11/1/2022
Samu (F/42) came for eye examination, with complaint of glaring with existing power of 7years. Light is seen as many slanting vertical light from light source. She was told about having keratoconus about 10years ago and was said to be due to genetic in 7-8 years back.. she was also told about having amblyopia in year 2000. No family history of keratoconus reported.
Vision with existing glasses
R: PL/-1.75×180 (6/6-)
L: -0.75/-1.50×70 (6/15-, 6/12-, 6/9-) shadowy
Examination shows:
R: PL/-2.00×15 (6/6) (+1.00 blur lens test 6/12-) N5@40cm [R: right dominant eye]
L: PL/-3.00×40 (6/6-) PH 6/6- N6@40cm (N5 blur)
Add: +0.75 (N5@40cm)
Better clarity but not as comfortable as existing glasses
Other assessments show:
Cover Test
Distance: NMD
Near: small XP, fast recovery
Howell Card (6^ BD on OD)
Distance: 0 – 1 EP
+1.00 Near: 8 XP
NRA
+2.00
PRA
-0.75
MEM
R: +0.75
L: +1.00
Accommodation Facility (Flipper +/- 1.00)
BE: 11 cpm, difficult minus lens
R: 16 cpm, difficult minus lens
L: 1 cpm, failed minus lens
(Add: +1.25) L: 7 cpm, difficult minus lens
Modified power (for comfort)
R: PL/-1.75×10
L: -0.50/-2.50×70
Add: +0.75/+1.25
Howell Card (6BD on OD)
Distance: 0 – 1 EP
Add +0.75/+1.25 Near: 6 XP
*UpdatedA (4/1/2023)
Samu (F/43) came for follow up. Vision with existing glasses is fine seeing far & near.
Unaided Vision
R: 6/12
L: 6/18-
Vision with existing glasses
R: PL/-1.75×15 (6/6)
L: -0.50/-2.50×70 (6/9- 6/7.5-)
Add: +1.25
Examination shows:
R: PL/-1.75×15 (6/6) (+1.00 blur lens test: 6/12- 6/15-) [R: right dominant eye]
L: -1.25/-1.75×60 (6/7.5) (PH 7.5+)
Add: +1.25 (N5@40cm)
Other assessments show:
Cover Test
Distance: NMD
Near: small XP, fast recovery
Howell Card
Distance: 1 EP
Near: 2 – 4 XP
+1.00 Near: 6 – 8 XP
-1.00 Near: 4 XP
NRA
+1.00 (occlusion monocularly: OD better, OD blurry)
PRA
-1.00 (occlusion monocularly: OD blurry, OD blurry)
NPC (RAF rule)
8/10cm, 8/10cm, 8/10cm, 8/10cm, 8/10cm, 8/10cm
AA (RAF rule)
R: 43yo, 43yo, 43yo
L: 20yo, 20yo, 20yo (blur @end of RAF rule, clear @43cm)
Accommodation Facility (Flipper +/- 1.00)
BE: 20cpm, difficult plus lens
R: 20cpm, difficult minus lens
L: 20cpm, difficult plus lens
MEM
R: +0.25
L: -0.50
Fusional Reserves (Prism Bar)
Near, NFV: x/18/14
Near, PFV: 10/14/12 (above blur point 10, double then single)
Distance, NFV: x/8/6
Distance, PFV: x/16/14
Vergence Facility (Prism Flipper of 12BO & 3BI)
Near: 0 cpm (double BO)
Distance: 7 cpm (slow BO)
* All near tests are done with Add.
3/3/2023
Examination shows:
R: PL/-1.75×15 (6/6)
L: -0.75/-1.75×60 (6/9)
Add: +1.25 (N5@40cm)