15/9/2020
Yiwen (F/9) came for eye examination, complaining slight blurry far vision at school. Her mother reported that she told her that she sometimes sees things being magnified and then minified. Her mother also said she always sees her phone very near, even when she does her homework, her whole body will slant towards the desk to write.
Vision without glasses
R: 6/7.5, Near: N6@30cm
L: 6/7.5, Near: N6@30cm
Examination shows:
R: -0.25 (6/6), N6@30cm
L: -0.25/-0.25×180 (6/6), N6@30cm
NPC (RAF rule)
18cm, 20cm, 22cm
AA (RAF rule)
Without any helper lens – cannot see N5 print
With +1.00 helper lens – only can see when nearer
NRA
+1.25
PRA
-1.00
Near, NFV: 12/10
Near, PFV: 12/10
*UpdatedA 6/4/2021
Yiwen (F/10) came back for follow up.
Vision without glasses
R: 6/7.5, Near: N5@40cm
L: 6/7.5, Near: N5@40cm
Examination shows:
NPC (RAF rule)
14cm, 18cm, 20cm
AA (RAF rule)
R: 7cm, 7cm, 7cm
L: 7cm, 7cm, 7cm
NRA
+1.00
PRA
-1.25
NFV @near (divergence stamina: how much eye can diverge) – with Base In Prism Bar
Blur/Break/Recovery: 10/14/8
(normal value Break: 7 to 17; normal value Recovery: 3 to 11)
Base In got blur point – uncorrected hyperope?
PFV @near (convergence stamina: how much eye can converge) with Base Out Prism Bar
Blur/Break/Recovery: 8/14/6
(normal value Break: 15 to 31; normal value Recovery: 10 to 22)
*UpdatedB
8/4/2022
Yiwen (F/11) came for eye examination, with complaint of blurry far vision with existing glasses of 2.5years. When prompted whether or not she still sees things magnified & minified, she said no more. When asked about her near vision, she sees blurry near vision on phone after a while. She will rub her eyes & vision becomes clear for a couple of minutes before seeing blurry again. Sometimes, she will wash her face & vision can be clear for about 2-3hours before she sees blurry on phone again. We observe that she will hold her phone very close (about 15cm) to see.
Vision without glasses
R: 6/24-
L: 6/12-
Examination shows: (Delay Fogging)
R: -1.25/-0.50×180 (6/6) [+1.00 blur lens test: 6/18-]
L: -0.25/-0.50×180 (6/6) [+1.00 blur lens test: 6/18] (L: left dominant eye)L>R
Adding +0.50 in right eye: R>L
Modified
R: -1.00/-0.50×180
L: -0.25/-0.50×180
Add: +0.50
Other assessments show:
Cover Test
Distance: NMD
Near: small XP, fast recovery
Howell Card (6BD on OD)
Distance: 0 – 1 EP
Near: 1 – 3 EP
+1.00 Near: 0 (top arrow paces around 0, slightly on yellow & blue)
-1.00 Near: 5 – 7 EP
NRA
+2.00
PRA
-2.00
MEM
R: +0.25
L: PL
AA (RAF rule)
R: 20yo, 20yo, 20yo
L: 10yo, 10yo, 10yo
R: 10yo, 10yo, 10yo (with Add +0.75)
NPC (RAF rule)
6/8cm, 8/10cm, 8/10cm, 9/12cm, 9/12cm, 9/14cm
Accommodation Facility (Flipper +/-1.50) *patient reported seeing double with -2.00
BE: 7 cpm, difficult minus lens
R: 7 cpm, difficult minus lens [both eyes see better than with right eye]
L: 7 cpm, difficult minus lens [left eye sees better than with both eyes]
Fusional Reserves (Prism Bar)
Near, NFV: x/10/8
Near, PFV: x/12/10
Distance, NFV: x/10/6
Distance, PFV: x/12/8
Fusional Reserves (Prism Bar) with Add +0.75
Near, NFV: x/10/6
Near, PFV: x/10/6
Vergence Facility (Prism Flipper of 12BO & 3BI)
Near: 4 cpm (slow BI)
Distance: 5 cpm (slow BO.. with repeated testing then, slow BI too)
Interpupillary Distance = 6.0cm
19/1/2023
Yiwen (F/12) came for follow up, with complaint slight blurry far vision sometimes with existing glasses of <1yr.
Vision without glasses
R: 6/21-
L: 6/15-
Existing glasses
R: -1.00/-0.50×180 (6/6-)
L: -0.25/-0.50×180 (6/6-)
Add: +0.50
Other assessments show: (with existing glasses)
Cover Test
Distance: NMD
Near: small EP, fast recovery
Howell Card (6BD on OD)
Distance: 1 EP
Near: 0 – 1 EP
(bottom portion of lens) Near: 0 – 2 XP
NRA
+1.75
PRA
-1.25 (occlusion monocularly: OD blur, OS clear)
NPC (RAF rule)
7/10cm, 7/10cm, 8/11cm, 8/11cm, 9/12cm, 9/12cm
AA (RAF rule)
R: 25yo, 27yo, 30yo
L: 30yo, 30yo, 30yo (blur @end of RAF rule, clear @26cm)
Accommodation Facility (Flipper +/- 1.50)
BE: 15cpm, difficult minus lens
R: 15cpm, difficult minus lens
L: 17cpm, difficult plus lens
MEM
R: +1.00 (top portion of lens) | R: +0.50 (bottom portion of lens)
L: +1.00 (top portion of lens) | L: +0.50 (bottom portion of lens)
Fusional Reserves (Prism Bar)
Near, NFV: x/10/6
Near, PFV: x/12/8
Distance, NFV: x/8/6
Distance, PFV: x/20/14
Vergence Facility (Prism Flipper of 12BO & 3BI)
Near: 3 cpm [slow BO(more difficult) & BI]
Distance: 6 cpm (slow BI)
Yiwen’s glasses were sliding down.. we adjust her glasses, reinforce proper visual hygiene & the correct usage of the glasses.