Michael L (M/38) came with complaint of sometimes blurry near vision & tired eyes after long hours on computer.. vision is fine seeing far. He feels that his eyes are dry towards end of day.
Vision without glasses
R: 6/30-
L: 6/60-
Existing glasses of 4-5years
R: -3.25/-2.75×175 (6/6-)
L: -6.00/-1.00×170 (6/6) [L: left dominant eye]
Examination shows:
R: -3.25/-2.75×175 (6/6-) [+1.00 blur test: 6/6]
L: -5.75/-1.00×170 (6/6) [+1.00 blur test: 6/6] [L: left dominant eye]
Add: +1.00
Lowering DS is xfavoured @far
Other assessments show:
Cover Test
Distance: NMD
Near: small XP, fast recovery
Howell Card (6BD on OD)
Distance: 0 – 1 EP
Near: 2 XP
+1.00 Near: 10 – 12 XP
-1.00 Near: 2 – 4 EP
+2.00 Near: 10 – 12 XP
-2.00 Near: 2 – 4 EP
NRA
+1.50 (mono occlusion: OD clearer, OS clearer)
PRA
-1.00 (mono occlusion: OD blurry, OS clearer)
NPC (RAF rule)
12/16cm, 12/16cm, 12/16cm, 12/16cm, 12/16cm, 12/16cm
AA (RAF rule)
R: 44yo, 45yo, 46yo
L: 38yo, 38yo, 38yo (blur @end of RAF rule, clear @42cm)
NPC (RAF rule) with Add
12/14cm, 12/14cm, 12/14cm, 12/14cm, 12/14cm, 12/14cm
Accommodation Facility (+/- 1.00)
BE: 15 cpm, difficult minus lens
R: 12 cpm, difficulty minus lens
L: 15 cpm, difficult minus lens
MEM
R: vy3 dim
L: dim
Fusional Reserves (Prism Bar)
Near, NFV: x/20/18
Near, PFV: 8/25/18
Distance, NFV: x/6/4
Distance, PFV: x/10/8
Vergence Facility (Prism Flipper 12BO/3BI)
Near: 9 cpm (slow BO)
Distance: 9 cpm (slow BI)
Interpupillary distance, IPD = 7.0cm
Fluorescein
R: -ve staining
L: -ve staining
