Vi (F/33) came for eye examination, with complaint of sometimes blurry far vision after seeing near especially worse since 1year ago. She always has headache after near work & headache goes away with rest. She was prescribed steroid eye drop previously & it relieved her headache for a short while before coming back 1 month later.
Vision without glasses
R: 6/6 [+1.00 blur test: 6/6-]
L: 6/6 [+1.00 blur test: 6/9]
Examination shows:
R: PL (6/6) [R: right dominant eye] R>L
L: PL (6/6)
Near: L>R
+DS is xfavoured @far monocularly/binocularly
Other assessments show:
Cover Test
Distance: NMD
Near: small XP, fast recovery
Howell Card (6BD on OD)
Distance: 0 – 1 EP
Near: 6 – 8 XP
+1.00 Near: 8 – 10 XP
-1.00 Near: 4 – 6 XP
+2.00 Near: 8 XP
-2.00 Near: 2 XP
NRA
+1.25 (occlusion monocularly: OD blurry, OS blurry)
PRA
-2.25 (occlusion monocularly: OD blurry, OS blurry)
NPC (RAF rule)
14/18cm, 14/18cm, 16/20cm, 16/20cm, 18/22cm, 18/22cm
AA (RAF rule)
R: 35yo, 36yo, 37yo
L: 33yo, 34yo, 35yo (blur @end of RAF rule, clear @34cm)
NPC (RAF rule) with Add +0.50
12/14cm, 12/16cm, 12/18cm, 12/20cm
Accommodation Facility (Flipper +/- 1.50)
BE: 17 cpm, difficult minus lens
R: 17 cpm, difficult minus lens
L: 18 cpm, difficult minus lens
MEM
R: +0.25
L: PL
Fusional Reserves (Prism Bar)
Near, PFV: x/6/4
Near, NFV: 10/12/10
Distance, NFV: x/6/4
Distance, PFV: x/12/10
Vergence Facility (Prism Flipper 12BO/3BI)
Near: 3 cpm (slow BO)
Distance: 3 cpm (slow BO & BI) pt said more difficult with BI
Modified
R: PL
L: PL
Add: +0.50
