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Headache Goes Away Wearing Glasses?

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Manjula (F/31) came for eye examination, vision with existing glasses made with us, is fine seeing far & near. She usually wears her glasses for driving & computer only. She had a bad headache few weeks ago, and she tried wearing her glasses longer time, eventually headache was gone.

Vision without glasses
R: 6/21 (better)
L: 6/24-

Existing glasses of 2+ years
R: -1.00/-1.00×100 (6/6)
L: -1.00/-0.75×90 (6/6)

Subjective Refraction
R: -1.00/-0.75×100 (6/6) (+1.00 blur lens test: 6/9-)
L: -1.00/-0.75×90 (6/6) (+1.00 blur lens test: 6/9-) L>R
Near: R>L
Vision is better wearing glasses seeing near.

Other assessments show:

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

Howell Card
Distance: 3 EP
Near: 4 XP
+1.00 Near: 6 XP
-1.00 Near: 4 XP
+2.00 Near: 8 XP
-2.00 Near: 2 XP

(blurry mono & bino)


TTN, TTN, TTN, TTN, RE deviates @8cm

R: 75D, 7.5D, 7.5D
L: 7.5D, 7.5D, 7.5D

Accommodation Facility (+/- 1.50)Β 
BE: 11 cpm, difficult minus lens
R: 11 cpm, difficult minus lens
L: 12 cpm, difficult minus lens R: +0.50
(very blurry with -2.00, take a while to see clearly with +2.00)

R: +0.50
L: +0.50

Fusional Reserves
Near, PFV: 6/14/10
Near, NFV: 12/16/12
Distance, PFV: x/12/8
Distance, NFV: x/18/16

Vergence Facility
Near: 0 cpm (double BO)
Distance: 1 cpm (double BO)

L: -ve staining
L: -ve staining

Interpupillary distance, IPD = 6.6cm

Happy birthday Manjula!πŸŽ‚πŸ˜Š


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 Posture
(Howell Card) by 6^ BD OD
– 0-3 XP (blue part) or
– 0-1 EP (yellow part)
– 0-6 XP (blue part)

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

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

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

AA(Amplitude Accommodation) β€“ 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) β€“ measure accommodation response seeing near target
+0.25 to +0.75 (with movement)

Accommodation Facility β€“ 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 β€“
Convergent/Divergent reserve stamina (Prism Bar)
Children 7-12yo
Near, BO/PFV: x/15-31/10-22
Near, BI/NFV: x/7-17/3-11
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  β€“ 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  β€“ 3D Vision