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JULIATI BT HASHIM

Juli (F/48) datang untuk pemeriksaan mata, mengadu sangat silau semasa memandu pada waktu malam terutamanya kalau tak ada lampu jalan. Penglihatan dalam keadaaan terang (pagi/petang) masih okay. Bila hadap hp/Ipad pun, tak tahan tengok lama.. bila kejar movie, akak mesti kena ambil rehat lepas rasa mata penat. Masa akak muda lagi, beliau pakai contact lens.. umur 20-an okay saje, tapi bila masuk 30-an, beliau mula dah tak boleh pakai contact lens.. ingatkan multipurpose solution yang tak ngam dengan mata. Akak perasan skrin hp nampak gelembung/berombak.

Vision without glasses
R: 6/60-1
L: 6/60-2

Vision with existing glasses
R: -3.50/-0.50×45 (6/6-)
L: -3.50/-0.50×125 (6/6-)
Add: +2.00

Examination shows: (Delay Fogging)
R: -3.25/-0.25×90 (6/6) [+1.00 blur lens test: 6/9-]
L: -3.50/-0.25×100 (6/6) [+1.00 blur lens test: 6/9-] (L: left dominant eye) L>R
Add: +2.00 (N5@40cm) (range of clear vision, ROCV: 30cm – 40cm)

Other assessments show:

Examination of Eye Alignment/Vergence (Cover Test, CT)
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
Near: 4 – 6 XP -> 2 – 4 XP -> 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
+0.25
(normal value: +1.50 to +2.50)

PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens 
-0.50
(normal value: -1.37 to -3.37)

NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
16/24cm, 16/24cm, 16/24cm, 16/24cm, 16/24cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)

Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Near, Base-Out/Convergent, PFV: x/10/2
Near, Base-In/Divergent, NFV: x/25/20
Distance, Base-In/Divergent, NFV: x/14/12
Distance, Base-Out/Convergent, PFV: x/16/10
(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 et al – Adult Data]

Vergence Facility – ability to make rapid repetitive vergence changes (by Prism Flipper of 12Base Out & 3Base In)
Near: 0 cpm (double with Base Out)
Distance: 0 cpm (double with Base Out)
(normal value: 1 cycle = 2 times clearing target
Distance: 12-18 cpm
Near: 12-18 cpm)

Near tests are done with Add.

Interpupillary distance, IPD = 6.4cm

Modified
R: -3.75 (6/6)
L: -3.75 (6/6)
Add: +2.00