I have a patient that is having a hard time with her new progressive lenses.
Her latest rx is: +1.25 -0.50 x 135 / +1.00 -0.50 x 108 150Add OU
Previous rx: +1.00 -0.25 x 132 / +1.00 -0.50 x 108 150Add OU
New frame is the same as her old "doesn't like change"
She originally came in for a disp and immediately took the glasses off and declared they "weren't right"
When talking further, she was unhappy with swim, distortion, and a narrow field of view. The lens we used was a poly Physio. Fitting cross was right in center of pupil horizontally, and bottom of pupil. Seg height was 21.5 and PD was 31 / 28.5
Double checked old pair (I didn't fit her initially) Her segs in old pair were at 17 fitting at bottom of lash line. The old lenses, I thought were Kodak, (+) symbol, (the nasal edge had one markign completely cut off, the other was beveled just to the side of the identifier)and poly... I remade lenses at 17 and in the Kodak Concise instead.
Picks them up yesterday, and back in office today. Lenses don't work as well as old at work. Field of view is more narrow, and computer work is much more laborous. Checked face form, tilt, BCs,vertex, etc. Compared heights, OC's etc.
The only thing I noticed was the monocular pd was opposite. IE they measured 28.5/30.5 The fitting cross in the right eye was fit at the nasal edge of the pupil. The left was a bit to the temporal edge.
She claims the periphery is clearer in old, including the temporal edge. Now I could understand the left eye possibly having a wider zone to the outside, but I would think the right would have less....
I called the previous dr and they couldn't tell me squat. They claim to have been using Kodak only the past two months, so the lenses must be a different manufacturer. I did notice on the concise, that the add was represented as 15 and on her previous pair as 150. Could this be a navigator? The previous place was a bargain chain using their own materials for Davis vision. We of course are using davis labs. When I called to ask for additional information and faxed them the patient release, I got they were poly, yep the rx was neutralized right, and they had a pds of 58/55 and could give me monocular or tell me what progressive it was. No prism prescribed and no notes for the low fitting. That info is stored at the labs and it wasn't possible to call them.
There wasn't much change in the rx at all... I remeasured her pd's both manually and using a pupilometer and ended up with 30.5/29 ... I know some people are sensitive... but geesh.. I am at wit's end here.
Cassandra
Bookmarks