JLe (M/21) came for eye examination, vision with existing glasses of 1year is fine seeing far & near. He told us that he will hold very close to see near.. but he seldom uses his phone.. mostly watch TV. He works in a factory.
Vision without glasses
R: 6/60- (better)
L: 6/60-
Existing glasses of 1 year of IPD 32/34
R: -3.75/-0.50×165 (6/7.5-)
L: -3.25 (6/15-)
Examination shows:
R: -4.00/-0.75×135 (6/6) [+1.00 blur lens test: 6/12] (R: right dominant eye)
L: -4.00/-0.50×45 (6/6) [+1.00 blur lens test: 6/12] L>R {adding +0.75 on left eye R>L}
Near: L>R
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance
small XP, fast recovery @Near
(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: 0 – 2 XP (blue part)
+1.00 Near: 0 – 2 XP (blue part)
-1.00 Near: 0 – 2 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
+2.00
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-1.75
(normal value: -1.37 to -3.37)
MEM – Monocular Estimation Method (Accommodation lag – to measure accommodation response seeing near target)
R: +0.25
L: +0.50
(normal value: +0.25 to +0.75)
Accommodation Facility – ability to change focus: far to near or near to far (by Flipper +/-2.00)
BE: 10 cycle per minit(cpm), difficult with minus lens(2nd lens)
R: 6 cycle per minit(cpm), difficult with minus lens(2nd lens) [both eyes see better than with right eye]
L: 11 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: 25/35/30
Near, Base-In/Divergent, NFV: 20/35/30
Distance, Base-Out/Convergent, PFV: 18/x/x
Distance, Base-In/Divergent, NFV: 12/x/x
(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 – Adult Data]
Vergence Facility – ability to make rapid repetitive vergence changes (by Prism Flipper of 12Base Out & 3Base In)
Near: 6 cpm (difficult Base-Out)
Distance: 11 cpm
(normal value: 1 cycle = 2 times clearing target
Distance: 12-18 cpm
Near: 12-18 cpm)
AA (Amplitude Accommodation/Focusing – eye stamina/ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 18 YO, 18 YO, 18 YO
L: 18 YO, 18 YO, 18 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)
3D Vision (Random Dot 3S)
12.5 (slow)
(normal value: 12.5″)
Modified
R: -4.00/-0.50×135
L: -4.00/-0.25×45
Interpupillary Distance = 7.0cm (IPD 35/35)
Fluorescein test shows staining.. we advise for non-preserved artificial tears (gel).