Progressives and redoing only one lens?

**NavyChief** · 08-05-2010, 07:46 PM

What's your feeling on this? A patient comes in with an Rx change in only one eye and wants to get only one lens redone. You don't have availability or ability to match the lens style on the old lens, for one reason or another.
If replacing only the one lens and having a different NL style in each lens, wouldn't you refuse to do this? I would think the non-matching corridors, etc would create a problem in the overall quality of vision.
Your thoughts?

**uncut** · 08-05-2010, 08:07 PM

I absolutely agree with your assessment...don't do it unless the other eye is subnormal/balance. I would typically point out that scratches, basecurve difference, thickness variations would create irritation as well. Often people need to be given a reason to change the lens that is the same power, and require a motive more than lens design to help them justify the cost.

**kcount** · 08-05-2010, 08:54 PM

Really? I have seen more times than I care to mention people walking around with two different 'lens brands'. The reality is that there are only a handful of lens design houses out there. the designs get used again and again under different names. Do you really think there's a difference between the Comfort, Natural, or Image? Same lens 3 different price points. The customer wants one lens, give them the corresponding product what ever the marketing department wants to call it.

**scriptfiller** · 08-06-2010, 08:04 AM

If they won't budge to replace the pair, sharpen your pencil and find a lense that you can get that's the closest. I would be full disclosure with the pat, they are making the decision to replace one lense only, no remakes for pat. sat. issues.

**Geirskogul** · 08-14-2010, 05:59 PM

What about prism thinning and the differences therof? I wouldn't do it. This patient may end up costing you more than you would make on the one lens. I may only work at a retail optical, but even after only three years I've grown conscious about things like this.

**Wes** · 08-15-2010, 09:08 AM

Originally Posted by Geirskogul

What about prism thinning and the differences therof? I wouldn't do it. This patient may end up costing you more than you would make on the one lens. I may only work at a retail optical, but even after only three years I've grown conscious about things like this.

Don't beat yourself up about where you work. The facts that you're aware of this, probably without being told, and that you've found and are posting on this board speaks volumes about you. Keep reading and posting, and invest in your education.
Wes

**Pogu** · 08-16-2010, 12:33 PM

Originally Posted by Geirskogul

What about prism thinning and the differences therof? I wouldn't do it. This patient may end up costing you more than you would make on the one lens. I may only work at a retail optical, but even after only three years I've grown conscious about things like this.

Measure at the Prism reference and order/surface to match:)

**KStraker** · 08-16-2010, 01:20 PM

Originally Posted by Geirskogul

What about prism thinning and the differences therof? I wouldn't do it. This patient may end up costing you more than you would make on the one lens. I may only work at a retail optical, but even after only three years I've grown conscious about things like this.

Most labs only use prism thinning on plus lenses. It is usually standard, according to the add power.

**kat** · 08-16-2010, 01:30 PM

Hopefully your lab can help you out in matching the lens style. You are correct that it is not always in the best intrest of the patient to replace just one lens for any number of reasons, the more you educate your patient the better off you will be.

**One science** · 08-19-2010, 04:27 PM

Originally Posted by NavyChief

What's your feeling on this? A patient comes in with an Rx change in only one eye and wants to get only one lens redone. You don't have availability or ability to match the lens style on the old lens, for one reason or another.
If replacing only the one lens and having a different NL style in each lens, wouldn't you refuse to do this? I would think the non-matching corridors, etc would create a problem in the overall quality of vision.
Your thoughts?

If you find something that it's ok i recommand you to give a try and change one of the lens, but only if the other won't be affected.

**One science** · 08-19-2010, 04:28 PM

What did you choose to do in the end?

**NavyChief** · 08-19-2010, 09:19 PM

Replace both. I was afraid that having different styles and areas of clarity would screw with the patients vision.

**Georg Mayer** · 08-20-2010, 03:08 AM

I am glad the post/thread ended full circle where it started i.e. you have to replace both lenses.
Everything else could be regarded as kind of optical gamble and therfore as unprofessional.

Georg Mayer

Munich / Germany

**EdgeOptical** · 08-21-2010, 11:59 AM

was that your decision or the patients?

thats not a situation i have come across (luckily), but i would expect in that situation i would have refused. Opens the door to too many issues. Not only with the PAL design, but scratches, Transitions, AR, etc. Its rare i ever sell anything with out AR, so that would influence my decision. What happens when the patient comes in to use the scratch warranty?

there are optical issues, as well as retail issues going there.

**conantoptics** · 12-26-2010, 10:10 PM

We met this before, and it was very hard to get the REDOs!
sometimes, a REDO one lens, means another REDO for NON-Adapt.

so, we refuse to redo PAL per lens.

**HarryChiling** · 01-03-2011, 12:52 PM

If you replace with the same PAL then you need to supply the base curve and prism thinning along with all other measures normally associated with the job, also send the lab all the data on the lens not being replaced so that their computers can make the proper determination that means Rx, heights, PD's, and center/edge thickness. It's not a problem until you replace different lens brands and manufacturers. The problems that will arise are smaller viewing zones, issues with binocular fusion, etc. Keep in mind that most modern PALs incorporate horizontal optical modulation a fancy way of saying that the left and right lenses are married to each other and work in unison to provide a more comfortable off axis view, by replacing one lens with a different brand this off axis comfort is broken and the patient may compain of issues.

In Short use the same brand and supplie all the data about the other lens, or replace both. NEVER MIX AND MATCH.

**Barry Santini** · 01-04-2011, 12:40 PM

I'm now experiencing the same witnh some FFSV Rxs.

Particularly with Shamir Auto II SV & now Spectrum, the base curve chosen and prism thinning originally delivered are *very* important parameters when redoing one lens in an aniso or mild antimetropic Rx.

FWIW

Barry

**Barry Santini** · 01-04-2011, 12:42 PM

Geez, Harry. My new QR reader took me from your avatar to Luzerne's website.

Excellent!

B

**HarryChiling** · 01-06-2011, 12:22 PM

Originally Posted by Barry Santini

Geez, Harry. My new QR reader took me from your avatar to Luzerne's website.

Excellent!

B

Other than my clients your the only person to have mentioned the QR code, they're poping up everywhere and real easy to use. Pre-2000 radio shack tried a similar concept with the Qcat, they provided a similar barcode and yuou could go to any radio shack and pick up a reader often for free. It never took off because it required a proprietary reader. The newer Qrcodes are gaining acceptability since they only require software which is free on a PDA phone with a camera, which almost everyone owns now.

I have the codes on my price lists and other documents, the ones for certain promotions I will link off to our specific page on the luzerne website.

**ThatOneGuy** · 01-06-2011, 03:46 PM

If the patient wasn't grasping the optical challenges posed by having mismatched lenses, I would use an analogy to explain why you simply HAVE to remake both.

Perhaps say that imagine a physician took you off of a medication because it could kill you, and instead prescribed another medication. However, instead of giving you a new bottle of liquid meds, the doctor simply tops off the bottle of old liquid meds with the new meds, successfully saving you money, and creating a whole lot of grief. :)