HYin (M/7) came for eye examination, mother Rachel reported that he always rubs his eyes after some time looking at tablet or watching TV. He has not worn any glasses before.
Vision without glasses
R: 6/6
L: 6/6- slow
Examination shows:
R: PL (6/6) [+1.00 blur lens test: 6/12] R>L [R: dominant right eye] N5@35cm
L: +0.75/-0.25×165 (6/6) [+1.00 blur lens test: 6/6, blur lens +1.50: 6/9] N6 blur @35cm
Near: Add is not favoured
He prefers to remove correction to see brighter
Vision fluctuation noted
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
small EP fast recovery @Distance
small EP 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: 5 EP (yellow part)
Near: 3 EP (yellow part)
+1.00 Near: 0 –> 1 –> 3 EP
+2.00 Near: 2 XP
(normal value: 0-1 EP or 0-3 XP @Distance and 0-6 XP @Near)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
Retinoscopy & Delay Fogging
R: +0.50
L: +1.25/-0.25×165
BE: 6/6
He does not like the correction & wants to remove it
HYin has longsightedness/hyperopia/plus power in both eyes. His eyes are tensed, in which they reject the hyperopic power that we give. Eye alignment shows some esophoria.. possibly due to eyes exerting focusing to autocorrect the hyperopic power.
We refer HYin for cycloplegic refraction – to put eye drop at eyes specialist clinic to temporarily suspend accommodation/focusing to get the true eye power. We will assess his eye systems after 4-6weeks of full-time wear of cycloplegic power.