Looking for some help with a troubled patient....

[fortheloveofframes]

HELP ME! I have a pt I have made glasses for in the past who has been super happy with them. This year I made him specs with this rx:

Old:
-0.50-1.75x084 Lens was SV POLY w/AR
-0.75-0.75x095

New:
-0.50-1.25x084 Lens is Hoya IQ Trivex Trans Xtra Active w/AR
-0.50-0.75x096

Pt swears he can not see clearly out of the center of the lens. It is clearer up, down, and on the sides, than in the middle of the lens. I have adjusted every which way. I have tried tilt, I have checked pds, had dr check rx, remade the lens just in case there was some fluke with the digital surfacing and it had an aberration.... WHAT DO I DO NOW! We do dilated exams on everyone so his retina has recently been checked. He is 46 years old. I am looking for any and all feedback. If you have a very generic answer I have probably already heard it. Even asked a few experts down at vision expo west, nothing I hadn't already tried. Ps. I did mark the OC ht on the lens and it is made to the proper OC and RX.

Thank you in advance for your help!

[SailorEd]

I've seen this before, a few times. Same frame, new lenses, more advanced lenses so that the patient can see better through them. Same measurements, a slight change of Rx and the person hates the lenses. Unbelieveable. Go back to the same lens he had before, same material etc, with new Rx and ... problem solved. We even have one patient that cannot take any change of Rx. Give him a new Rx, can't get used to it. If you've tried everything else, go back to the original lens material with the new Rx. SV Poly Transitions with AR.

[DragonLensmanWV]

Probably not liking the new Rx. I had a customer who LOVED his Hoya IDs. He's a radiologist. He comes in with a new Rx and I had mentioned how much I liked the Zeiss Individuals I'm wearing. And he wants Xtractive lenses, available in Individual but not Hoya. So we get him the Zeiss lenses. he wears them for a month, says they're still not working for him as well as the IDs.Remake them into IDs, he still has trouble. Problem is the new Rx removed a half diopter of minus.

[Robert Martellaro]

Problem is the new Rx removed a half diopter of minus.

I had a much younger associate of a od that I refer to do this to my neighbor, and then again with another client. Simple, single vision Rxs in the mid minus three's, age thirty or so. Now when my clients ask if it's okay to see the younger OD because the doctor I recommended is booked 6 weeks in advance, I just say I don't know enough about the younger OD to make a recommendation.

To the OP-

You have two choices. Tell the client to wear the Rx for a minimum of 48 hours, but preferably 10 days. If there's no improvement, then give him back his -.25 OU. Or do it now and be done with it. Good luck.

[THE MEB]

This thread reminds me of dealing with the majority of new hyperope rx's. The Opthamologists, who share an adjoining reception area with us will often refer refractions to the 2 OD'S we work for, claiming that hyperopes have a personality trait where they don't care for change in their rx, even while refracting they find a half diopter more increase to get va's at 20/20. The OD's say basically the same thing, that they rarely give hyperopes the full amount of rx that their refraction calls for, both instances because they know they won't be happy with the new rx. Having been in this business 37 years, I have found refractions of hyperopes, in my humble opinion, is an art, and one of the most subjective techniques in the optical trade.