magic shelf?

[Bobbi]

10/10/07 rx:
+1.00 sph 3.00 add 20/25+1
-.50 +1.00x115 3.00 add 20/400
Ovation fit at 24mm (fit elsewhere)

10/13/08 rx:
+1.00 sph 3.00 add 20/25+1
-.25 +.75 x115 3.00 add 20/400
Definity CR-39 W/alize in POF fit at 27 by myself

Patient comes in with complaints of blur at distance and feels like it's the axis because the "optician" at the last store told her she probably needed the axis in her rx checked. I marked them up and they were sitting just slightly high, made adjustments, they look beautiful, she stated she loves the new lenses and can finally read without moving her head all the way back (last lenses were obviously extremely low) but wants her old distance in new glasses. Refraction was reviewed and no change was warranted...I asked her to try the new adjustment and she refused and said she just knows it won't work because she's really hard to fit and most people don't get it right the first COUPLE of times!

Is this a case for the magic shelf? I hate to pay another couple hundred dollars on such a small change, when I have a sneaking suspicion that she's just convinced that she's always gonna have a difficult time, and I am wondering if I should go back to the ovation (yuck) even though she's commented on the lenses seeming better...I have personally never used the magic shelf, and am reluctant to mention it to anyone here at my new office- will it be viewed as decietful? But I've seen the magic shelf or drawer or sunshine treatment work before....what should I do with this one?

[Jacqui]

Is this a case for the magic shelf?

That's what I would try. If it doesn't work then go to new lenses.

[Crazy-bout-Optics]

Half of seeing is Believing!

[tmorse]

10/10/07 rx:
+1.00 sph 3.00 add 20/25+1
-.50 +1.00x115 3.00 add 20/400
Ovation fit at 24mm (fit elsewhere)

10/13/08 rx:
+1.00 sph 3.00 add 20/25+1
-.25 +.75 x115 3.00 add 20/400
Definity CR-39 W/alize in POF fit at 27 by myself

I asked her to try the new adjustment and she refused and said she just knows it won't work because she's really hard to fit and most people don't get it right the first COUPLE of times!

Is this a case for the magic shelf?

Up here we call it giving the 'DDT' (Dark Drawer Treatment).
Yes, do try it in this case.:cheers:

[obxeyeguy]

Patient comes in with complaints of blur at distance

Ovation fit at 24mm (fit elsewhere)


Definity CR-39 W/alize in POF fit at 27 by myself

First, look at whats changed, seg height. Patient complaint? Distance blur. Just because the seg height is right to us does not mean the patient will like it. Maybe thats how the ovations got to an "extremely low" 24mm, on the second or third try elsewhere?
Second, a +3.00 add in a progressive can be a problem. High adds = small reading areas. Try to compliment with a pair of readers, if not, try the shelf. (minimum 7 days;))

[drk]

10/10/07 rx:
+1.00 sph 3.00 add 20/25+1
-.50 +1.00x115 3.00 add 20/400


10/13/08 rx:
+1.00 sph 3.00 add 20/25+1
-.25 +.75 x115 3.00 add 20/400

Note: OS is 20/400. It's not the problem, regardless of the "axis"!

Note: OD is the same distance Rx as always!

I'd agree with OBX's seg ht issue on a monocular patient...or she's a moonbat.

Rule out the latter, first, with your placebo "axis adjustment".
Rule out the former by remaking 1 mm lower, if need be.

[Fezz]

or.........

Get out your voodoo doll and make the patient have so many other *ailments* that they forget about this issue!


:cheers::cheers::cheers::cheers::cheers:

[MarcE]

Rule out the latter, first, with your placebo "axis adjustment".
Rule out the former by remaking 1 mm lower, if need be.

I'm sure you know this, but add more panto and spread the nose pads just a bit. TaDa! You lowered the SH by 1.5mm. Of course this procedure should take 4-7 days.

BTW, some people really like Ovations. It's one of the top 5 lenses developed prior to 2006, IMHO.

[Cindy K]

I like Ted's name- DDT. Remember that stuff? It killed everything:D

I once had a chap who was notorious for redo's- and he had it in his head that the first RX would never work, and often the second didn't either. I seem to recall this one time he had changed from white glass to PGX and had a remake done- I think there was something like .25 and a small axis change on a low cyl. Anyways, I guess the other optician hadn't advised him of the need to harden the new lenses overnight unlike the procedure for white glass, and after having the lenses cut I returned the glasses with the originals to him. Before I could remind him to return the next morning for the new lenses to be installed after overnight hardening, he looked around, looked at a reading card and exclaimed how very much better the 'new' lenses were. If only we'd known it was that simple!

