Natalie (F/5) who just hit 5years old came for an eye examination on 20/6/2020
Mother notices daughter’s eye deviated sometimes, not sure which eye & which direction, no headache reported.. since last year
Unaided vision (no glasses)
(Distance) (R) 6/6, (L) 6/6
(Near) N5@30cm
(she stopped after continuously reading for a while, of 20 numbers, she stopped at number 14)
Hirschberg
(R) symmetry
(L) corneal reflex displaced nasally about 1mm (Left Eye Exotropia)
– to check cornea light reflex
(let us know position of eye/eye alignment)
Bruckner
red reflex (both eyes)
– ocular media/eye structure all clear
ExtraOcular Movement
smooth, accurate, full, extensive
– to check eye muscles
Deviation (Howell @near)
8-16 Exo
+1.00 2 Exo – 3 Eso
+2.00 20 Exo
– to check amount of eye deviation
(Exo: eye deviates outwards, Eso: eye deviates inwards)
3D Vision (Titmus)
25”
Cover Test
(Distance) orthophoria
(Near) moderate Exophoria moderate recovery
– to check for eye alignment
(Orthophoria: eye is centred)
Prism Cover Test
LE 8-10 BI
– to check for amount of eye deviation by using prism to align deviated eye back to looking straight
Jump Vergence
sustained (eye no deviated out)
– (see pentip further away then see pentip nearer) x 3-4x,
(two pentips held between patient & examiner)
– to check how much your eyes can maintain single clear image
(whether eye easily gives up by turning outwards after repeated attempts)
Observation
slight head turn to her right
Management
Next appointment
i) 3months or earlier should symptoms like eye deviates more frequently/she reports complaint of headache with near work often
ii) to prescribe vision therapy (eye exercise)
iii) to prescribe lenses for near work (should the need arises when more demand on kindy homework/complaint on near work)
Thank you Ms Deborah & Natalie for your trust & support!????
Thank you Ms Prema for your insight!???? Thank you Mr Stanley for the behavioural classes????