Patient needing more height for her reading in her progressive.

[ChrisinNH]

Patient is currently wearing the New Comfort 2 with RX of OD +3.75 sph OS +3.75 -1.00 x180 in CR-39 with a 'B' Measurement of 34mm and a Seg Height of 21mm in a Semi-Rimless frame. She is having trouble with not being able to see a full page so far as height.

From side to side, the width, she has no issues but in order to see the whole page from top to bottom at reading distance (16inches or so) she has to move her head up and down which she does not wish to do. She wants a lens that will allow her to see the entire page up, down, left and right without moving her head around.

Suggestions?

-Chris

[Uncle Fester]

I fear she has expectations that are greater than any progressive can deliver.

I'd suggest a second pair of sv.

FWIW- I try to forewarn progressive candidates that this type of field of vision is not going to happen with any multifocal.

[ChrisinNH]

With the current Comfort 2, she can see about 2/3 - 3/4 of the page from top to bottom.

[uncut]

After checking pantoscopic angle, and perhaps shifting it.......I would observe what a slight tilt, or variation of tilt does to the page(bottom in, top out)

[chip anderson]

Tell her to hold head still and move reading material.

[Uncle Fester]

With the current Comfort 2, she can see about 2/3 - 3/4 of the page from top to bottom.

That's about as good as it'll get (and that's pretty good too!).

[Robert Martellaro]

I try to forewarn progressive candidates that this type of field of vision is not going to happen with any multifocal.

I put my fist out at 40cm and say that's it. Sure, emerging presbyopes get a tad more, but why overpromise? Underpromise, overdeliver. And don't forget Finagle's Law: Anything that can go wrong, will—at the worst possible moment. For example, if you don't loctite the chassis screws, a lens will fall out when the client is out of town on a Saturday night.

[EyeCare Rich]

That's about as good as it'll get (and that's pretty good too!).

+1. Especially the (and that's pretty good too!)

Sounds like a good case for SV task specific second pair.

[TLG]

She wants a lens that will allow her to see the entire page up, down, left and right without moving her head around.

There is ONLY one solution for this comment - single vision. And even with that, if 'the page' happens to be a newspaper laying on the kitchen table.....

[sharpstick777]

Patient is currently wearing the New Comfort 2 with RX of OD +3.75 sph OS +3.75 -1.00 x180 in CR-39 with a 'B' Measurement of 34mm and a Seg Height of 21mm in a Semi-Rimless frame. She is having trouble with not being able to see a full page so far as height.

From side to side, the width, she has no issues but in order to see the whole page from top to bottom at reading distance (16inches or so) she has to move her head up and down which she does not wish to do. She wants a lens that will allow her to see the entire page up, down, left and right without moving her head around.

Suggestions?
-Chris

What is the add power? I don't think we can may any decent suggestions without knowing the add.

[sharpstick777]

You need a lens that has multiple fixed corridor options, not just two. Many lenses now like Seikos and Shamirs offer you the ability to keep the same seg, but by using a shorter intermediate section you effectively make the reading higher and bigger. If you patient is willing to give up some intermediate this could work.

It wont work as weell with the Comfort however, since there are only two corridor heights available. It limits your options a little.

For example, I would favor the Seiko Surmount/WS because it customizes the corridor for Hyperopes, maybe better than any other lens. It comes in 4 corridor lengths I believe. So instead of just sending a fitting height, you would specify a corridor length too. I believe the Surmount corridor runs 10 mm -14 mm. You could choose the 12 mm one,and you are basically starting her reading at 14mm below OC. Depending on her add, you could even do a 10 mm corridor, but the intermediate gets smaller. The Surmount has enormous int. width though, so it will make up for that.

If you really want to quadruple her reading, use the Surmount WS in the 10mm corridor. She may gain 4 times the area that she has now.

An alternative would be to order the Definity Short but use your Seg of 21. Her reading would be enormous, but although the Definity is great for Hyperopes, the reading bottoms out for Ground View, the Seiko Surmount would keep her in reading longer. I would favor the Definity over the Comfort for Hyperopes, better symmetry.

The Shamir Auto II would work, a lot corridor options, but the reading is narrower than a Comfort and you may solve one problem and leave another.

Did I explain myself well enough? Pls let me know.