Refractionists who today, still write Rx's in "+" Cyl

[Barry Santini]

form..


...need to be spanked!

I'm gettin too old to deal with this...especially when using wrap compensators.

My two cents...what's yours?

Barry

[Fezz]

Come on Barry, a little transposing never hurt anyone! :D


I have one MD who refers ALOT of patients to me. With the amount of patients he refers...........I would have to *spank* myself (back to reality) before I would ever vote for a "NO Plus Cylinder Rule"!


:cheers::cheers::cheers::cheers:

[chip anderson]

As long as it gets out of the doctors office and into my store I don't care how he writes it. If I can't read it or don't understand anything I call.
But then I still remember when plus cylinder was ground on the front, minus cylinder on the back.
I have even had practioners who occasionally wrote one eye in plus cylinder and the other in minus.

Chip

[DragonLensmanWV]

As long as it gets out of the doctors office and into my store I don't care how he writes it. If I can't read it or don't understand anything I call.
But then I still remember when plus cylinder was ground on the front, minus cylinder on the back.
I have even had practioners who occasionally wrote one eye in plus cylinder and the other in minus.

Chip

Ohh, man. I had a job once that was CR-39,high plus, plus cyl and about 5D cyl axis 90. Just TRY to keep that in a 52 eye Cambridge!

[braheem24]

My two cents...what's yours?

Barry

Most ECPs that refract in +cyl see 90% hyperopes, it's a little easier for them to add Cyl without taking away plus.

[gemstone]

:eek:

[Barry Santini]

wait till you make, or have to make wrap transpositions regularly..

You will HATE plus cyl...

B

[braheem24]

Hire an elf to transpose for you, I think there's one about to get fired in another thread :D

[TLG]

I work for an MD and deal with it everyday. The math is simple, especially since we are working with a relatively limited number set. However, I find myself constantly transposing to answer patient questions about Rx differences etc and of course always when calculating contact lens powers.

Barry, could you give us an example of how plus cylinder complicates your wrap Rx's? I am asking only out of curiosity and hope you won't take offense to me asking.

Perhaps this should be a separate thread, but why do MD's tend to write in plus cyl and OD's in minus?

[lab fly]

The only time I see OD's use this is when they in an Opthamology clinic. My opinion is it makes them feel more like MD's. Now OD's do not get offended, that is my opinion but it just happens to happen every time in my experience.

[braheem24]

ODs tend to have no choice when the autorefractor is set to +cyl and all the phorotptors are +cyl. ;)

Nothing to do with feeling important my friend.

[Spexvet]

I key the Rx into my computer, then click the "transpose" button. :bbg:

[Barry Santini]

Barry, could you give us an example of how plus cylinder complicates your wrap Rx's? I am asking only out of curiosity and hope you won't take offense to me asking.

Perhaps this should be a separate thread, but why do MD's tend to write in plus cyl and OD's in minus?

I use Darryl's wrap compensator. I have it set to a precision of 0.01D. Since I *evaluate* the compensated Rx, the starting Rx, the previous Rx history (which usually is in minus cyl), and the expected Rx progression when I decide how to order and tolerance the wrap eyewear, and that the compensator *only* gives results in minus cyl form...well..it is just easier if they are all in the same cyl convention. There is simply less chance of mistakes being made.

No matter how you slice it, I see no excuse for continued use of "+" cyl form. Some might say I'm lazy. But I'll counter that the refractionist is too lazy to "get with the program" in the new millenium.

FWIW

Barry

[mlm]

ODs tend to have no choice when the autorefractor is set to +cyl and all the phorotptors are +cyl. ;)

Nothing to do with feeling important my friend.I too thought it has somthing to do with MDs having + cyl in their phoropters, while ODs have - cyl.

[Bezza]

I really fail to see the problem here. Transposing from plus cyl to minus cyl is so easy that you ought to be able to do it in your head without barely giving it a second thought, (except to double check of course).

[npdr]

I think the original poster's intent may be misplaced or is trying to take a swipe at optometrists. What a ridiculous post.

1. A plus cylinder prescriptiondon't mean you have to dispense as plus cylinder base curve lens form.
2. If you cannot transpose, don't accept the Rx's.
3. If you're so upset, tell the prescribing doctor so the doctor can send the Rx somewhere else.

