help please

**stiff** · 07-26-2007, 06:55 PM

k people im stuck here i have a lady at my work which was originally wearing adapter PAL's , she choose a smaller frame so i decided to change her into AO compact 16 seg ht , (by the way this was in her budget not Nikon I which i would have loved to fit her with) she tried on the glasses and said they dont feel right i doulble checked pd,panto seg ht and rx ,all was fine i told her to give them a chance and ry them out for 1 week at home . she came back after 1 week and said her os distance is blurry monuculary and od is blurry reading and that she feels a pulling sensation in her eyes i told her to go to the optometrist and have her rx examined again but the optometrist said all is fine with his original dispensed rx, i need help i think its the rx but the optometrist says its fine unless hes being a prick and not correcting it since she never went to him to get glasses
help please

rx od +.75-.50 x80 +2.00 add
os -.75sph +2.00

**For-Life** · 07-26-2007, 07:13 PM

First off, when you took the PD and OC, did you take it monocularly or biocularly?

I just know that if there is one lens I have had trouble with, it has been the AO Compact.

Put her into the Essilor Ellipse or Small Fit. Rodenstock XS would probably work too.

Either that or back into a larger frame.

**kmc** · 07-26-2007, 07:27 PM

are lens materials the same?
what was the add power in old rx?
occaisionally, the add power has to be bumped up +.25 in order to accomodate a smaller frame size.

**cocoisland58** · 07-26-2007, 07:52 PM

The first thing I would do is cross check ALL the measurements in the old glasses vs. the new If she was wearing an incorrect PD that could be it, or the drop is different, or her add is higher now which could make her more aware of the multifocal. If that didn't turn up anything I might just put her in the exam chair and have our doc check the Rx. No charge to the patient, we don't bad mouth her doctor, if there is something wrong we just say "oh yes, if we just tweak it a liitle here you will see much better". Sorry, but putting her in our exam chair saves much headaches and guess work.

**chip anderson** · 07-26-2007, 08:25 PM

Have used this on a number of patients including my wife. In the wife's case she said it took her a whole 14 days to make friends with them. All complained when origionally trying the lenses. Haven't actually had to eat any but you can expect some patient negative reaction whenever you convert to short corridor.
Whenever possible try to avoid short B measurement frames for progressives. Either find a deeper frame or convert them to a segmented bifocal.
Don't know if any of the others actually made friends with them or gave them up and went elsewhere, they did stop coming in after about 2 weeks wear and complaining. Wish I were sure this is a good thing.

Chip

**MarcE** · 07-27-2007, 12:00 AM

pulling = PD is off, right?

Blurry in one or other eye = cyl axis is off or over plussed, right?

No cyl to speak of, so the axis isn't the problem.

Maybe over plussed because of the short corridor. Check the old specs at the pupil, and check the new. If the old specs were fit low (which was popular in the not so distant past), and theses are fit right on, she is looking down the road overplussed by +0.25

I also don't like the Compact. Smallfit is barely more $ but only comes in poly.

one plus lens and one minus lens? Check the Rx

My doctor would tell you to check the BC, but that's not the issue.

Better to lower the expectations on those that change from large frame to short corridor PAL. They are never completely happy.

**Chris Ryser** · 07-27-2007, 04:55 AM

Originally Posted by chip anderson

Haven't actually had to eat any but you can expect some patient negative reaction whenever you convert to short corridor.
Chip

Chip is right.

From a larger PAL to a smaller..........with increased add........channel gets narrower and a small frame provides very small or no reading seg.

**bren_03825** · 07-27-2007, 08:33 AM

Refit to larger PAL

**Lucasdad** · 07-27-2007, 02:58 PM

Here is an idea, try fitting her in an AO Compact Ultra and dropping the seg ht 2mm to 14. AO says that minimum ft height is 13 and that is to FULL add power (no 85% bull). I have pretty much given up on the Compact in favor of the Ultra and have had better results while only costing me slightly more per pair that the original Compact.Good Luck.:bbg:

**igirl** · 07-27-2007, 05:32 PM

Agree with trying the Compact Ultra. Since it has been released early this year, it has already surpassed the standard Compact in sales within our lab. Everyone that I have talked to wearing it loves it.

**Optowoman** · 07-27-2007, 06:53 PM

I wear a Physio 360, Image, Compact, Hoya products and lastly have tried the Ultra. I have dispensed the Ultra with no complaints. (to new prog. wearers) Personally I despise it. There is so much swim and such a narrow corridor I will not wear it. Of course I put it into one of the most expensive frames I own. Anyone else with this problem or am I a whiner?