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Spek Sudah Hancur & Rosak?

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Yuvanes (M/22) datang untuk pemeriksaan mata, cermin matanya hancur & rosak, sudah beberapa minggu tak pakai spek. Penglihatannya tanpa cermin mata.. tengok jauh kabur, bila kerja & kena lihat dałam jarak satu tangan kabur jugak.. tengok hp okay.

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

Subjective Refraction
R: -1.75/-1.50×10 (6/6) R>L
L: -2.00/-1.25×165 (6/6)
Near: L>R
Add +0.50 is not favoured
Lower astigmatism is not favoured for near vision.

Other assessments show:

Cover Test
Distance: NMD
(upon ACT: pt reported RE sees no movement, LE sees target going to his right)

Near: small – moderate XP, fast – moderate recovery
(upon ACT: small XP movement seen in RE, moderate XP movement is seen in LE)

Howell Card
Distance: 0
Near: 16 XP
+1.00 Near: 18 XP
-1.00 Near: 0
+2.00 Near: 20 XP
-2.00 Near: 0

NRA
+1.75

PRA
-1.75

NPC
8/10cm, 8/10cm, 8/10cm, 8/10cm, 8/10cm, 8/10cm

AA
R: 9D, 9D, 9D (blur @end of RAF rule, clear @32cm)
L: 10D, 10D, 10D (blur @end of RAF rule, clear @32cm)

Accommodation Facility (+/- 1.50)
BE: 8cpm, difficult minus lens
R: 6cpm, difficult minus lens
L: 6cpm, difficult minus lens
– cannot clear -2.00 & very slow with +2.00

MEM
R: +1.00
L: +1.00

Fusional Reserves
Near, PFV: x/12/4
Near, NFV: x/14/8
Distance, NFV: x/8/6
Distance, PFV: x/10/8

Vergence Facility
Near: 1 cpm (double BO)
Distance: 0 cpm (double BO) 

Interpupillary distance, IPD = 6.5cm

Kita tanya Yuvanes sama ada penglihatan dekatnya okay dengan cermin mata, beliau kata tengok jauh & dekat okay saja.. dan boleh tengok hp lama.

We try
R: -1.50/-1.50×10 
L: -1.75/-1.25×165

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)

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, 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