Nur Syuhada Izrin – 88 Optometry

20/10/2021

Syu (F/14) puteri En. Izrin, datang untuk pemeriksaan mata selepas anak tidak lulus ujian penglihatan tengok jauh ayah. Syu akan pulang ke kampus dalam beberapa minggu lagi. Cermin matanya tertinggal di kampus.

Power cermin mata 1+ tahun
R: -0.75
L: -0.50

Tahap penglihatan tanpa cermin:
R: 6/21
L: 6/12

Pemeriksaan menunjukkan:
R: -1.25 (6/6) {+1.00 blur lens test 6/12-} [R: mata kanan dominan] R>L
L: -0.50 (6/6) {+1.00 blur lens test 6/12-}
Relax Add: +1.50

Pemeriksaan lain menunjukkan:

Pemeriksaan Alignment Mata (Cover Test)
NMD @ jauh
NMD @ dekat
(normal value: orthophoria/NMD-No Movement Detected atau small XP small recovery)

Pemeriksaan Alignment/Postur Mata (Howell Card) by 6^ Base Down on Right eye
Jauh: 0
Dekat: 0 – 2 XP
+1.00 Dekat: 2 – 4 XP
+1.50 Dekat: 4 XP
(normal value: 0 – 1 EP or 0 – 3 XP @Jauh & 0 – 6 XP @Dekat)
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 with plus lenses)
+2.50
(normal value: +1.50 to +2.50)

PRA (accommodation analysis – ability to stimulate accommodation with minus lenses)
-1.75
(normal value: -1.37 to -3.37)

MEM (Accommodation lag – to measure accommodation response seeing near target)
R: +0.50
L: +0.50
(normal value: +0.25 to +0.75)

NPC (Convergence/Penumpuan – ability of eye to maintain a single clear near image) by RAF rule
7cm, 7cm, 7cm
(normal value: less than 10cm or to the nose, TTN)

Syu menunjukkan peningkatan rabun jauh/miopia dalam 075 & 025 dalam 1+ tahun. Dalam setahun, peningkatan rabun yang melebihi 075 membimbangkan. Kalau setahun naik power 100, senang power anak kita cecah 1000 nanti.

Postur mata, fokusing & penumpuan mata Syu semua elok & stabil. Kita bagi cermin myopia control untuk relekkan mata hadap dekat bila berdepan dengan banyak tugasan kerja & kuliah yang akan datang. Kita tahu penglihatan yang sering fokus pada dekat akan mengundang peningkatan miopia. Bagikan power optima pada mata, biar mata senang nampak, kerja senang lenang, miopia anak stabil, ibu ayah pun steady je

Syu juga jinak2 nak cuba contact lens. Kita akan bagi tutorial pemakaian contact lens & Syu boleh cuba pakai untuk event/function bila rasa tak nak pakai cermin mata.

Biasanya, kita nak jumpa anak-anak setiap 6 bulan supaya kita dapat kesan peningkatan miopia dari awal. Jumpa berkala juga dapat kita kukuhkan proper visual hygiene & kemudian terus sebati dalam kehidupan seharian anak-anak kita.

En. Izrin sangat peka dalam memastikan penglihatan puterinya okay sebelum menghantar pulang ke kampus dalam masa kita beralih ke fasa pemulihan 4 untuk kembali sedia kala.

Terima kasih En. Izrin.. bak kata pepatah.. sepakat membawa berkat! Kita sama-sama berganding bahu supaya miopia anak-anak kita semua terjaga & kesihatan mata terjamin.

Jom kita jumpa eye care practitioner anda setiap 6 bulan untuk kalahkan ancaman miopia ini!

*KemaskiniA

Syu datang untuk follow up.. penglihatan jauh & dekat dengan cermín mata okay saja.

Vision without glasses
R: 6/18-
L: 6/6-

Subjective Refraction
R: -1.00/-0.25×180 (6/6) {+1.00 blur lens test 6/12-} [R: mata kanan dominan] R>L
L: -0.25/-0.25×180 (6/6) {+1.00 blur lens test 6/12-}
Add: +0.50 L>R

Other assessments show: (with existing glasses)

Cover Test
Distance: NMD
Near: NMD

Howell Card
Distance: 0 – 1 EP
Near: 2 XP (lower portion: 4 xP)
+1.00 Near: 4 XP
-1.00 Near: 1 EP
+2.00 Near: 6 XP
-2.00 Near: 3 EP

NPC
8/12cm, 8/12cm, 8/12cm, 8/12cm, 8/12cm, 8/12cm

AA (done seeing through top portion)
R: 12D, 12D, 12D
L: 12D, 12D, 12D

AA (done seeing through bottom portion)
R: 13.5D, 13.5D, 13.5D
L: 12D, 12D, 12D

Accommodation Facility (+/- 1.50) cannot clear +2.00
BE: 10 cpm, difficult plus lens
R: 8 cpm, difficult plus lens
L: 10 cpm, difficult plus lens

MEM
R: +0.50
L: +0.50

Fusional Reserves
Near, PFV: x/20/18
Near, NFV: x/14/10
Distance, NFV: x/10/6
Distance, PFV: x/14/12

Vergence Facility
Near: 6 cpm (slow BO)
Distance: 7 cpm (slow BO)

Interpupillary distance, IPD = 6.3cm

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
ACT: alternating CT

Examination of Eye Alignment
(Maddox Rod) placed on RE

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)

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)

Random Dot 3S – 3D Vision/Stereopsis
12.5″

Worth 4 Dots – Binocular Perception 4 dots