Mr Lim SL (M/45) presented with complaints of seeing horizontal diplopia binocularly when driving with his new progressive glasses made about 3 months ago. He reported no double seen in his old glasses.
Vision without glasses
R: 6/60-1
L: 6/60-2
Vision with existing glasses of 3months
R: -7.00 (6/6) [+1.00 test: 6/6-]
L: -6.00/-0.25×35 (6/6) [+1.00 test: 6/7.5-]
Add: +1.75
Examination shows:
R: -6.50 (6/6) [R: right dominant eye]
L: -5.75/-0.25×20 (6/6)
Add: +1.50 (N5@40cm)
Other assessments show:
Random Dot 3S
12.5”
Cover Test
Distance: Right Esotropia
Near: small Esophoria, fast recovery
Maddox Rod
Distance: 12 – 14 Base Out
Near: 6 Base Out
NRA
+0.75
PRA
-0.75
NPC
LE deviates @8cm, 8/10cm, 8/10cm, LE deviates @8cm, 8/10cm, 8/10cm
AA
R: 45yo, 45yo, 45yo
L: 45yo, 45yo, 45yo
Accommodation Facility (+/- 1.00)
BE: difficult minus lens
R: difficult plus lens
L: difficult minus lens
MEM
R: very dim
L: very dim
Fusional Reserves (Prism Bar)
Near, NFV: 10/14/8
Near, PFV: 25/35/20
Distance, NFV: x/1/-4
Distance, PFV: x/25/20
Trial Framing
R: -6.50 2BO
L: -5.75/-0.25×20 2BO
Add: +1.50
Fusional Reserves (Prism Bar) with 2BO in each eye
Distance, NFV: x/4/1
Distance, PFV: x/35/30
Vergence Facility (Prism Flipper 12BO/3BI) with 2BO in each eye
Near: 11 cpm
Distance: 0 cpm (double BI)
Fusional Reserves (Prism Bar) with 3BO in each eye
Distance, NFV: x/6/4
Distance, PFV: 30/40/16
Colour Vision
R: normal
L: normal
Worth 4 Dots
Distance: 2 pairs of 4 dots
Near: 4 dots
