PAL'S with -6.00 astigmatism

[SunnyNC]

I am the optician, I am the patient. Would like suggestions and willing to explore all avenues.

Kerataconic contact lenses is one option.

As I have had corneal grafts OU I like to wear glasses and would appreciate any suggestions as far as lenses go.

I have my own thoughts but a community of thoughts is far better.

Rx

-1.25 -6.00 x065
-4.25 -5.00 x155

+3.25 Add

Thanks for any input.

[SKIP]

If you are an optician, then you know that the smaller the frame size, the less edge thickness you will have to deal with.
Would recommend 1.67 index for as thin as possible lenses. Are you after a PAL or a lined bifocal?
As an optician, you probably deal with one lab as your primary supplier. I would talk to my sales rep and see if they would comp. you some lenses.

[THE MEB]

you don't mention what your visual needs are, what frame size best suits you, your pd etc: to give you a chance at the best results. As far as giving you the best vision, a glass standard index ft 28 in a round 44 eye frame sounds like a good start with the limited info you have given us. I would shy away from high index or progressives, to give you the best VA possilbe, with the amount of cyl and especially with corneas that look like the face of a teenager after eating chocolate, potatoe chips and downing a 1 litre bottle of coke.
Ok vultures, have at it!

[THE MEB]

just now noticed this thread in progressive forum, lol also just noticed your subject header. probably some sort of free form lens, don't know if you can get glass in free form or not. sorry about the first post of mine

[SunnyNC]

Maybe I wasn't clear enough. The optical stuff I know. There are so many lenses out there to chose from I thought someone might have had more success with having -6.00 ground into a particular PAL. Any good answers will be appreciated.

[MarcE]

Here is what I would try: Send your topographic maps to some of those freeform generator guys. See if they can do something better than normal cylinder. Most will say they can't do anything, but it's worth a try.

I have no experience with the Izon lenses, but if there ever was a canidate, you are it.

I would not agree with the 1.67 recommendation - but you know what you can wear

Maybe the Hoya ID in 1.7?

[Bobie]

Rx

-1.25 -6.00 x065
-4.25 -5.00 x155

+3.25 Add

Just try Impression FreeSign 1.74 :D

[dweinstein]

Varilux Physio 360 is available up to a -6.00 cyl in all materials.

[bigeyejim]

As mentioned above, the 360 is a pretty great lens. I just got one a few months ago, and it is great. I have also been toying with some other "High Def" lenses, but the physios are better in the periphery in my opinion. Of course you could get a thousand opinions here, and youknow what they say!

We have had a few patients with that high astigmatism come through, and in the past they have been thrilled with SolaOne and the like. Would stick with 1.60, since it is next best thing from glass and plastic abbe value speaking.

[Jubilee]

hmm.. my ELOA told me I couldn't get a -4.25 cyl on any of those just this past week.

I would certainly try freeform if you can get it. I love my autograph! You could talk to one of the guys here who specialize in that tech to see if it could be done.

Crickett13, and IceTech are two members who operate digital labs..

[bigeyejim]

I think Essilor just released the physio (only) in cyl. up to 6 diopters. It has to be the Physio 360 and no other Essilor lens. I confirmed this with our lab this morning, as they have been getting sheets from Essilor recently.

Not sure on all of the materials, but again, I would recommend 1.60 (which it is available in) due to abbe value.

Good luck, I love my physio.

:cheers:

[lensguy]

I think Essilor just released the physio (only) in cyl. up to 6 diopters. It has to be the Physio 360 and no other Essilor lens. I confirmed this with our lab this morning, as they have been getting sheets from Essilor recently.

Not sure on all of the materials, but again, I would recommend 1.60 (which it is available in) due to abbe value.

Good luck, I love my physio.

:cheers:

I think this goes to prove the physo is NOT FreeForm. I is as much a FF as a VIP.

[bigeyejim]

I think this goes to prove the physo is NOT FreeForm. I is as much a FF as a VIP.

I think that all the lens manufacturers (or their reps) have succeeded in confusing a lot of us who are dispensing these products. Freeform, digital surfacing, front side/back side, it goes on and on. I think the Ipseo might be the only Varilux lens that is FF. I don't use very much Essilor, so I am more than likely wrong.

I think the problem with all of the "new" lens designs is that they did not have the algorithms to go beyond the -4.00 cyl. A quick peek at the major's websites yields the same -4.00 limit, whether an Autograph, Creation, Zeiss Individual, etc. Even the Kodak Unique, which starts from a SV blank (in any material) limits at -4.00.

I have just had pretty decent success with the Physio with higher powers and cyls.

[Crazy-bout-Optics]

So I still moonlight at LC. Just dispensed a pair of glasses with the following RX:

OD +4.25 -3.00 (I forget the Axis)
OS +3.00 -6.00 (again, axis) ;-)
Add +2.25
Seg at 18

The lady was about 75 years old and the lenses were a Mid Index Photo Plastic PAL. (I believe they are 1.56, I just dont know what they were as they came from LC's Central Lab) I will assume it was an Essilor product though.

She had a relatively small frame, and didn't have any issues after putting panto and Face Wrap (I am sure there is a technical term for this, I just don't know it!), even though the change in Rx was about 1.5D more in the Cyl OU.

Edge thickness I would guesstimate at 4-5mm.

OOPS: Just saw you were looking for a 3.25 add. Call up the labs and start asking around. I think you will be surprised to find more options than you think.

Good Luck in finding the appropriate lens.

[nickrock]

How about an RGP to get rid of all the irregular astigmatism, then you can wear what ever PAL you want over it?

[Robert Martellaro]

I am the optician, I am the patient. Would like suggestions and willing to explore all avenues.

Kerataconic contact lenses is one option.

As I have had corneal grafts OU I like to wear glasses and would appreciate any suggestions as far as lenses go.

I have my own thoughts but a community of thoughts is far better.

Rx

-1.25 -6.00 x065
-4.25 -5.00 x155

+3.25 Add

Thanks for any input.

Maybe I wasn't clear enough. The optical stuff I know. There are so many lenses out there to chose from I thought someone might have had more success with having -6.00 ground into a particular PAL. Any good answers will be appreciated.

Do you have binocular vision? If so, you'll need to be aware of vertical imbalance at far and near- consider slabed STs or separates, maybe a PAL (Hoya ID goes up to 6.00 DC) for general purpose, and separate SV readers.

If you're not binocular, I'd employ a similar strategy except for the concern with VI.

Either way, give some thought to cutting the Add power if you choose the PAL and a separate reader (with the full Add).

If you have time, write up a detailed step by step history of how this transpires.

Thanks,

[chip anderson]

If grafts ever need replacement, try to get a neater surgeon.