[Chris Ryser]

A + 3.00 add is like paying the lottery at high stakes.

Smallest reading seg possible

smallest progressive area

largest distortion area possible

[Fezz]

"I am the only licensed distributor of the FezzJohns(R) Magic Optical Shelf(TM). The shelves retail for $99.95 + $24.99 shipping & handling. Each Magic Optical Shelf(TM) will hold up to 4 orders simultaneously. The recommended hold time for each job will vary between 3 days and 2 weeks depending on job parameters and difficulty of Magic Repair."





I must apologize for coming into this discussion so late. It seems that our American distributor for the FezzJohns, Inc Magic Optical Shelf has fallen of the face of the Earth. This situation calls for this highly effective piece of optical equipment!


Has anybody seen our Man-about-Town, bob_f_aboc? I hope he is OK. He missed a Golden Oppurtunity here to promte the famous FezzJohns, Magic Optical Shelf!

[Refractingoptician.com]

I purchased an early version of this shelf when they first came out .Until you have tried one ,you simply can't imagine the results. It is Absolutely Amazing ! This shelf this will teach you things about optics that you have never seen discussed in any physics books or manufacturer's technical manuals. It should be required before you can graduate.

Some years back I remember a particularly difficult customer and his wife . So difficult that we had to give him a refund , but before we did we asked the wife to put an identifying mark on a pair of lenses (without telling the husband) and we used the MAGIC SHELF to bench rest the lenses for a week . A week later when they came in to pick up the refund check , unbeknownst to him, he left with the refund check & wearing his new lenses (with her identifying mark ) instead of his old ones .

She never did tell her husband , but she did come back in to refund our refund .

[Fezz]

Gary,

Your endorsement check is in the mail!

;):cheers::cheers::cheers::bbg:

[Andrew Weiss]

Earlier version, the WOT*, TM'd by Irving Weiss, O.D., in 1933+. Not as fancy as the (R)Magic Optical Shelf(TM), but equally effective, imho.

Numerous eyeglasses received the WOT after patients complained that the vision with their new glasses just wasn't as good as with the old ones. A 10-day rest in the dispensing drawer after receiving the WOT was just what they needed. Patients were thrilled with the results.

*WOT = "Wipe-Off Treatment"
+ Sorry, FezzJohns, just wanted to give credit to the earlier version. :bbg:

[Andrew Weiss]

Bobbi,

I agree with both drk and MarcE. A WOT, coupled with a slight increase in panto and a slight pad spread, and reinforced with a 5-7 day rest on the Magic Optical Shelf, will probably work wonders.

[Robert Martellaro]

First, look at whats changed, seg height. Patient complaint? Distance blur. <snip> Maybe thats how the ovations got to an "extremely low" 24mm, on the second or third try elsewhere?

Yup.

Second, a +3.00 add in a progressive can be a problem.

And being essentially monocular compounds the problem. So, we have a much softer design, fit higher, with a high add, and the distance suffers. Don't even think about lowering the Definity- you'll only get a slight improvement at far and the near will go away.

Consider using the Physio in this situation- it will have better distance, with the near as good or better than the Definity. You'll need to be very accurate with the fitting cross placement on the horizontal compared to the Definity- no more than +/- 1mm deviation and check the near PD for any surprises.

Try to compliment with a pair of readers

Probably essential if she's an avid reader (SV or segmented multifocals). Consider cutting the Add on the general purpose glasses a step or two if you go this route.

[Dave Metzger]

Always preferred the wipeoff, made sure the white powder from the edger was generously applied to the lenses. Cleaned off in front of the patient and I made sure I warmed the temple tips in the salt pan enough to make her eyes water but not enough to burn .

I was only slapped once in 30 years, didn't call the cops because I knew I'd wake up dead one day. Long story, labor union business. I always coded my union work's record card with "KD". I 'll award a brass figalee with oak leak clusters to the first to identify "KD"

[obxeyeguy]

Kiss of death?

[optigrrl]

And to be sure it is not the design, you could always trial lens her with some stock lenses.

Yup.

And being essentially monocular compounds the problem. So, we have a much softer design, fit higher, with a high add, and the distance suffers. Don't even think about lowering the Definity- you'll only get a slight improvement at far and the near will go away.

Consider using the Physio in this situation- it will have better distance, with the near as good or better than the Definity. You'll need to be very accurate with the fitting cross placement on the horizontal compared to the Definity- no more than +/- 1mm deviation and check the near PD for any surprises.

