What would you recommend for this (anisometropic) prescription??

[Win C]

Hi all,

I have a customer with the following prescrition:
Age45 year old.

R -1.50/-1.75x180
L-7.00/-0.50x180
Add+2.25

He does not have amblyopia and VA in both eyes is 6/6 for distance and near.

Have not worn progressive lenses before.
He used to be using specs as monovision to help him read.

May I know which lens you guys would use and how would you manage such a prescription?

Thanks

[chip anderson]

Bifocal rigid contact lenses. Second: Choice Single vision toric soft contacts with bifocal glasses worn over same.
Third choice Bifocal aspheric glasses with slab off and some possible immage balancing with bi-lateral over refraction to reduce any image size diploplia.
Or in glasses the advise of a really good orthoptic person (like one trained in same at John's Hopkins).

Chip

[Dave Nelson]

You cannot always be sure of the image disparity that will result based solely on the rx. It is possible to have aniseikonia with same rx in both eyes. This makes it difficult to predict what action to take, but using the rx alone will at least be correct in determining the imbalance more often than not.You can usually manage aniseikonic imbalances by altering several things. Base curve, thickness, vertex distance and power. There is no real need to run through a series of complicated calculations... most good labs have computer programs which do it for you. You may be able to use base curves and thickness to control about half the image size disparity, then change the vertex by putting the bevel further foreward on one lens than the other. It is also feasable, as a last resort, to simply reduce the disparity by changing the rx in the non-dominant eye towards the power in the dominant eye. This will obviously result in reduced acuity in that eye, but some reduction may be acceptable under the right circumstances. As chip mentioned, there are other options as well, but I would consider eikonic specs, one for near and one for distance as an option to look into. Good luck