30/10/2020
Kay (M/35) came for eye examination, spectacles lenses have quite some scratches.
Vision with his glasses:
R: -3.00/-1.00×20 (6/7.5-)
L: -2.25/-0.75×10 (6/6)
Examination showed:
R: -2.75/-1.25×20 (6/6)
L: -2.25/-0.75×10 (6/6)
Kay has slight difference in power as compared to his own glasses. Scratches lead to a lot of scattering light, so he notices great improvement in his vision with new lenses, despite the little change in his power. He has mild red-green deficiency in which he is aware of his condition during eye screening when he was young. This does not hinder him to excel in any means. As his work does not require him to differentiate between two very similar shades of a colour, then it is absolutely fine✨
Kay knows the kind of frames that he wants.. nothing else than a comfy pair that rests well on his face, given the wacky wide width of his face. Passen, extraordinarily made for “IGotABigHead” caters well in this manner, rocking it with a double bar in retro gold. Functionally pairing with Kodak City Lens for blue-filter-and-glare-cut soothing vision to gear us through this Covid storm.
Happy to hear that your vision is clear now.
Thank you Kay for your trust & support!
* Updated
Kay (M/37) came for eye examination to get contact lenses for sports purpose. He reported that he cannot wear contact lenses to see computer & hp as he will feel very dry & uncomfortable. Viewing computer & hp with glasses is fine. The longest he can have his contact lens on is about 5-6 hours. . normally it’s just 3-4 hours. He also has some tired eyes upon prolonged near work with spectacles.
Vision without glasses
R: 6/60+1
L: 6/30-
Vision with glasses
R: -2.75/-1.25×20 (6/6-)
L: -2.25/-0.75×10 (6/6)
Examination shows: (Delay Fogging)
R: -2.75/-1.25×20 (6/6) (+1.00 blur lens test 6/9-)
L: -2.25/-0.50×10 (6/6) (+1.00 blur lens test 6/9) [L: left dominant eye]
We tried to lower shortsightedness 025 in both eyes, but not so favoured
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @Distance (pt reported – target moves down upon covering LE & target moves up upon covering RE alternatingly)
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 – 2 XP (blue part)
Near: 14 – 16 XP (blue part)
-1.00 Near: 12 XP (blue part)
(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
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
8/10, 8/10, 8/10, 8/10, 8/10cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
Examination of Eye Alignment/Posture (Maddox Rod)
Distance: 4 BI, RE 1 BD
Near: 18 BI, RE 1 BD
(normal value: 0-1 EP or 0-3 XP @Distance; and 0-6 XP @Near)
BO/EP = Base Out/Esophoria is misalignment of the eye, eye is deviated inwards
BI/XP = Base In/Exophoria is misalignment of the eye, eye is deviated outwards
BD = Base Down/Hyperphoria is misalignment of the eye, eye is deviated upwards
BU = Base Up/Hypophoria is misalignment of the eye, eye is deviated downwards
Other assessments show:
NRA (Accommodation analysis – ability to relax accommodation) by plus lens
+2.00
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-2.00
(normal value: -1.37 to -3.37)
MEM (Accommodation lag – to measure accommodation response seeing near target)
R: +0.75
L: +0.75
(normal value: +0.25 to +0.75)
Facility (Accommodation facility – ability to change focus: far to near or near to far) by Flipper +/- 2.00
BE: 11 cycle per minit(cpm), difficult with minus lens (2nd lens)
R: 11 cycle per minit(cpm), difficult with minus lens(2nd lens)
L: 11 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)
Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Near, Base-Out/Convergent, PFV: x/12/4
Near, Base-In/Divergent, NFV: 14/25/20
(normal value: Blur/Break/Recovery)
Near, PFV: x/10-28/7-21
Near, NFV: x/7-19/5-15
Distance, PFV: x/4-18/5-9
Distance, NFV: x/4-10/2-6
[Scheiman – Adult Data]
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
8/10, 8/10, 8/10, 8/10, 9/11cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
– NPC testing is repeated again at the end of examination
Interpupillary Distance = 7.2cm
Kay seems to have significant exophoria 14-16 XP at near. When prompted whether or not he sometimes sees blurry near vision or loses focus on near task, he said near vision with glasses is fine.. near vision with contact lens – he feels dry & uncomfortable. With significant exohoria at near, firstly, we will check on NPC to see if his convergence, NPC is reduced causing the exophoria at near.. but his NPC seems fine. Next, we will check his PFV to see his eyes are able to pull in & balance his exophoric near posture.. his PFV is 12 when he should have at least double the near exophoria.. but he has only half of it.
We know that exophoria will be worse on contact lens, hence his complaint on near vision with contact lens wear. His findings tell us that his accommodation/focusing is pretty good, probably contribute in sustaining clear near vision at near despite significant near exophoria. But when he shifts to contact lens wear (that requires eyes to do focusing more as compared to spectacles wear), it puts further strain on his already exhausted eyes.. hence the short wearing hours with contact lens.
We prescribe free space stereogram to improve his PFV and we will see him in 1month.