Jamie N (F/29) came for eye examination, vision with existing glasses is blurry seeing far2 away. She reported having headache with near work sometimes, about twice a week. She will wear contact lens when she goes out & she finds her right vision is blurry with contact lens. She reported that her power keeps increasing with each spec change… about 0.50 every 2years.
Vision without glasses
R: xguess 6/60 (w/ squinting : 6/60-)
L: xguess 6/60 (w/ squinting : 6/60+)
Vision with existing glasses of 2yrs
R: -5.50/-0.75×175 (6/7.5- 6/6-)
L: -5.00/-1.00×170 (6/6)
Existing contact lens (monthly)
R: -5.00
L: -5.00
Examination shows:
R: -5.75/-0.25×175 (6/6) (+1.00: 6/7.5-) (R: dominant eye)
L: -5.25/-0.25×170 (6/6) (+1.00: 6/9-)
Other assessments show:
Cover Test
Distance: NMD
Near: small XP, fast recovery
Howell Card (6BD on OD)
Distance: 0
Near: 4 – 6 XP
+1.00 Near: 2 – 4 XP
-1.00 Near: 2 XP
NRA
+2.75
PRA
-3.00
NPC (RAF rule)
TTN, TTN, TTN, TTN, TTN
AA (RAF rule)
R: 15yo, 29yo, 20yo, 25yo
L: 29yo, 29yo, 29yo
Accommodation Facility (Flipper +/- 2.00)
BE: difficult minus lens
R: difficult minus lens
L: difficult minus lens
MEM
R: +1.00
L: +1.00
Fusional Reserves (Prism Bar)
Near, NFV: 10/16/14
Near, PFV: 16/25/20
Distance, NFV: x/12/10
Distance, PFV: x/35/30
Vergence Facility (Prism Flipper of 12BO & 3BI)
Near: 7 cpm (slow BO)
Distance: 7 cpm (slow BO)
Slit Lamp Examination
R: vy mild conjunctival injection & corneal neovascularisation
L: vy mild conjunctival injection & corneal neovascularisation
Fluorescein staining
R: vy2 mild staining
L: -ve staining
Prescribe Relax lens
R: -5.75/-0.25×175
L: -5.25/-0.25×170
Add: +0.50
Contact lens biweekly (Acuvue Oasys 8.8)
R: -5.50
L: -5.00
We advise her:
1) to wear glasses more to reduce time of daily contact lens wear
2) to have at least a day off from contact lens every week