Consider this RX, as written...

R -6.00 - 2.00 x 45 2 base IN
L -3.00 -2.00 x 135
Add + 2.00
"Please dispense progressives"
Signed: Joe Blogs MD

So you think about it...
Clearly the patient is:
Just about aneisometropic, has oblique cyls, and is a moderate myope

A discussion with the patient confirms the need for a multi-purpose pair of spectacles - he works in a shop, selling computers, typing up orders, and serving customers all day long, and often multitasks

In the first instance, this looks like a perfect example of a RX for free-form progressives, where the free-form optimisation, can go some way to alliviating some of the problems this type of RX poses

What do we do next? What other info do we need from the practitioner, who is not in the building?

So eagerly we run off and (for no other reason than its the first one to come to my mind) grab that ILT order pad the Rodenstock rep left behind

It asks you for

  • Test BVD
  • The order and power of the lenses in the trial frame including the prisms
  • How you want the prism split up
  • How much the patient converges
and
  • The dihedral angle of the frame
  • Frontal angle
  • BVD for the dispensed frame
  • Mono OC's
  • Mono Heights
Now we are stuck. To start off with (to my mind) the BVD ought to have been on the original order. The other information (to do with the test) is not available. How many "regular dispensers" would struggle with the dispensing measurements.. the implication on the form, is that they want them pretty accuratally

The industry as a whole is not set up to deal with this sort of free-form technology - and thats pre-order. This technology is what we all have, available in our practices today, and it is allready being "demanded" by patients. Some are calling them the "ultimate lenses", but at the moment, unless the refractionist is doing the whole job "from refraction to dispensing and ordering", or, if the dispenser is working hand and glove with the refractionist... the process stops

what practitioners need to do is start recording this type of information, if they have a slight idea that this sort of lens may be used in the dispensing. what dispensers will need to do is learn how to measure all of the new measurements (that most) dont ever measure for anything

The lens manufacturers are throwing down a chalenge to us