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KOMALARANI NEHRU

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Komala (F/16) came for eye examination, with complaint of tired eyes with near work.

Vision without glasses
R: 6/24-, 6/21-
L: 6/9-, 6/7.5-3, 6/6-

Vision with glasses
R: -1.25/-0.50×180 (6/6)
L: PL/-0.50×180 (6/6)

Examination shows: 
R: -1.25/-0.50×180 (6/6) (+1.00 blur lens test 6/12-) [R: right dominant eye] L>R
L: +0.25/-0.75×180 (6/6) (+1.00 blur lens test 6/9-)
Add: +0.75
Adding shortsightedness 025 in right eye R>L, but not added

Other assessments show:

Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance
NMD @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 – 1 EP (yellow part) 
Near: 0 – 2 XP (blue part)
+1.00 Near: 0 – 2 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

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
-1.25
(normal value: -1.37 to -3.37)

MEM (Accommodation lag – to measure accommodation response seeing near target)
R: +1.00
L: +0.50
(normal value: +0.25 to +0.75) 

Facility (Accommodation facility – ability to change focus: far to near or near to far) by Flipper +/- 2.00
BE: 8 cycle per minit(cpm), difficult with minus lens (2nd lens)
R: 6 cycle per minit(cpm), difficult with minus lens(2nd lens)
L: 8 cycle per minit(cpm), difficult with minus lens(2nd lens)
(normal value: 1 cycle = 2 words read
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)

AA (Amplitude Accommodation/Focusing – eye stamina/ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 18 YO, 19 YO, 19 YO
L: 16 YO, 16 YO, 16 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
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)

Komala has been studying for examination.. her eye findings on accommodation/focusing shows eye fatigue in right eye.. high lag of MEM, reduced AA, difficult with minus lenses on facility.

There are a few ways to go about this:

  1. Manual way : so that eyes are well-rested to refresh & recharge stamina to keep up with near visual demand
    1. taking regular break following 20-20-20 rule
    2. holding reading material at Harmon distance of an elbow distance
    3. blink your eye regularly
    4. adequate lighting
    5. good posture
    6. put eye drop to lubricate & refresh
  2. Spectacle lenses with added plus at near (or we call them relax lenses): to give eyes the little boost power needed to support the continuous near visual demand
    1. these lenses look like normal lenses only
    2. by eyes looking through the bottom portion of lens to utilise the boost function (looking straight ahead is for far vision)
    3. all lens companies have their own designated name for this type of lens
  3. Contact lenses
    1. some contact lenses work in giving more comfortable near vision besides correcting your power
    2. some also act as myopia control for children

You see what works for you as everyone is different in our lifestyle & expectation.

– We will do near NFV when she comes by