Help, pt says screen looks hour glass shaped...

[OptiChick21]

Does anyone know why a patient would say his computer screen looks hour glass shaped?

He is wearing SV hi index 1.67 with Rx:

-3.75-2.75 075
-4.00-2.50 108


My ABO studies was many moons ago... sorry!

[jpways]

Do you have his previous prescription?

[braheem24]

Is that his intermediate rx or distance?

Hourglass as in pincushion or Trapzoid?

[Darryl Meister]

Visual effects like this are typically caused by magnification disparities, excess prism, or geometric distortion. Fortunately, these symptoms generally improve with time, but if the symptoms are intolerable or do not eventually subside, you will have to isolate the exact problem.

As Braheem noted, have the patient describe the exact shape of the "distortion," perhaps using a more regular pattern, like an Amsler grid. Additionally:

Does the effect occur when only one eye is used?
Is the effect worse in one eye?
Is the effect worse through certain regions of the lens?
Is the effect persistent or intermittent?
Has the prescription (sphere, cylinder, axis) changed?
Has the base curve changed?
Has the thickness or refractive index changed?
Has the vertex distance changed?
Has the optical center position (relative to pupil center) changed?
Has the lens design (i.e., aspheric) changed?

Asking the patient probing questions like this and running the patient through these troubleshooting exercises will also inspire greater confidence in your ability while conveying your commitment to resolving his concerns. (Although you're undoubtedly doing a great job of that already!)

[FVCCHRIS]

Visual effects like this are typically caused by magnification disparities, excess prism, or geometric distortion. Fortunately, these symptoms generally improve with time, but if the symptoms are intolerable or do not eventually subside, you will have to isolate the exact problem.

As Braheem noted, have the patient describe the exact shape of the "distortion," perhaps using a more regular pattern, like an Amsler grid. Additionally:

Does the effect occur when only one eye is used?
Is the effect worse in one eye?
Is the effect worse through certain regions of the lens?
Is the effect persistent or intermittent?
Has the prescription (sphere, cylinder, axis) changed?
Has the base curve changed?
Has the thickness or refractive index changed?
Has the vertex distance changed?
Has the optical center position (relative to pupil center) changed?
Has the lens design (i.e., aspheric) changed?

Asking the patient probing questions like this and running the patient through these troubleshooting exercises will also inspire greater confidence in your ability while conveying your commitment to resolving his concerns. (Although you're undoubtedly doing a great job of that already!)

Did the patient have a similar issue when he got his last pair?? And if so did he adjust?

[Carbon Pit]

You may want to see if the lens shape is distorted. The lens may have been edged a little too big and forced into the frame. This can cause the lens to "bow" making images distorted.

[Didier]

Did theses lenses are spincoated. Sometime if the lenses are thin in the middle, the suction cup who hold the lens cause a distorsion in the middle. Look by reflection if the neon are strait or if you can see kind of wave in the middle.

[drk]

Pincushion, baybee!

[Fezz]

Maybe the patient is an ingester of mescaline?