Punitan (M/13), brother of Bharathaan, came for eye screening when we first detected that he has significant shortsighted power in just one eye and the other eye is almost no power. He did not have complain of blurry vision, and he can see whiteboard at school.
Examination showed new power:
R: -3.75/-1.00×175 (6/7.5)
L: -0.75/-0.75×180 (6/6)
Punitan’s shortsighted power has increased 050 in a year. There is a big difference of power between both eyes, we call this condition as anisometropia that may be due to two factors:
1. One eyeball is longer from birth, hence higher shortsighted power
2. Improper posture.. always lie down sideway on bed to read book
Punitan has lazy eye/amblyopia on his right eye. His lazy eye has picked up pretty good and now, he misses out just the last smallest line on testing chart. When he opens both eyes & without glasses, his brain has suppressed/shut off the very blurred image from his right eye and only accepts clear image from his left eye, so, he can still see far fine. With his previous power, there was not big difference between wearing glasses and not wearing glasses & he admitted that he won’t wear his glasses sometimes. This is the tricky, challenging part… when you don’t see the vision improvement in wearing your glasses, you might think that you do not need them. In case like this, follow-up visit will be able to reinforce the importance of wearing his glasses full time, to let him realise the difference in vision of his right eye with and without glasses.
Amblyopia or lazy eye means that your eye cannot see those smaller lines that other people can see, even when you wear full power. Anything that happens to your good eye, you are left with vision seeing with your lazy eye. If your lazy eye is very severe, in which it can just see the biggest alphabet on testing chart, then you almost go blind!
Punitan & Bharathaan have both wanted black colour frame. Mummy was asking them to choose different colour & frame shape for easy identification. Brothers have the same taste & chemistry it seems.. so at the end, Punitan is happy with squarish frame while Bharathaan looks adorable in a roundy frame, both having them in their favourite black colour.
Both also have their lenses in Kodak UVBlue, having additional protection against blue light, be it from the sun or digital devices.
Thank you Punitan, you have grown so tall now.. almost as tall as aunty already? Thank you Rajeswari for your continuous trust & support!?
*Updated
Vision with existing glasses:
R: -3.75/-1.00×175 (6/6)
L: -0.75/-0.75×180 (6/18)
Examination shows:
R: -3.75/-1.00×175 (6/6) [R : dominant right eye]
L: -1.25/-1.25×180 (6/6)
Other assessments show:
Examination of 3D Vision (Random Dot 3S)
12.5″
(normal value: 12.5″)
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance
NMD @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
NRA (accommodation analysis – ability to relax accommodation)
+2.50
(normal value: +1.50 to +2.50)
PRA (accommodation analysis – ability to stimulate accommodation)
-2.50
(normal value: -1.37 to -3.37)
Examination of Eye Alignment (Howell Card)
Distance: 0 – 2 XP
Near: 0 – 2 XP
(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
There is power increment in left eye only while the higher power in right eye is maintained. Despite the big difference between two eyes, optimum 3D is attained.
The value of NRA & PRA is balanced, that’s great! This balanced value is what we like to see in our patients. Eye alignment is good too!
We will update his left lens and follow up in 6months.