As a novice I get the impression that the seg height measurement is the weak link or limiting factor in successful PAL fitting. After all, the P.D is easy to do properly with the pupillometer. I have read and applied many tips regarding "dotting the pupil" but still find it rather inaccurate. I have done it standing up while having them look at distance. I have measured sitting down with their elbows not on the table. Eye to eye etc. Nonetheless, for a measurement that has to be really precise I have not been impressed at the reproducibility of this. I have even had several staff members measure seg heights on the same patient and come up with answers that are 3mm apart. I have considered using a cut out with an occluder and a little hole in the middle and asking the patient to fixate on a letter on the wall chart until he sees it through the little hole (and then dotting at that point). Alernatively I have read about a mechanical device called the Y-touch that is being sold by Laramy K. Any advice would be appreciated since I think all my redo's are coming from this issue.
ilan
Bookmarks