Sharon K (M/39) came for eye examination, vision with existing glasses is fine seeing far & near. She is full time contact lens wearer and she wears contact lens -3.50 in both eyes. Signboard can sometimes be difficult to see. Her job requires her to use computer on long hours, she feels tired eyes & blurry vision sometimes. We observe that she will hold her reading material further away to see.
Vision without glasses
R: 6/60+
L: 6/45-
Vision with existing glasses
R: -3.50/-1.50×180 (6/6)
L: -3.50/-1.50×180 (6/6)
Examination shows: (Delay Fogging)
R: -3.25/-1.50×180 (6/6) [+1.00 blur lens test: 6/9-]
L: -3.25/-1.50×180 (6/6) [+1.00 blur lens test: 6/15] (L: left dominant eye)
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test, CT)
NMD @Distance
small XP, fast recovery @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
Examination of Eye Alignment/Posture (Howell Card) by 6^ Base Down on Right eye
Distance: 0
Near: 2 – 4 XP (blue part)
+1.00 Near: 2 – 4 XP (blue part)
-1.00 Near: 0 – 2 XP (blue 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
+1.50
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-1.50
(normal value: -1.37 to -3.37)
MEM – Monocular Estimation Method (Accommodation lag – to measure accommodation response seeing near target)
R: +1.00
L: +1.00
(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: 35 YO, 35 YO, 35 YO
L: 35 YO, 35 YO, 35 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
6/8cm, 6/8cm, 6/8cm, 6/8cm, 6/8cm
(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: 12 cycle per minit(cpm), difficult with minus lens(2nd lens)
R: 13 cycle per minit(cpm), difficult with minus lens(2nd lens)
L: 13 cycle per minit(cpm), difficult with minus lens(2nd lens)
(normal value: 1 cycle = 2 words read
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)
We prescribe contact lens
R: -3.25/-0.75×180
L: -3.25/-0.75×180