Aida (F/25) datang untuk follow up, mengadu tengok jauh2 pada sign board ada kabur sikit. Beliau banyak hadap komputer, tapi penglihatan komputer/hp masih okay.
Vision without glasses
R: 6/60-2
L: 6/60-2 (better)
Vision with existing glasses of 2.5years
R: -6.00/-1.25×175 (6/9-)
L: -6.50/-1.25×5 (6/7.5+)
Examination shows: (Binocular Refraction)
R: -6.50/-1.00×175 (6/7.5+) [PH 6/7.5+] (R: right dominant eye) R>L {adding +0.50 R>L, adding +0.75 L>R}
L: -6.50/-1.00×5 (6/7.5+) [PH 6/7.5+]
Add: +0.75 L>R
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test, CT)
NMD @Distance
(alternating CT: upon covering left eye, patient reported the target goes to her right. when covering right eye, the target stays at middle)
small EP, fast recovery @Near
(alternating CT: upon covering left eye, patient reported the target goes further away.. when covering right eye, the target comes nearer)
(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/Posture (Howell Card) by 6^ Base Down on Right eye
Distance: 0 – 1 EP (yellow part)
Near: 1 – 3 EP (yellow part)
+1.00 Near: 0 – 1 EP (yellow part)
-1.00 Near: 3 – 5 EP (yellow part)
(normal value: 0-1 EP (yellow part) or 0-3 XP (blue part) @Distance; and 0-6 XP (blue part) @Near)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
NRA (Accommodation analysis – ability to relax accommodation) by plus lens
+3.00
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-3.50
(normal value: -1.37 to -3.37)
MEM – Monocular Estimation Method (Accommodation lag – to measure accommodation response seeing near target)
R: +0.75
L: +0.25
(normal value: +0.25 to +0.75)
AA (Amplitude Accommodation/Focusing – eye stamina/ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 8 YO, 8 YO, 8 YO
L: 8 YO, 8 YO, 8 YO
(normal value: AA goes according to age; YO=years old)
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
TTN, TTN, TTN, TTN
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
Accommodation Facility – ability to change focus: far to near or near to far (by Flipper +/-2.00)
BE: 14 cycle per minit(cpm), difficult with minus lens(2nd lens)
R: 14 cycle per minit(cpm), difficult with minus lens(2nd lens) [right eye sees better than with both eyes]
L: 14 cycle per minit(cpm), difficult with minus lens(2nd lens) [left eye sees better than with both eyes]
(normal value: 1 cycle = 2 words read
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)
Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Near, Base-In/Divergent, NFV: x/4/2
Near, Base-Out/Convergent, PFV: x/4/2
Distance, Base-In/Divergent, NFV: x/12/10
Distance, Base-Out/Convergent, PFV: x/10/8
(normal value: Blur/Break/Recovery)
Near, PFV: 10-28/7-21
Near, NFV: 7-19/5-15
Distance, PFV: 4-18/5-9
Distance, NFV: 4-10/2-6
[Scheiman et al – Adult Data]
Vergence Facility – ability to make rapid repetitive vergence changes (by Prism Flipper of 12Base Out & 3Base In)
Near: 3 cpm (double with Base-Out)
Distance: 12 cpm
(normal value: 1 cycle = 2 times clearing target
Distance: 12-18 cpm
Near: 12-18 cpm)
With Add +1.00 BE
Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Near, Base-In/Divergent, NFV: x/20/18
Near, Base-Out/Convergent, PFV: x/20/18
3D Vision (Random Dot 3S)
25″
With Add: +0.75 BE: 25″
(normal value: 12.5″)
Interpupillary distance, IPD: 6.2cm