Opinions?

[Jubilee]

I have a patient that is very finicky. She spent HOURS choosing a frame, and the one that was finally settled upon by all of us involved (hubby and a lab/frame rep were here as well) has a fitting height of 18.

She has a mild plus script (+0.50) with some cyl and a 2.25 add. The pair she bought 3-4 years ago were a Natural. She has tried some other types in the past few years, but has ended up not using them, or returning in the case of the last pair, because she hasn't liked the vision in them.(they were purchased at a chain store for insurance purposes, and has decided the insurance wasn't worth the frustration.)

She works at a computer all day, but doesn't want to invest in a computer pair at this time.

I was considering switching her to one of the premium brands, to see if I can help her get a wider intermediate and good overall use.

I thought about switching her to the Gradal Top, but I also know many here think that the Gradal should be a 20-22 height, instead of 18. The Brevity I was afraid would not have a large enough intermediate since it is meant for a 16 height.

Of course there is the Comfort which is very similar to the Natural...

Then there is the why switch if she likes the other design...

What are your thoughts? (her old add was a 2.00)

Cassandra

[QDO1]

has she also posted on the board?

[QDO1]

fit her well with a Comfort,and tell her to fit S/V for intermediate in the old pair. If she refuses, explain and note on your records the limitations of the comfort

Write the patient a note on the recipt saying something like: "sold - 1 pair of general lenses designed only for general purpose vision tasks"

If 2 weeks down the line the patient kicks off, explain that against your professional opinion, she went for a single multipurpose pair of spectacles, for which you explained the limitations, and refuse the refund

[Happylady]

What is the height of the Natural she is wearing now? If it is 20 or more explain to her that she will lose some of the reading area off the bottom of the lens. I will sometimes take a dark marker and mark out the amount of reading area a patient will lose.

If she is okay with it then keep her in the Natural, if not I suggest the Comfort. The channel in the Comfort is 2 mm shorter then in the Natural so it can be fit a little lower.

[Jubilee]

Her current Natural is also fitted at 18.

She hasn't posted here ;) Though she might be inclined to be like some others who have. She has had some bad experiences, so is now back to us, because the insurance portion was a hassle if it meant bad vision....

Cassandra

[For-Life]

Use the Ellipse or Ovation. The Ovation is an overall good lens, and the Ellipse is a doll of a lens. I find that people using computers love the Ellipse.

[spartus]

I second the Ellipse recommendation, but have you thought about going with a computer-only lens like an Access/Office/Interview instead of a PAL? With her light distance RX, there's a good chance she won't use them often away from computer and reading.

[Happylady]

This patient is very picky so if she is happy with the Natural then why change her?

I computer lens would be great for when she is just sitting reading or at the computer but she wouldn't be able to walk around with it. With her correction everything from about 2 feet in would be blurry. It is nice to be able to just put a pair on and not have to hunt them down whenever you want to look at your watch or anything close up.

[Jubilee]

I am trying the Ellipse. I am hoping to improve things for her, rather than maintain the status quo of her 3-4 year old pair. I have also had successfully fitted several people to the Ellipse, and so far not a one of them have complained. Including previous comfort/panamic wearers.

We discusssed a computer only pair, and she might bite on that in a few months after she has a chance to try the new ones, and recoup some of the expense.


Cassandra