High Plus puzzler...

**Uilleann** · 02-12-2009, 04:12 PM

Haven't seen one of these in about a year and though I'd run it past the crew and perhaps see if there's anything I've missed:

Rx: +12.00 -1.25 X 180 with a +2.50 Add OU

Going into a small round frame: 40-19

PD: 26.0/29.5

Young guy about 10 yrs old I believe. He's had some appallingly badly made ft-28's from a local Eyeglass World I think it was.

I was thinking perhaps a Super Modular, or possibly an aspheric round 22 seg. As a last resort I guess I can think of a lenticular 'bubble' lens.

All else being equal, the two things I would *like* to do are try to keep him in a flat top design vs. round, and of course minimize thickness as much as I possibly can. CR is about the only real option in this power range from what I remember.

Suggestions?

**Fezz** · 02-12-2009, 04:21 PM

I'll beat Chipster to it!

Fit this poor LITTLE RASCAL with contacts!

;):cheers::cheers::cheers::cheers::D

**Jacqui** · 02-12-2009, 04:31 PM

He's 10 years old Fezz !!!

Anyway, how about a bi-convex (saddleback)??

**finefocus** · 02-12-2009, 04:39 PM

Originally Posted by Uilleann

Haven't seen one of these in about a year and though I'd run it past the crew and perhaps see if there's anything I've missed:

Rx: +12.00 -1.25 X 180 with a +2.50 Add OU

Going into a small round frame: 40-19

PD: 26.0/29.5

Young guy about 10 yrs old I believe. He's had some appallingly badly made ft-28's from a local Eyeglass World I think it was.

I was thinking perhaps a Super Modular, or possibly an aspheric round 22 seg. As a last resort I guess I can think of a lenticular 'bubble' lens.

All else being equal, the two things I would *like* to do are try to keep him in a flat top design vs. round, and of course minimize thickness as much as I possibly can. CR is about the only real option in this power range from what I remember.

Suggestions?

No point doing (and paying for) a lenticular, the OZ would be about 40 mm anyway. Hyper-aspheric flattops are still around, although their original target group (aphakics) are now rare.

**obxeyeguy** · 02-12-2009, 05:23 PM

Originally Posted by finefocus

No point doing (and paying for) a lenticular, the OZ would be about 40 mm anyway. Hyper-aspheric flattops are still around, although their original target group (aphakics) are now rare.

+1 to that. Also a super modular would loose all advantages in a frame that small.

**chip anderson** · 02-12-2009, 06:28 PM

There's no reason not to fit a 10 year old aphakic patient with contacts.
There is a reason not fit the little myopes who momma wants to have contacts just like hers (they should wait for the hormones to kick in at 14)
But whenever there's a theraputic reason, the time is right.

No reason to not fit a 5 year old either. Only problem with younger is so many parents lose interest after a while and a bunch of lost lenses that it breaks your heart when they bring them in as teenagers and have irretrieveably lost vision.

Now as to the spectacles use a round top.

Chip

**Uilleann** · 02-12-2009, 07:37 PM

Patient came to us with an outside Rx. So the contacts vs. not wasn't a decision made in our practice. The doc (and the parent's) would like to keep the patient in a FT instead of a round seg if at all possible.

Just was told today by an old lab manager friend of mine that the super modular has been discontinued. And we are trying to move as quickly on this as we can...so it seems lenticular may be the flavor of the week. *sigh* I still wonder anfter years and years, why none of the lens mfrs make any offering in a higher indice than CR-39 for these types of patients. Sure they're not as common as the rest, but something would be nice. Oh well.

**Fezz** · 02-12-2009, 07:44 PM

Originally Posted by Uilleann

*sigh* I still wonder anfter years and years, why none of the lens mfrs make any offering in a higher indice than CR-39 for these types of patients. Sure they're not as common as the rest, but something would be nice. Oh well.

I heard that the manufacturers have been working on a polycarbonate version. They can't get it to happen though. They all agree that Trivex/Phoenix is a MUUUUUUUUUUUUUUUUUUUCH bettter material. Research and cost/benefit ratios are being explored!!

