Lens recommendations for -19.25

**Joann Raytar** · 06-27-2006, 08:50 PM

Any lens recommendations for a -19.25 sphere OU? It's been a long time since I've fit something that high - they didn't have super high index back then.

Her last lenses were purchased outside of the US and don't appear to be aspheric. Looks like she was wearing .50 BC sperical front cut to a 1.2 CT and 10.8 ET.

I've helped her choose a slightly smaller frame than the Shillouette SPX type that she was wearing but now I have to think lenses.

**HarryChiling** · 06-27-2006, 09:00 PM

If you were to make a myodisc out of a 1.67 index blank with 0.50 base and a 30mm bowl diameter (for lack of better term), and surface to 1mm center thickness. The actual thickness would be about 4 1/2 mm, I would definately recommend an AR coat and if you were to make them in a plastic frame They would look great for that Rx.

**thep** · 06-27-2006, 09:11 PM

Depending on your frame size and decentration, you could consider a 1.70 tokai SV. GREAT ACUITY. also a bi-concave in a 1.67 would be a good option.:p

**chip anderson** · 06-27-2006, 09:29 PM

Contacts!

**HarryChiling** · 06-27-2006, 09:39 PM

Originally Posted by chip anderson

Contacts!

Definately the first choice, but it would be good to have a pair of glasses as a back up.

**Jim Stone** · 06-27-2006, 09:45 PM

Originally Posted by Jo

Any lens recommendations for a -19.25 sphere OU? It's been a long time since I've fit something that high - they didn't have super high index back then.

Her last lenses were purchased outside of the US and don't appear to be aspheric. Looks like she was wearing .50 BC sperical front cut to a 1.2 CT and 10.8 ET.

I've helped her choose a slightly smaller frame than the Shillouette SPX type that she was wearing but now I have to think lenses.

Frame as small as possible. Lasik.

**orangezero** · 06-27-2006, 09:53 PM

I just don't understand why people feel lasik for high myopes is ever a good idea. Doesn't a -19 myope have enough to worry about??

**Jim Stone** · 06-27-2006, 09:58 PM

Originally Posted by orangezero

I just don't understand why people feel lasik for high myopes is ever a good idea. Doesn't a -19 myope have enough to worry about??

Hell, I don't know. I aint no doc. I just know if was a -19, I'd be looking for some type of sergery. Maybe remove the crystaline lens? I'd see an Ophthalmoligist. Maybe two or three.
You know so much. What'd YOU do?

**Fezz** · 06-27-2006, 10:01 PM

Bi-concave in 1.66/1.67. AR coating would be a must. I would also suggest breaking out the old Distometer to get a real accurate vertex distance and compare to the phoropter distance.
Maybe a blended type myodisc which has been mentioned. It would be thinner. I have used them for -20 and up. I belive there was a post not too long ago about a -53.00? I think a lab in England produced them. Do a search.

Fezz
:cheers:

**HarryChiling** · 06-27-2006, 10:18 PM

Originally Posted by Fezz

I belive there was a post not too long ago about a -53.00? I think a lab in England produced them.

The diameter of that lens couldn't be more than 26mm or so and even in a myodisc would be thick. Wow

**Fezz** · 06-27-2006, 10:26 PM

Harry,

Yeah, I was impressed that they could even do it. They even posted pictures on here. Wish I could find it. I would like to review the specifics again.

Found it. It was a -35.00(my bad) The thread dated 10-14-2005 "Hi-Minus" by a member called Optispares.

Fezz
:cheers:

**orangezero** · 06-28-2006, 12:33 AM

sure, have them see an ophthalmologist. Most of them at least had a two week night course on optics and refracting while they were training to become doctors.

**Steph26** · 06-29-2006, 09:57 AM

What about the 1.74 high index lens?

**optixbil** · 06-29-2006, 10:49 AM

What works really well is contacts and a pair of eyeglasses to correct the balance. If contacts are not an option, a bi concave lens looks pretty good if you use a 6 base lens with a small bowl, say -15 on the front. I've done quite a few of those. A flat base bi concave is pretty ugly in a frame whereas the 6 base fits nicely.

Bill Belanger

**Ory** · 06-29-2006, 11:48 AM

Originally Posted by Jim Stone

Hell, I don't know. I aint no doc. I just know if was a -19, I'd be looking for some type of sergery. Maybe remove the crystaline lens? I'd see an Ophthalmoligist. Maybe two or three.
You know so much. What'd YOU do?

If the patient is desperate you could consider a LASIK procedure to remove some of the minus but I highly doubt anyone has enough corneal thickness to deal with a -19. You'd also have to use intralase to make the flap as putting a suction ring on a -19 in very risky.

I also doubt you'd find too many ophthalmologists who would want to operate on this patient unless there is no other alternative. Any surgical solution increases the risk of retinal damage, and when taking out a clear lens they often need to use a bit more energy. Again, not a good idea.

It really sucks being so far "above average."

**RGC_man** · 06-29-2006, 11:56 AM

Rodenstock Lentilux.

**sharon m./ aboc** · 07-08-2006, 06:13 PM

Originally Posted by Fezz

Bi-concave in 1.66/1.67. AR coating would be a must. I would also suggest breaking out the old Distometer to get a real accurate vertex distance and compare to the phoropter distance.
Maybe a blended type myodisc which has been mentioned. It would be thinner. I have used them for -20 and up. I belive there was a post not too long ago about a -53.00? I think a lab in England produced them. Do a search.

Fezz
:cheers:

HOW SMALL WOULD AND EYE LOOK BEHIND A -53.00 LENS? PROBABLY THIS SIZE OF A PIN HEAD.

**chip anderson** · 07-08-2006, 07:39 PM

Sharron:

How long/large would an eye have to be to need a -53.00? Of course the patient probably had keratoconnus and the practioner was not a master of rigid lenses.
Chip

**sharon m./ aboc** · 07-12-2006, 03:07 AM

Chip,
I asked how small it would LOOK, you know minimized to the tune of -53.00 diopters. Even a -10.00 in a high-index makes a persons eye look extra beady.

**Joann Raytar** · 07-30-2006, 08:22 AM

We went with the 1.67 AR. Hmmm. It was better than what she was wearing and yet was a bit disappointing. Actually, the whole process was a bit disappointing. Our lab couldn't make the job in-house; they had to send it out to another lab. When I first started, high pluses and minuses weren't this big a problem to make. I looked at it and knew that 10 years ago even I could have come up with a thinner product in a lower index.

I suppose part of the problem may have been the 2.2mm CT. I'm not sure if that was the best the lab could do or if that is just a policy to control shrink due to breakage.

**Dave Nelson** · 07-30-2006, 04:50 PM

What the heck does everyone have against 1.8 or 1.9 index lenses? I have used the Nikon pointal 1.8 in very high minus with good sucess. Why does 1.67 keep coming up even in severe myopic cases? Not the abbe? My suggestion for this rx: 1.8 ground to 1mm, a little "face form" on the frame to put some curve in front of the patients nose, and a heavy feather to buff down the edge.

**Dave Nelson** · 07-30-2006, 04:55 PM

If you have a hruby attatchment for your slit lamp you can see for yourself.

Originally Posted by sharon m./ aboc

Chip,
I asked how small it would LOOK, you know minimized to the tune of -53.00 diopters. Even a -10.00 in a high-index makes a persons eye look extra beady.