Kak Leela (F/62) datang untuk pemeriksaan mata, penglihatan dengan cermin matanya kabur tengok jauh & dekat sejak 3-4bulan ini. Beliau telah buat pembedahan katarak mata kanan 3tahun lepas & mata kiri 2tahun lepas. Beliau ada frontal sakit kepala belah kiri hingga ke tepi, sakit kepala beliau tak berkaitan dengan tengok dekat.
Vision without glasses
R: 6/24- slow
L: 6/24
Vision with habitual glasses of 2years
R: -0.50/-0.50×55 (6/30)
L: -0.25/-1.75×100 (6/21-)
Add: +2.75
Examination shows:
R: +0.50 (6/24) PHNI
L: -1.00/-0.75×100 (6/18) PHNI
Add: +3.00
Other assessments show:
Colour Vision
R: defect
L: normal
(normal value: normal)
Amsler Chart (assess integrity of macula)
R: all lines are straight (but blurry)
L: some crooked lines (when face turn to right)
(normal value: lines are straight with equal gaps in between lines & no brown/black patch/spot)
Pupil Reflex
R: PERRL, -ve RAPD (pupil very small)
L: PERRL, -ve RAPD (pupil very small)
(normal value: PERRLA, -ve RAPD)
Fluorescein
R: -ve staining
L: -ve staining
Slit Lamp Microscope
R: very mild PCO
L: very mild PCO