;):cheers::cheers::cheers::cheers::cheers::D

**chip anderson** · 02-12-2009, 07:49 PM

Save yourself some time you are not going to find a higher index for this patient unless you can get one of these "freeform" people to do it.
It ain't out there unless it's in glass.,

**obxeyeguy** · 02-12-2009, 07:59 PM

Just was told today by an old lab manager friend of mine that the super modular has been discontinued.

I thought so too, but I just spoke with my lab Tuesday as we also have a similar RX going thru, and he offered a super mod as a choice. Better make a phone call...

**mshimp** · 02-12-2009, 09:55 PM

With this high plus rx, the super modular aspheric round seg 22 would be the best (11.00 base). too bad if discontinued. Why do they want a FT ? The round seg looks more invisible.

**chip anderson** · 02-12-2009, 10:22 PM

The round seg. also has base down prism to offset the base up in the distance power. Patient would not have as much displacement when looking down.
Minus=flat top
Plus = round top

Basic Optics 101

**Jacqui** · 02-13-2009, 06:54 AM

Originally Posted by Uilleann

, why none of the lens mfrs make any offering in a higher indice than CR-39 for these types of patients. Sure they're not as common as the rest, but something would be nice. Oh well.

Check with Docinchina, someone over there is making a high base, high index FT or round seg lens.

**iaam008** · 02-13-2009, 07:43 AM

Fezz...Fit this poor schmuck with contacts! Fezz, I know you are well versed in optics and I respect your knowledge, however, using profanity in this thread is NOT necessary. The word "schmuck" in Hebrew means "prick", and I would appreciate it that you do not use this type of language. Thank you.

**spazz** · 02-13-2009, 07:55 AM

That was kind of a schmucky post.
:D:D

**Fezz** · 02-13-2009, 09:31 AM

Originally Posted by iaam008

Fezz...Fit this poor schmuck with contacts! Fezz, I know you are well versed in optics and I respect your knowledge, however, using profanity in this thread is NOT necessary. The word "schmuck" in Hebrew means "prick", and I would appreciate it that you do not use this type of language. Thank you.

My fullest apologies! I had no idea that that was the meaning! I appreciate the public scolding and learning oppurtunity!

:shiner::cheers::cheers::cheers::o

**iaam008** · 02-13-2009, 10:44 AM

Fezz,

I wish I had your optical knowledge...it may take me many, many years to acquire your knowledge and experience.

Thank you so much for your many contributions to the optical world.

Of course your apology is accepted.

Again, thank you.

**ayoco** · 02-13-2009, 10:59 AM

Bristolite (BCD) polycarbonate ft 28 can handle this rx. contact them or your lab.Nothing new to learn
• Dispense like ordinary polycarbonate lenses
• Fit like ordinary FT-28 lenses
• Offer your patient a lens that will produce repeat business and new customers

The next step
To learn more about Bristol lenses, call toll free 877/255-1181, or fax toll free 877/235-9730.

Download the Poly-B Aspheric Lenses Product Sheet

Poly-B FT-28 Lens Availability Base Curve SV Aspheric9.0 Available 11.00 Available

**Uilleann** · 02-13-2009, 11:49 AM

I appreciate all the info so far guys. The round vs. ft argument isn't lost on me - and I certainly know about the cosmetic/optical properties of each. The request was made by the patients original prescribing doctor, and the patient and pt's mother for ft, so that was my initial fitting goal.

Thanks once more!

Brian~

**chip anderson** · 02-13-2009, 12:18 PM

Of course if you do it in Bristolite you better tell them the coatings will fail in 11 months!

**ayoco** · 02-13-2009, 12:22 PM

what is the basis for this comment? polycarbonate from bristol is factory coated on the front like all poly and back side coated by your lab , like all poly. is your lab having a problem?

**chip anderson** · 02-15-2009, 12:44 PM

Every time I have ever used bristolite I have had coating problems at 11 months. And I think we all agree that one should not use poly on lenses over five diopters.

Chip