advise needed - patient having PAL issues

[EdgeOptical]

patient came in saying the seg height was too high, wanted a sharpie so he could mark it for us... so he does, and its correct. Look everything over, it is as ordered and as prescribed.

distance RX, PD, and Seg height are in the same frame as before, the only change is the add power. he went from a 1.25 to a 1.75 od 2.00 os.

so I'm sure with the big increase in add he is having problems with the int area being stronger, so more noticeable giving him the feeling that it is higher. (distance RX is -1.25 sph ou)

Went from a definity to GT2. seg height of 26

now, first thought would be since there is more then enough room in the frame, drop the seg to 24, keep the int. area out of his lower peripheral, and there will still be plenty of reading. I think that is really masking the actual issue though.

next option would be change PAL styles to something "softer" like the AO Easy, or (insert PAL here) and see if that calms it down enough.

third would be to talk to the doctor about lowering the add power this time to split the old and new so it will be a more manageable Rx progression for him.


this is a a dumb issue and i cant figure out what it is that is really bothering me about it, its like my head goes blank when i start looking into the chart and order history. Help is greatly appreciated.

[j.maran]

Put him back into the Definity, also is he really needing a different add power in each eye?

[jezzicaz789]

patient came in saying the seg height was too high, wanted a sharpie so he could mark it for us... so he does, and its correct. Look everything over, it is as ordered and as prescribed.

distance RX, PD, and Seg height are in the same frame as before, the only change is the add power. he went from a 1.25 to a 1.75 od 2.00 os.

so I'm sure with the big increase in add he is having problems with the int area being stronger, so more noticeable giving him the feeling that it is higher. (distance RX is -1.25 sph ou)

Went from a definity to GT2. seg height of 26

now, first thought would be since there is more then enough room in the frame, drop the seg to 24, keep the int. area out of his lower peripheral, and there will still be plenty of reading. I think that is really masking the actual issue though.

next option would be change PAL styles to something "softer" like the AO Easy, or (insert PAL here) and see if that calms it down enough.

third would be to talk to the doctor about lowering the add power this time to split the old and new so it will be a more manageable Rx progression for him.


this is a a dumb issue and i cant figure out what it is that is really bothering me about it, its like my head goes blank when i start looking into the chart and order history. Help is greatly appreciated.

Thank you for the post.
Hi guys, Im a newbie. Nice to join this forum.

[Chris Ryser]

Most probably the difference in tha add. Smaller intermediate and larger distortion area.

[Happylady]

Did you check where the height is on his Definity lenses, maybe he was wearing them low.

[drk]

Just sayin': All I hear are solutions.

The patient: "The seg is too high"
The optician: "Lower the add, soften the design"
etc.

What the PROBLEM? Study the problem and the solution will probably present itself.

[jimrask]

patient came in saying the seg height was too high, wanted a sharpie so he could mark it for us... so he does, and its correct. Look everything over, it is as ordered and as prescribed.

distance RX, PD, and Seg height are in the same frame as before, the only change is the add power. he went from a 1.25 to a 1.75 od 2.00 os.

Are you sure the OD didn't make a mistake here? This difference in add power will cause different degrees of distortion in the lenses (more in OS and less in OD), making them feel uncomfortable. Start with checking and double checking this. A GT2 is already quite soft. You could try to lower the seg height by 1 or 2 mm's, recheck centration of the lenses.

And if all else fails, I could give you data on a PAL I use that uses a fundamentally different geometry and with which I solve problems like these in the store I work. ;)