Probably essential if she's an avid reader (SV or segmented multifocals). Consider cutting the Add on the general purpose glasses a step or two if you go this route.

[Andrew Weiss]

Robert, most of the time I not only agree with you, I defer to your greater depth of knowledge. In this case, I respectfully disagree on a couple of points:

With a 3.00 add, the Definity would be my go-to lens because of the split surfacing of the corridor. Putting 0.75 of that add on the back side will ease off a bit of the pinch in the corridor and reading area.

I'd also say that one could easily lower the height to 22-24mm without sacrificing much of the near area. An experiment with increased panto/widening the pads will tell our dispenser whether there's any improvement from dropping the height, even a little bit. If there is, I'd remake the lenses with the lowered height. Even with the Definity, I'd still put the fitting cross at 3mm below pupil center.

I would also double-check the fitting height with the patient standing up in a natural position. She may be tilting her chin up when she stands, and that would complicate matters.

[bob_f_aboc]

"I am the only licensed distributor of the FezzJohns(R) Magic Optical Shelf(TM). The shelves retail for $99.95 + $24.99 shipping & handling. Each Magic Optical Shelf(TM) will hold up to 4 orders simultaneously. The recommended hold time for each job will vary between 3 days and 2 weeks depending on job parameters and difficulty of Magic Repair."





I must apologize for coming into this discussion so late. It seems that our American distributor for the FezzJohns, Inc Magic Optical Shelf has fallen of the face of the Earth. This situation calls for this highly effective piece of optical equipment!


Has anybody seen our Man-about-Town, bob_f_aboc? I hope he is OK. He missed a Golden Oppurtunity here to promte the famous FezzJohns, Magic Optical Shelf!

Never fear, I'm alive and...well? I hadn't received the necessary documents to secure my exclusivity as the sole US distributor of the Magic Optical Shelf(tm). Without exclusivity, there would be no reason for me to carry the shelf.

Could you imagine what would happen to my business if you gave a contract to someone as ethical as Andrew Weiss? :D

I wouldn't stand a chance!

[Robert Martellaro]

Robert, most of the time I not only agree with you, I defer to your greater depth of knowledge. In this case, I respectfully disagree on a couple of points:

I doubt that my depth of knowledge is greater than yours. However, that doesn't mean I won't try to justify my recommendation.:)

With a 3.00 add, the Definity would be my go-to lens because of the split
surfacing of the corridor. Putting 0.75 of that add on the back side will ease off a bit of the pinch in the corridor and reading area.

But does splitting the Add between both surfaces really have any effect on the quality or quantity of vision, and might the reduced, unwanted astigmatism be due to the fundamental PAL design? In other words, is it possible to achieve the same result with a molded front, or free-form generated back surface design with the all of the Add on one surface?

I'd also say that one could easily lower the height to 22-24mm without sacrificing much of the near area.

I sampled the JJ version, so I'll use that as my point of reference. Maybe the Essilor version is different, but I found the near to be very low in the lens, similar to the Gradal Top. That's with the fitting cross bisecting the pupil. I also found the distance vision to be average- disappointing considering the long corridor. This is common with the very soft designs, and depends somewhat on how soon the power changes below the cross. I found that the power change started high in the corridor, but had a smooth, linear change to the near point.

An experiment with increased panto/widening the pads will tell our
dispenser whether there's any improvement from dropping the height, even a
little bit. If there is, I'd remake the lenses with the lowered height. Even with the Definity, I'd still put the fitting cross at 3mm below pupil center.

Agree to disagree? Again, I found the near to be only adequate, and that was with the fitting cross positioned by the book. It's a reasonably balanced lens, with emphasis on a generously sized corridor (tall, smooth, and wider- mod to strong hyperopes might like this), and might be good for the emerging presbyope, for folks with average to below average very close tasks, and those who are not sensitive to slightly reduced distance vision performance.

I would also double-check the fitting height with the patient standing up in a natural position. She may be tilting her chin up when she stands, and that would complicate matters.

Right.

The answer to the puzzle is "Known Degenerate". Not sure where I heard that, maybe from being glued to hte screen through six seasons worth of the The Sopranos. No shortage of degenerates in that universe.

[Dave Metzger]

KD = knuckledraggers

[Fezz]

KD = knuckledraggers

***LAUGHS***

We use that term at Rendezvous every year!!

:cheers::cheers::cheers::cheers::cheers::cheers:

[Bobbi]

patient picked up "new" glasses and was thrilled. After follow up with her she is very excited that it's working out for her and thinks she wants another backup pair. Thanks for your help and input!!