Ms Tan (F/46) came for eye examination, with complaints of stressful/heavy eyes wearing her own glasses of 4years. She wears her glasses when driving only & she can see near okay.
Vision without glasses
R: 6/15 (better)
L: 6/15-
Existing glasses
R: -0.75/-2.00×80
L: -2.00/-0.50×100
Examination shows: (Delay Fogging)
R: -1.25/-1.50×80 (6/6) [+1.00 blur lens test: 6/9-] (R: right dominant eye) R>L
L: -1.75/-0.75×100 (6/6) [+1.00 blur lens test: 6/9-]
Near: +1.50 (N5@40cm) L>R
We tried to lower her shortsightedness binocularly, she did not like it
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test, CT)
NMD @Distance
NMD @Near
(alternating CT: upon covering left eye, patient reported the target goes to her left.. when covering right eye, the target goes to her right)
(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 – 1 EP (yellow part)
Near: 2 – 4 XP (blue part)
-1.00 Near: 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
+0.75
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-0.50
(normal value: -1.37 to -3.37)
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
6/8cm, 6/8cm, 6/8cm, 6/8cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
Ms Tan’s eye findings are good. But for her power, she should be wearing her glasses full time. It seems that her power is higher than expected. When we do not wear our correction accordingly, eyes would want higher power in order to see far better.