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Aunt Lucy (F/63) came with complaint of blurry near vision.. she removes glasses to see near.. but she finds it difficult to read her Bible these days.

Vision without glasses
R: 6/60
L: 6/45

Existing glasses
R: -3.25/-1.00×120 (6/12+)
L: -3.00/-1.00×45 (6/12+)

Examination shows:
R: -4.25/-0.25×120 (6/9-) [PHNI] [R: right dominant eye]
L: -4.00/-0.25×45 (6/9-) [PHNI]
Add: +2.50

Other assessments show:

Cover Test
Distance: NMD
Near: small XP, fast recovery

Howell Card (6BD on OD)
Distance: 0
Near: 4 – 6 XP
-1.00 Near: 2 – 4 XP



NPC (RAF rule)
8/10cm, 8/10cm, 8/10cm, 8/10cm, 8/10cm

R: dim
L: dim

Fusional Reserves (Prism Bar)
Near, PFV: x/20/18
Near, NFV: x/16/12
Distance, NFV: x/6/4
Distance, PFV: x/14/12

Vergence Facility (Prism Flipper 12BO/3BI)
Near: 9 cpm (slow BO)
Distance: 8 cpm (slow BO)

Interpupillary distance, IPD = 6.1cm

Slit Lamp
R: cataract
L: cataract

R: -ve staining
L: -ve staining