Trifocal Intermediate ADD, can it be less than half?

**DRAINGE1** · 10-08-2010, 08:40 AM

Hello everyone, I need some professional help! .... ha!

I have a very difficult patient who is full of medical problems and will never be happy with her vision. AMD, Glaucoma, Cataracts,...ect....

I'm going on my 3rd "Dr.'s Change"....

This time the almighty MD will not sign the rx:
-0.50 + 1.50 x 008
+0.75 + 1.50 x 178
**(+1.50 Intermediate)
+3.00 ADD
Trifocal

He ONLY wants me to fill this with a +1.25 Intermediate, and will not sign the rx without .... I have called a few labs and they say this isn't possible. The Doc swears it is... (even though he doesn't know a damn thing about Spectacles).

Does anyone have any insight on this? Thanks for your time!

**Judy Canty** · 10-08-2010, 09:21 AM

Once upon a time there were tri's with a 60% intermediate, but I haven't seen them in many years. Now that being said, if the prescriber won't sign the rx, your hands are tied and the patient needs to know what's going on as well.

**Jacqui** · 10-08-2010, 09:25 AM

Check with X-cel, I think they make something similar. Or you may need to do a Franklin.

**MikeAurelius** · 10-08-2010, 09:27 AM

It appears that you can, but only in glass...40% is the lowest that I can see. All X-Cel seems to supply in any of the plastic/polycarbonate forms (and this is just a quick perusal of their data files) is a 50% intermediate.

**DRAINGE1** · 10-08-2010, 10:13 AM

Thanks for the info...
Found out Epic Labs CAN custom make one. Only in Plastic Trans (I also needed Poly Trans, I left that part out, but beggers can't be chooser.)
Cost on something like this you ask????? $550.00 HAHAHHAHAA. Take THAT Doctor. Think he'll swallow that remake cost?? I'll let cha know!

**MikeAurelius** · 10-08-2010, 10:30 AM

Yep, that's what happens with one-off lens manufacturing. Kudos to EPIC (who btw is part of the evil E empire).

**Jacqui** · 10-08-2010, 10:33 AM

If things were better down here, I would make you a pair cheaper just to irritate them. Oh, I don't do poly, it doesn't glue properly for me.

**paulcr39** · 10-09-2010, 08:20 AM

Per X-Cel Optical's website this AM:

Acclaim 61%
8X34 10X35 12X35 14X35
4.25 1.50 to 3.00 1.50 to 3.50 2.00 to 3.00 1.50 to 3.00
6.25 1.50 to 3.00 1.50 to 3.50 1.50 to 3.00 1.50 to 3.00
8.25 1.50 to 3.50 2.00 to 3.00
Acclaim 61%™ Trifocal
Scratch Coated
All Acclaim series lenses have a 61% intermediate power
and are a good choice for computer and instrument panel users.

Since the OP needed a lower intermediate one idea is to use a 3M press on power cut to fit above bifocal line. Since this is the 3rd go around it would be a lot less $$ than going the Epic $550 route.