA

Mr Kumaresan (M/52) came for follow up, he recently lost his glasses. He mentioned that he also went to his eye appointment & was prescribed medication for hypertension, blood thinner, high cholesterol & heart. He did not start taking the medication prescribed previously. His next appointment is in October.

Vision without glasses
R: 6/7.5+
L: 6/12- slow

Subjective Refraction
R: +0.50/-0.25×120 (6/6) R>L
L: +1.25/-0.50×25 (6/6)
Add: +2.00 R>L (good ROCV)

Other assessments show:

Colour Vision
R: normal
L: normal

3D Vision (Random Dot 3S)
40″
3D Vision (Titmus Fly)
20″

Cover Test
Distance: alternating exotropia
Near: alternating exotropia

Howell Card
Distance: 0
Near: 0
-1.00 Near: 0

NRA 
+1.00

PRA 
-0.25

MEM
R: +0.25
L: +0.25

Fusional Reserves (with control)
Near, NFV: 16/18/12
Near, PFV: x/6/2
Distance, NFV: x/10/6
Distance, PFV: x/8/6

Vergence Facility 
Near: 3 cpm (double BO)
Distance: 2 cpm (double BO)

Interpupillary distance, IPD = 6.7cm

We ask Mr Kumaresan whether or not he knows that his eyes can turn out alternatingly, he said yes & he is able to bring his eyes back in. He started to realise his eyes turning out, more on his left eye.. about 8years ago. He normally can see his phone for about 10minutes only.. before his near vision becomes blurry & completely whitish.. and by then, he will stop seeing his phone.

We prescribe Dot Card eye exercise.. see whether or not he is willing to put in some effort to do it.

We will see him back after his eye appointment.