William Sin Heng Guan

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3/11/2022

Mr William (M/50) came, vision with existing glasses is fine seeing far & he removes glasses to see near. He also has a newer pair of progressive (but he did not bring).

Vision without glasses
R: 6/30+
L: 6/30

Existing glasses SV of 3+yrs
R: -1.50/-0.25×80 (6/9)
L: -1.25/-0.25×60 (6/6)

Examination shows:
R: -1.75 (6/6) [+1.00 blur test: 6/18+] [R: right dominant eye]
L: -1.50 (6/6) [+1.00 blur test: 6/12]
Add: +1.75 (N5@40cm)
– habitual ATR DC is favoured @N, prescribe? (as corneal w/ WTR DC)

Other assessments show:

Cover Test
Distance: NMD
Near: moderate XP, moderate recovery

Howell Card (6BD on OD)
Distance: 0 – 2 XP
Near: 14 XP
+1.00 Near: 14 XP
-1.00 Near: 10 XP

NRA
+1.50

PRA
-1.75

NPC (RAF rule)
LE deviates @10cm/12cm x6

AA (RAF rule)
R: 44yo, 44yo (blur @end of RAF rule, clear @44cm)
L: 45yo, 45yo (blur @end of RAF rule, clear @44cm)

MEM
R: +0.25 (small pupil)
L: +0.25 (small pupil)

Fusional Reserves (Prism Bar)
Near, PFV: x/25/18
Near, NFV: x/14/12
Distance, NFV: x/8/4
Distance, PFV: x/14/12

Vergence Facility (Prism Flipper 12BO, 3BI)
Near: 12 cpm (slow BO)
Distance: 15 cpm

We repeated
Fusional Reserves (Prism Bar)
Near, NFV: x/20/18

Interpupillary distance, IPD = 6.8cm

We ask Mr William to bring his progressive.

7/3/2023

Existing glasses
R: -2.00/-0.50×95 (6/7.5-)
L: -2.00/-0.25×105 (6/6)
Add: +1.75

Examination shows:
R: -2.00 (6/6) [+1.00 blur test: 6/7.5-] [R: right dominant eye]
L: -2.00 (6/6) [+1.00 blur test: 6/7.5-]
Add: +2.00 (N5@40cm)

Other assessments show:

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

Howell Card (6BD on OD)
Distance: 0 – 2 XP
Near: 12 – 14 XP
+1.00 Near: 12 – 14 XP
-1.00 Near: 8 – 10 XP

NRA
+1.00

PRA
-1.50

NPC (RAF rule)
LE deviates @8cm, 9cm, 10/12cm, 12/14cm

Accommodation Facility (Flipper +/-1.00 & +/-0.50)
BE: difficult plus lens
R: difficult plus lens
L: difficult plus lens

MEM
R: -0.25 (small pupil)
L: -0.25 (small pupil)

Modify
R: -2.00
L: -2.00
Add: +1.50

Fusional Reserves (Prism Bar)
Near, PFV: 8/16/12 (LE deviates @14)
Near, NFV: 16/18/16 (LE deviates @16)
Distance, NFV: x/10/6
Distance, PFV: x/14/12

Vergence Facility (Prism Flipper 12BO, 3BI)
Near: 5 cpm (slow BO)
Distance: 8 cpm (slow BO)

We prescribe Brock string.

KIV 2/12