EQUIPMENT NEEDED Phoropter Near point card with vertical line of 20/30 letters SETUP 1. Seat the patient comfortably behind the phoropter with the patient’s distance correction in place. 2. Place the near point card at a 40-cm distance from the patient, with good illumination. PROCEDURE 1. Instruct the patient to look at the target and keep it clear and single. 2. Instructions: “I will be changing the lenses in front of your eyes. Try to keep the line of letters clear and single for as long as you can. Tell me as soon as the letters become blurry 3. Add plus lenses in +0.25 D increments until the patient reports the first sustained blur or diplopia. 4. Record the amount of plus added above the distance prescription as the NRA. 5. Remove the plus lenses and return to the distance prescription. 6. Add minus lenses in −0.25 D increments until the patient reports the first sustained blur or diplopia. 7. Record the amount of minus added above the distance prescription as the PRA. 8. Stop the PRA test when you reach −2.50 D above the distance prescription. IMPORTANT POINTS 1. Stress the importance of reporting both blur and diplopia. 2. Discontinue the PRA at −2.50 D.

1. BY BABLI SHARMA
B.OPTOM, M.OPTOM

2.  Trail frame
 Trial box
 Near point card with vertical line of 20/30
letters

3.  Seat the patient comfortably with the
patient’s distance correction in the trail frame
 Place the near point card at a 40-cm
distance from the patient, with good
illumination.

4.  Instruct the patient to look at the target and
keep it clear and single.
 Instructions: “I will be changing the lenses in
front of your eyes.
 Try to keep the line of letters clear single for
as long as you can. Tell me as soon as the
letters become blurry.”

5.  Add plus lenses in +0.25 D increments until
the patient reports the first sustained blur.
 Record the amount of plus added above the
distance prescription as the NRA.
 Remove the plus lenses and return to the
distance prescription.
 Add minus lenses in −0.25 D increments
until the patient reports the first sustained
blur.
 Record the amount of minus added above the
distance prescription as the PRA.
 Stop the PRA test when you reach −2.50 D
above the distance prescription.

6.  Stress the importance of reporting both blur.
 Discontinue the PRA at −2.50 D.

7. THANK YOU