Results 1 to 20 of 20

Thread: Varilux Physio 360 problems... Feedback?

  1. #1
    Bad address email on file
    Join Date
    Feb 2012
    Location
    Glendale, AZ
    Occupation
    Dispensing Optician
    Posts
    2

    Confused Varilux Physio 360 problems... Feedback?

    I have a patient who continues to complain that the poly physio 360 w/ Crizal Avance AR is clearer to the left and right of the OC, but not dead center. PD/OC has been verified multiple times, dr has re-refracted to ensure rx is optimal, but patient continues to complain. What could the issues be? Has another pair that are essilor ovations with the same rx, and has no problem. I've gone through two sets of lenses to be told he is having the same problem with both sets. Patient says the problem is only in the left lens. Lenses are mounted into one of the new Prodesign Axiom (model 6122). Any thoughts?

    RX:
    -0.25-0.75x018
    -0.50-1.00x165
    +2.75
    Last edited by hyperoptix; 02-03-2012 at 05:04 PM. Reason: additional info

  2. #2
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
    Join Date
    May 2000
    Location
    Virginia Beach, VA
    Occupation
    Dispensing Optician
    Posts
    7,482
    How is the pts binocular vision?

  3. #3
    Bad address email on file
    Join Date
    Feb 2012
    Location
    Glendale, AZ
    Occupation
    Dispensing Optician
    Posts
    2
    Quote Originally Posted by CuriousCat View Post
    How is the pts binocular vision?
    No issues with binocular vision -- corrects 20/20, and has no convergence issues.

  4. #4
    Master OptiBoarder
    Join Date
    Mar 2010
    Location
    north of 49
    Occupation
    Dispensing Optician
    Posts
    3,002
    I would try -0.12, +0.12 over the lens, to see if he prefers a slightly different power.

  5. #5
    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
    Join Date
    May 2000
    Location
    Virginia Beach, VA
    Occupation
    Dispensing Optician
    Posts
    7,482
    Quote Originally Posted by hyperoptix View Post
    No issues with binocular vision -- corrects 20/20, and has no convergence issues.
    20/20 with glasses on?

  6. #6
    Rising Star
    Join Date
    Jul 2006
    Location
    brooklyn
    Occupation
    Dispensing Optician
    Posts
    83
    Verify the relative fit of the the two pairs (panto, wrap, vertex, base curve,etc). Remember that increasing panto is like dropping the oc. Also check the amount of prism thinning. I've found some people sensitive to that!
    Also, visually check the front surface for distortion (blocking rings..)

  7. #7
    OptiBoard Novice
    Join Date
    Mar 2010
    Location
    lebanon
    Occupation
    Optometrist
    Posts
    6
    Presence of "blocking rings" will affect right & left gaze more than it affect it centrally.

    Is the ovation also a POLY?....... if not change the material to either MR8 or trivex.

  8. #8
    OptiBoardaholic J.P.'s Avatar
    Join Date
    Nov 2011
    Location
    Alabama, United States
    Occupation
    Dispensing Optician
    Posts
    218
    Full Metal, Zyl, Grooved Rimless or Drilled Frame?

    Reasons why I ask:
    Full metal frame; if the A is cut too wide it could be causing addtional stress in the OC of the lense that just can't be see by the naked eye, but would verify correctly on your lensometer.
    Zyl Frame: Same reasons as a full metal
    Grooved Rimless: If the B is cut too short, the line could be causing a horizantal stress that can't be seen but verifies correctly.
    Drilled Rimless: Nothing here should cause any addtional distortion in the OC unless the lenses have a defect that can only be seen by a Wave Form Analyzer.

    I don't know if you have tried this, But put on a pair of Polarized Sunglasses, hold her glasses up to the computer screen, and see if you can see any major stress being added upon the lenses.

    Let me know if any of this helps
    Better to remain silent and be thought a fool than to speak out and remove all doubt.
    ~ Mark Twain ~

  9. #9
    One eye sees, the other feels OptiBoard Silver Supporter
    Join Date
    Jul 2002
    Location
    Wauwatosa Wi
    Occupation
    Dispensing Optician
    Posts
    5,458
    Quote Originally Posted by hyperoptix View Post
    Patient says the problem is only in the left lens.
    Have you noticed that when folks cover the right eye with their hand or paddle, they usually turn their head to the right, sometimes significantly?

    After a ten day adaptation (PALs), an equal turn of the head when looking at distance or near objects with both eyes open, should induce a similar amount of blur for each eye, if the RXs and vertex distances are about the same for both eyes. If the vision becomes clearer when the head is turned, there is a problem with the Rx and/or the lens position.

    Hope this helps,
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



  10. #10
    What's up? drk's Avatar
    Join Date
    Mar 2004
    Location
    Ohio
    Occupation
    Optometrist
    Posts
    9,388
    Are you talking about the distance portion?

  11. #11
    One eye sees, the other feels OptiBoard Silver Supporter
    Join Date
    Jul 2002
    Location
    Wauwatosa Wi
    Occupation
    Dispensing Optician
    Posts
    5,458
    The OP said the OC, which I assume they meant the straight ahead gaze. The old Rx might provide some insight, although the doc is standing firm on the Rx.
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



  12. #12
    What's up? drk's Avatar
    Join Date
    Mar 2004
    Location
    Ohio
    Occupation
    Optometrist
    Posts
    9,388
    So really, it can't be a progressive issue...I can't think of a reason that someone sees better off the visual axis. Is it possible the centers are too thin and are warping with glazing, as JP suggests, or is it a nylon mount? I have some of those axioms, but don't know the one of which you speak.

