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Wear Glasses To School Only?

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Noelle (F/13) came for follow up.. she wears her glasses to school only. She does not wear her glasses for near as she finds it more comfortable seeing near without her glasses.

Vision without glasses
R: 6/15-
L: 6/15-

Existing glasses
R: PL/-3.00×180
L: PL/-3.00×175

Subjective Refraction (Delay Fogging +2.00 OU)
R: +0.25/-2.75×180 (6/7.5-) PHNI, N5- (R>L)
L: +0.25/-2.75×175 (6/7.5-) PHNI, N5-
Near: L>R

Other assessments show:

Cover Test
Distance: NMD
Near: small – moderate XP, fast recovery

Howell Card
Distance: 0
Near: 8 – 10 XP
+1.00 Near: 8 – 10 XP
-1.00 Near: 6 XP
+2.00 Near: 10 – 12 XP
-2.00 Near: 6 XP

NRA
+2.00

PRA
-2.00

NPC
6/8cm, 6/8cm, 6/8cm, 8/11cm, 8/11cm, 8/11cm

AA (N8 target on RAF Rule)
R: 14.5D, 14.5D, 14.5D (blur @end of RAF rule, clear @36cm)
L: 15.5D, 15.5D, 15.5D (blur @end of RAF rule, clear @34cm)

MEM
R: PL
L: PL

Accommodation Facility (+/- 2.00) N8 target
BE: 15cpm, difficult plus lens
R: 12cpm, difficult plus lens
L: 14cpm, difficult plus lens
– BE sees better than with RE/LE

Fusional Reserves
Near, PFV: x/10/8
Near, NFV: x/16/14
Distance, NFV: x/12/10
Distance, PFV: x/20/18

Vergence Facility
Near: 12 cpm
Distance: 10 cpm

Random Dot 3S
32″
20″ (with Add +0.75)

Motility
Ortho, V pattern

Interpupillary distance, IPD = 6.2cm

AE? We will recheck after full-time wear of glasses.

We prescribe Noelle for full-time wear. We emphasise the importance of having her glasses on full-time, seeing clear vision at all times.

We will see her again in 6-8weeks.

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

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, PFV: x/15-31/10-22
Near, NFV: x/7-17/3-11
Adult
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

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 
12.5″