Makcik Ros (F/75) datang untuk pemeriksaan mata, penglihatan dengan spek masih okay, tapi adakalanya kabur juga tengok jauh & dekat. Makcik sudah buat pembedahan katarak 10tahun lepas. Beliau biasanya tengok TV & pakai spek okay, kurang tengok hp.
Vision without glasses
R: 6/9+
L: 6/24+
Existing glasses of 10years
R: -0.50/-1.00×85 (6/7.5-)
L: -0.50/-1.75×90 (6/7.5-)
Add: +3.00
Subjective Refraction
R: -0.50/-0.50×85 (6/7.5-)
L: -0.50/-1.25×90 (6/7.5-)
Add: +2.50 (N8+@40cm)
We let makcik compare, she said it’s about the same for D & N
Lowering astigmatism is also about the same
Other assessments show:
Cover Test
Distance: NMD
Near: small XP, fast recovery
Howell Card
Distance: 0
Near: 10 – 12 XP
-1.00 Near: 8 XP
Amsler Grid
R: distorted lines
L: distorted lines
W4D
Distance: 4 lights
Near: 4 lights
Slit Lamp
R: no PCO
L: no PCO
Fluorescein
R: no staining, TBUT 4s
L: no staining, TBUT 4s
Interpupillary distance, IPD = 6.3cm
Kita bagitahu makcik untuk berjumpa dengan doktor pakar mata makcik.
Notes
Vision without glasses
6/6 – smallest testing line
6/7.5 – 2nd smallest line
6/9 – 3rd smallest line
6/12 – 4th smallest line
6/15 – 5th
6/18 – 6th
6/21 – 7th
6/24 – 8th
Examination of Eye Alignment
Cover Test, CT @ Distance & Near
– NMD(No Movement Detected) or
– small XP, fast recovery
EP = Esophoria is misalignment of eye, eye is deviated inwards
XP = Exophoria is misalignment of eye, eye is deviated outwards
Examination of Eye Posture
(Howell Card) by 6^ BD OD
Distance:
– 0-3 XP (blue part) or
– 0-1 EP (yellow part)
Near:
– 0-6 XP (blue part)
Accommodation/Focusing analysis – ability to relax
NRA
+1.50 to +2.50
Accommodation/Focusing analysis – ability to focus
PRA
-1.37 to -3.37
Convergence, NPC – ability of eye to maintain a single clear near image (RAF rule)
Break/Recovery – within 10cm or TTN(to the nose)
AA(Amplitude Accommodation) – eye stamina (Dioptre, D) (RAF rule)
6yo – 16.5D | 6cm
9yo – 15.5D | 6.5cm
12yo – 14.5D | 7cm
15yo – 13.5D | 7.5cm
18yo – 12.5D | 8cm
21yo – 11.5D | 9cm
24yo – 10.5D | 10cm
27yo – 9.5D | 11cm
30yo – 8.5D | 12cm
MEM(Monocular Estimation Method) – measure accommodation response seeing near target
+0.25 to +0.75 (with movement)
Accommodation Facility – ability to change focus: far to near or near to far) by Flipper +/- 2.00
Monocular: 6cpm – 16cpm
Binocular: 4cpm – 14cpm
(1 cycle per minute, cpm = 2 words)
Fusional Reserves –
Convergent/Divergent reserve stamina (Prism Bar)
Blur/Break/Recovery
Children 7-12yo
Near, BO PFV: x/15-31/10-22
Near, BI NFV: x/7-17/3-11
Adult
Near, BO PFV: x/10-28/7-21
Near, BI NFV: x/7-19/5-15
Distance, BO PFV: x/4-18/5-9
Distance, BI NFV: x/4-10/2-6
Vergence Facility – ability to make rapid repetitive vergence changes (Prism Flipper 12BO & 3BI)
Distance: 12-18 cpm
Near: 12-18 cpm)
(1 cycle = 2 times clearing target)