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Prescription Sunglasses For Driving?

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Mr Lau (M/67) came for eye examination, vision is fine seeing far.. he would like to make sunglasses for driving. He had cataract surgery in LE 10years ago. He does not wear glasses.. he only wears his reading glasses when he is at home.

Vision without glasses
R: 6/12
L: 6/30

Subjective Refraction
R: +0.75/-0.50×90 (6/7.5-) PH 6/6-
L: -0.75/-0.75×90 (6/7.5-) PH 6/6-
Add: +2.25/+2.00

Modified for comfort
R: +0.50/-0.50×90
L: -0.50/-0.75×90
Add: +2.25/+2.00

Other assessments show:

Cover Test
Distance: NMD
Near: small XP, fast recovery

Howell Card
Distance: 0
Near: 14 XP
-1.00 Near: 8 XP

NRA
+0.75

PRA
-0.75

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

Fusional Reserves
Near, PFV: x/18/16
Near, NFV: x/16/14
Distance, NFV: x/6/4
Distance, PFV: x/14/12

Vergence Facility
Near: 5 cpm
(double BO & BI, blink3 & single)
Distance: 7 cpm
(double BI, single slowly)

Fluorescein
R: -ve staining
L: -ve staining

Amsler Grid
R: normal
L: normal

Slit Lamp
R: cataract
L: no PCO

Interpupillary distance, IPD = 7.2 cm

Mr Lau has no systemic conditions.

NPCI?

To monitor near posture.

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

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)

AA(Amplitude Accommodation) – eye stamina (Dioptre, D) (RAF rule)
6yo – 16.5D | 6cm
9yo – 15.5D | 6.5cm
12yo – 14.5D | 7cm
15yo – 13.5D | 7.5cm
18yo – 12.5D | 8cm
21yo – 11.5D | 9cm
24yo – 10.5D | 10cm
27yo – 9.5D | 11cm
30yo – 8.5D | 12cm

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, PFV: x/15-31/10-22
Near, NFV: x/7-17/3-11
Adult
Near, PFV: x/10-28/7-21
Near, NFV: x/7-19/5-15
Distance, PFV: x/4-18/5-9
Distance, 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)