Mr Teoh (M/37) came for eye examination, with complaints of tired eyes & blurry near vision with near work and sometimes blurry far vision when driving. He has a pair of glasses that he found it dizzy to wear. Work requires him to travel, so he drives quite a bit.
Vision without glasses
R: 6/6
L: 6/12-
Vision with existing glasses of few years
R: +0.25
L: +1.25/-0.25×165
Examination shows:
R: +0.75/-0.25×90 (6/6) [+1.00 blur lens test: 6/9] (R: dominant right eye)
L: +1.50/-0.75×105 (6/7.5) PHNI [+1.00 blur lens test: 6/9]
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance
small EP, fast recovery @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 (Howell Card)
Distance: 1 EP
Near: 5 -> 3 -> 1 <-> 0
+1.00 Near: 3 -> 1 <-> 0 EP
Distance No glasses: 3 EP
(normal value: 1 EP-0 or 0-3 XP @Distance & 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
Mr Teoh has hyperopia/longsighted power with mild astigmatism in both eyes for far vision. Without glasses, he can see far clearly when he is fresh. Low hyperopia would be just fine without correction as our eyes can help to autocorrect a little hyperopia during eye focusing (like how we focus our camera during photography). Higher hyperopia needs correction as our eyes can only help so much. The higher the longsighted power/hyperopia is, the more at risk your eye is for amblyopia/lazy eye – when your eye is deprived of clear image. No clear image is seen, so the vision may not be as strong. The higher the uncorrected power (hyperopia or myopia/shortsighted power or astigmatism), the poorer the vision is.
High hyperopia is particularly very important in young children.. as they can develop squint eye (eye turned in) from over-using their focusing system(by their strong eye muscles) to autocorrect hyperopia in order to see clearly. Having squint eye means that the vision would be even poorer as the eye is not at the centre of our sight.
Mr Teoh’s hyperopia can still be corrected to give good vision, so we prescribe full hyperopia prescription to him. Some patients may come in with very tensed eyes.. in which eyes reject the hyperopic power that we give. Optometrist will perform certain refraction techniques to elicit hyperopic power while stabilising your focusing that at times causes yoyo vision fluctuation. If all else fail, we will refer for a cycloplegia (put eye drop to temporarily paralyse eye muscles to get the real eye power as well as to relieve the tensed muscles) from eye specialist clinic/hospital only.. or when we do not get optimum vision with our prescription.
Our vision focuses more on near nowadays. If you experience any blurry near vision with headache/dizziness or even sometimes blurry far vision as well as tired eyes from screens (when you did not have these signs/symptoms previously), you know that you need to get an eye examination from your nearby eye care practitioner.
Our eyes flavour our lives.. sometimes we feel anxious, the other times we are sad.. but most of the times we come back the happiest beings we are.. even if in tasting the bitter-sour of our everydays is indeed a life journey we must cherish!
Let us all say “We love our eyes so much & we will take good care of them!” You and I and Us all together in caring for our eyes the best we can!