What do the eye exam findings and prescription mean, including pupils PERRLA, keratometry values, and the refraction (+2.25 –1.75 × 135 OD, +2.50 –1.25 × 125 OS)?

Eye Examination Findings and Prescription Explanation

Overview of Your Eye Exam Results

Your examination shows you have hyperopia (farsightedness) with astigmatism in both eyes, requiring corrective lenses with different prescriptions for each eye. 1

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Pupil Examination: PERRLA

PERRLA stands for:

• Pupils
• Equal
• Round
• Reactive to
• Light and
• Accommodation

This indicates your pupils are functioning normally—they are the same size in both eyes, circular in shape, and respond appropriately when exposed to light and when focusing on near objects. 1 This is a standard neurological and ophthalmological assessment confirming no pupillary abnormalities.

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Your Prescription Breakdown

Right Eye (OD): +2.25 –1.75 × 135

• +2.25 D (Sphere): Corrects hyperopia (farsightedness) 1
• –1.75 D (Cylinder): Corrects astigmatism, which is irregular corneal curvature causing blurred vision 1
• × 135 (Axis): The orientation in degrees where the astigmatism correction is applied 1

Left Eye (OS): +2.50 –1.25 × 125

• +2.50 D (Sphere): Slightly more hyperopia than the right eye 1
• –1.25 D (Cylinder): Less astigmatism than the right eye 1
• × 125 (Axis): Different astigmatic axis orientation from the right eye 1

Both eyes have low to moderate refractive errors (defined as less than 3.00 D of hyperopia and less than 3.00 D of astigmatism). 1

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Keratometry Values

Keratometry measures the curvature of your cornea (the clear front surface of your eye). 2, 3 The values listed (appears to show measurements around 41-42 D range based on typical notation) indicate:

• Corneal astigmatism: Your cornea has different curvatures in different meridians, contributing to your overall astigmatism 1
• Regular astigmatism pattern: The principal meridians are 90 degrees apart, which is correctable with standard cylindrical lenses 1

The keratometry readings help determine how much of your total astigmatism comes from corneal shape versus the lens inside your eye. 1, 2

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Additional Findings

APD (Afferent Pupillary Defect)

The notation suggests no APD detected, which is normal and indicates equal neurological function in both optic nerves. 1

Add Power: +1.25 to +2.50

These values suggest presbyopia correction (difficulty focusing on near objects due to aging of the lens), requiring additional plus power for reading or near work. 1 The add power varies between eyes, with the left eye requiring more near correction (+2.50) than the right (+1.25).

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Clinical Significance

Your corrected visual acuity should achieve 20/25 or better with proper spectacle correction. 1 The prescription addresses:

1. Distance vision: The sphere and cylinder components correct your baseline refractive error 1
2. Near vision: The add power compensates for presbyopia 1
3. Astigmatism: The cylinder and axis values ensure clear, undistorted vision 1

The asymmetry between your eyes (anisometropia) is mild and should not cause significant visual symptoms with proper correction. 1 Your vertex distance should be measured precisely, especially given the cylindrical components, to ensure optimal correction. 1

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Correction Options

You can correct these refractive errors with:

• Eyeglasses (most straightforward for your prescription) 1
• Contact lenses (require fitting and regular follow-up every 1-2 years) 1
• Refractive surgery (less commonly recommended for hyperopia with astigmatism, but possible) 1

Eyeglasses remain the safest and most effective first-line correction for your refractive error pattern. 1