  13. #13
    One eye sees, the other feels OptiBoard Silver Supporter
    Join Date
    Jul 2002
    Location
    Wauwatosa Wi
    Occupation
    Dispensing Optician
    Posts
    5,458
    Quote Originally Posted by drk View Post
    So really, it can't be a progressive issue...I can't think of a reason that someone sees better off the visual axis. Is it possible the centers are too thin and are warping with glazing, as JP suggests, or is it a nylon mount? I have some of those axioms, but don't know the one of which you speak.
    Maybe a wave, but with both pair in the same eye? I think the client is self testing, and is encountering parallax error. The enhanced has a variable corridor length, and the high Add can have plenty of blur off-axis, especially if the fitting height is much less than a usable 18mm. What say Hyperoptix? (BTW, welcome to Optiboard, and nice first post!)
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



  14. #14
    Bad address email on file
    Join Date
    Feb 2012
    Location
    Brazil
    Occupation
    Ophthalmologist
    Posts
    20
    Analyzes the non adjustments PAL are often complex.His case does not seem to have a simple solution. Could surfaçar other lenses and the result is repeated. Before that, I believe is more accurate charting deflectometria in PAL and check for normal patterns. These complaints do not relate to change Panto, Wrap, base curve or adjustment Prism thining. Regards

  15. #15
    Bad address email on file
    Join Date
    Feb 2012
    Location
    Brazil
    Occupation
    Ophthalmologist
    Posts
    20
    To understand better.
    The complaint of the patient is in the field from distance?
    When he has his eye on the front (on the fitting cross) vision is less clear that looking at 10 or 15 ° lateral, is it?
    Regards

  16. #16
    Master OptiBoarder
    Join Date
    Jun 2008
    Location
    Seattle WA
    Occupation
    Optical Wholesale Lab (other positions)
    Posts
    3,137
    That is unusual total sphere and add power combination. I rarely see 2.75 adds with that little distance RX, but its possible.

    Can you post his old RX?

    Even if he refracts 10 times correctly for the new one, if had more Cyl change in one eye over the other (and wore the prev pair a long time) you encounter this effect, of what Robert calls "Self Correcting".

  17. #17
    OptiBoard Professional
    Join Date
    Oct 2010
    Location
    Saint Louis
    Occupation
    Optical Laboratory Technician
    Posts
    141
    I remember a patient with the same problem awhile back. Her physios were remade 4 times but she kept complaining that vision was blurred straight ahead but clear when she looked straight ahead and turned her head, and clear when looking to the side. For the 5th remake panamic was used and all was good again. It seems that some people just can't wear some lenses and there is no explanation. Why not remake in the ovation if that worked before?

  18. #18
    Master OptiBoarder
    Join Date
    Jun 2008
    Location
    Seattle WA
    Occupation
    Optical Wholesale Lab (other positions)
    Posts
    3,137
    Quote Originally Posted by oxmoon View Post
    I remember a patient with the same problem awhile back. Her physios were remade 4 times but she kept complaining that vision was blurred straight ahead but clear when she looked straight ahead and turned her head, and clear when looking to the side. For the 5th remake panamic was used and all was good again. It seems that some people just can't wear some lenses and there is no explanation. Why not remake in the ovation if that worked before?
    I love mysteries like that... Some I can figure out, some I cannot. But I would guess that her RX combination in the Physio was pushing her farther way from Best Form Optics than the Panamics were. Its just random chance sometimes because in ground lenses we compromise some RX's as one blank has to cover a wide range of RX's, and really only one single RX works perfectly for each BC/Blank. We don't get BC charts (easily) to see if an RX falls in the middle, or to edge of ideal. Unfortunately its often seen as one lens being better, when its really one lens's base curve is closer to Best Form than another. Thankfully, Free-form fixes some of that.

  19. #19
    OptiBoard Novice
    Join Date
    Nov 2011
    Location
    Northern Virginia
    Occupation
    Dispensing Optician
    Posts
    3
    Go for physio or physio enhanced and the problem usually goes away. Had the same issues with patients years ago. The physio, in my opinion, is the better product. Consider adaptation issues involving comfort and panamic years back.

  20. #20
    Master OptiBoarder
    Join Date
    Jun 2008
    Location
    Seattle WA
    Occupation
    Optical Wholesale Lab (other positions)
    Posts
    3,137
    In general if the patient experiences any decreased DVA centrally, but its improved peripherally, its either the result of abberation, misground PD/OC, or the RX is incorrect. Most likely the latter.

    +.12/-.12 Flippers should be in every dispensers tool box. If the patient see better through the flippers centrally then you know its not abberation or PD/OC centration, its an RX issue. 2 seconds and your done.

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. varilux physio verses varilux 360
    By Ralph 5519 in forum Progressive Lens Discussion Forum
    Replies: 12
    Last Post: 02-22-2010, 02:26 AM
  2. Varilux Panamic vs. Varilux Physio
    By jeffsoptical in forum General Optics and Eyecare Discussion Forum
    Replies: 13
    Last Post: 11-17-2007, 08:02 PM
  3. Essilor Introduces Varilux Physio 360 and Varilux Physio Lenses
    By Newsroom in forum Optical Industry News
    Replies: 0
    Last Post: 10-19-2007, 01:54 PM
  4. Varilux Physio comments & feedback please
    By Bezza in forum Progressive Lens Discussion Forum
    Replies: 93
    Last Post: 06-29-2007, 11:48 AM
  5. Essilor Marks Varilux Physio 360° And Varilux Physio Milestones
    By Newsroom in forum Optical Industry News
    Replies: 0
    Last Post: 12-20-2006, 10:49 PM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •