Jin (F/25) came for eye examination, own glasses were broken. She uses computer a lot every day.
Vision without glasses
R: 6/18
L: 6/21
Vision with existing glasses of 1+ year
R: -2.25 (6/6)
L: -3.00 (6/6)
Examination shows:
R: -2.25 (6/6) R>L [R: dominant right eye]
L: -2.25 (6/6)
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
small XP, fast recovery @ 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: 4 – 6 XP (blue part)
Near: 2 – 4 XP (blue part)
(normal value: 0-1 EP or 0-3 XP @Distance and 0-6 XP @Near)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
7cm, 7cm, 7cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
Left eye turns in a lot when fixating nearer
Jin has some overpower in her own glasses. When she first got her glasses, she recalled feeling strain wearing them. But after a while, she was okay. For those who do a lot of near work, their non-dominant eye will tend to want higher power.. as non-dominant eye takes charge of our near vision (and dominant eye takes charge of far vision). Continuous looking at near can cause non-dominant eye wanting higher power during examination.
Jin’s eye posture shows some exophoria at far. It is not sure the exophoric position is induced due to the overpower or the eye is exophoric on its own. Also, her vision without glasses does not seem to match with her new power. Normally, when we try to bring down the power, it is usually about -0.50 to -0.75 & rarely go beyond that, more often in one eye at a time, depending on your response – how your eyes accepting the power reduction.
Imagine eyes have gotten used to working along the power for years, and sudden big changes would disrupt the eye systems & it will be difficult to adapt. Like how we are used to the way we work, sudden change would terrify us too.. wouldn’t it?
First step is to let her wear the updated power for a few months and recheck. If she is a contact lens wearer, we can update her power slowly (for big power changes) as we go along. But, she is not.
Therefore, it is absolutely crucial to have your eye examination regularly, any distress of the eye can be detected & rectify earliest possible.
Jini, your spare spec is still with aunty?