Yvonne (F/48) came for eye examination, with complaint blurry near vision. Her far vision is fine with existing Single Vision, SV glasses of quite some years.
Vision with existing SV glasses
R: -8.50 (6/6-)
L: -7.75/-1.00×10 (6/6-)
Examination shows:
R: -8.25/-0.25×45 (6/6)
L: -7.50/-1.25×10 (6/6) [L: dominant left eye]
Add: +1.75 (N5@40cm)
Other assessments show:
Examination of Eye Alignment/Vergence (Cover Test)
NMD @ Distance
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)
Distance: 2 XP
Near: 10 XP
(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
Examination of Eye Alignment/Posture (Maddox Rod)
Distance: 2.5 BI & RE 2 BU
Near: 3 BI & RE 2 BU
(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
[Interpupillary distance: 63mm]
Yvonne has high myopia/shortsightedness.. power that goes beyond -5.00 is categorised as high myopia. As we hit the age of 40s, we enter the stage of presbyopia.. ini which we need reading power for us to continue seeing clear & comfortable at near. And this is normal for everyone. There seems to be a slight vertical misalignment requiring 2 prism BU in right eye, consistent in both far & near vision. But she did not complain of seeing double. When we place prism over, she reported no difference. B Head Tilt Test, BHTT is negative & Hirschberg seems fine too. There seems to be a slight fitting misalignment in the glasses.. that may contribute to the vertical misalignment?
We prescribe a pair of reading glasses & we will see how how it goes.