[35oldguy]

Chip,

I can remember when I used to rock them cylinders in. I bet you do too!

*quote=chip anderson;191341]As long as it gets out of the doctors office and into my store I don't care how he writes it. If I can't read it or don't understand anything I call.
But then I still remember when plus cylinder was ground on the front, minus cylinder on the back.
I have even had practioners who occasionally wrote one eye in plus cylinder and the other in minus.

Chip[/quote]

[35oldguy]

For us old dogs it is a piece of cake!

I think the original poster's intent may be misplaced or is trying to take a swipe at optometrists. What a ridiculous post.

1. A plus cylinder prescriptiondon't mean you have to dispense as plus cylinder base curve lens form.
2. If you cannot transpose, don't accept the Rx's.
3. If you're so upset, tell the prescribing doctor so the doctor can send the Rx somewhere else.

[Barry Santini]

I really fail to see the problem here. Transposing from plus cyl to minus cyl is so easy that you ought to be able to do it in your head without barely giving it a second thought, (except to double check of course).

Again, with the advent of wrap compensations (done to a precision of 0.01D), I think you'll see my point when you are doing quite a number of these, as I do.

Barry

[Barry Santini]

I think the original poster's intent may be misplaced or is trying to take a swipe at optometrists.

To clear the air... I was *not* trying to take a swipe at ODs...only those refractionists who continue writing Rxs in "+" cyl form.

Barry

[orangezero]

IMO, it has pretty much everything to do with who buys the equipment, or what equipment was there to begin with. The autorefractors may have a neat little button to switch from + to -, but the phoropters rarely do :)

I doubt there are any ODs who feel more *special* because they write a prescription in +cyl.

[chip anderson]

The answer is really simple, Jack Copeland taught refraction at most medical schools. Jack thought +cylinder was better. Of course he also thought myopes were geneticly inferior to hyperopes.
He carried a retinasocpe (skiascope) with him at all times (copeland streak) and married a hyperoptic woman to avoid having myoptic children.
You guessed it, he had myoptic daughters.
Chip
On a related vien, Archie Manning married a tall woman so he would have tall sons, that worked.
G. Gordon Liddy married a mathmatics prodigy to have intelligent children, that supposedly worked at least in his view.

[MarcE]

We have an opthalmologist nearby that works in - cyl. He is the only one near us. Is this rare or very rare?

[braheem24]

The answer is really simple, Jack Copeland taught refraction at most medical schools. Jack thought +cylinder was better. Of course he also thought myopes were geneticly inferior to hyperopes.
He carried a retinasocpe (skiascope) with him at all times (copeland streak) and married a hyperoptic woman to avoid having myoptic children.
You guessed it, he had myoptic daughters.
Chip
On a related vien, Archie Manning married a tall woman so he would have tall sons, that worked.
G. Gordon Liddy married a mathmatics prodigy to have intelligent children, that supposedly worked at least in his view.

Thanks Chip, can I call you Cliff Clavin?:D

[rdcoach5]

wait till you make, or have to make wrap transpositions regularly..

You will HATE plus cyl...

B

I don't understand the problem, since all our Rx's are written in plus cylinder and the wrap comp is written in minus . So, transpose the Orig Rx and read it the way your lab has compensated for the wrap. It's only about 1/12 of a diopter, anyway for most Rx's.

[edKENdance]

There's a Doc around these parts that writes his RX in a plus cyl and a minus cyl for the other eye if people aren't going to shop at his store and go elsewhere. It takes a fair bit of explaining to the customer why you are changing their prescription. I want to feed him broken glass. Is that wrong?

[Barry Santini]

It's only about 1/12 of a diopter, anyway for most Rx's.

Tell me you didn't *mean* "1/12"!!

The bottom line is that transposition is just another venue for error. Last night I met with the head of the ECP division of Carl Zeiss for an "Eye Terminal" presentation/demonstration. At dinner, he enthusiastically agreed with me on this transposition point, since Zeiss continues to experience needless redo's with Individual order because Germany/Canada's system for order processing of this Rxs is based in *plus* cyl, whereas the majority of Rxs are written in minus. (this just goes to show it is not about + or -, but rather about the error-ladened transposition process.

We both agree that transposition produces needless communication errors. This is my point!

Barry