very high myope

[kristiekyle]

I have an rx O.D. -18.00 +1.25 X 15 O.S. -19.00 +1.25 X 180. One of the labs our Ophthalmology office utilizes said to put the patient in 1.67 high index biconcave. The other lab said the rx would look better in high index 1.67 aspheric on a plano base curve. The patient does not have glasses now, and wears contact lenses. She wants them to be as thin as possible, however optics is just as important to her. Any suggestions?

Thanks,
Kjk

[AngeHamm]

I have an rx O.D. -18.00 +1.25 X 15 O.S. -19.00 +1.25 X 180. One of the labs our Ophthalmology office utilizes said to put the patient in 1.67 high index biconcave. The other lab said the rx would look better in high index 1.67 aspheric on a plano base curve. The patient does not have glasses now, and wears contact lenses. She wants them to be as thin as possible, however optics is just as important to her. Any suggestions?

Thanks,
Kjk

This patient needs to embrace the fact her lenses will never be "thin." They will just be slightly less thick. But the first step is finding out what she was previously wearing. I'd shoot to match that above all.

[scriptfiller]

1.74 with A/R

[optical24/7]

Hoya 1.70 has better abbe's than 1.67 or 1.74. Her off axis viewing will be better.

[Java99]

This patient needs to embrace the fact her lenses will never be "thin." They will just be slightly less thick. But the first step is finding out what she was previously wearing. I'd shoot to match that above all.

What he said. In as small an eyesize as possible.

[eyechick1969]

umm, I have 2 really good looking Vanni Italian frames I'm saving for Rx's like this. One is a 40 eye, one is a 42 eye & a 3rd one is a polo 39 eye. These are all premium frames & designed to fit a good sized head. I didn't come by them super cheap, but they will someday be a perfect match for someone with a really high minus rx.

[Wes]

Hoya 1.70 has better abbe's than 1.67 or 1.74. Her off axis viewing will be better.

+1
ABOMs and High myopes both prefer 1.70

[Robert Martellaro]

The right lens (see pics below) was about -25.00 +5.00 x XXX in 1.74 index, left was -16.00 with 1.60 index. About 2 in. Base curve was plano or slightly positive. Frame measured 40-25-xxx. Temples closed, and the nasal thickness did not interfere with the pads and arms. This can be done without a minus base curve, but probably not on a free-form generator. And yes, if you can get the back curve you need on a 1.70 index of refraction material, without going bi-concave, do so.

[optical24/7]

The right lens (see pics below) was about -25.00 +5.00 x XXX in 1.74 index, left was -16.00 with 1.60 index. About 2 in. Base curve was plano or slightly positive. Frame measured 40-25-xxx. Temples closed, and the nasal thickness did not interfere with the pads and arms. This can be done without a minus base curve, but probably not on a free-form generator. And yes, if you can get the back curve you need on a 1.70 index of refraction material, without going bi-concave, do so.

I'll echo Robert, avoid bi-concave designs whenever possible.

[Fezz]

Hoya's 1.70 is currently unavailable.

I am not sure that they offer them in those powers either.

To the OP = check vertex distance with a distometer, or refer out to someone who can handle a job like this!

[Judy Canty]

Vision ease has a 1.70 Thindex SV.

[Jubilee]

Crud, I can't remember who (forgive me, it has been a year or so since I ordering lenses) but there is another distributor/manfacturer who makes 1.70. I remember having the "off brand" available for VSP....

[a1vo]

http://questopticallab.com/Services.htm

they claim they have "Hi-power minus lenses in ALL indexes and lens types"

	#1 Standard
	#2 Bi-Concave Standard
	#3 Standard Myodiscs
	#4 Blended Myodiscs
	#5 Blended Myodiscs CC Front
	#6 Blended Myodisc QUEST Form

[vince]

I just had a pt in for new specs, -13.00 currently wears 1.60 index with Avance smaller frame nice fit, pt does not wear cls. New glasses he wants a larger frame (larger and deeper) does not want any type of hi index lens only wants CR-39 lenses and AND does not want AR. Pt states he wants to save money only wants what VSP will pay for. After I explained all the disadvantages of the design of his new eyewear, optics, weight, thickness and reflections etc he said "thats OK if I dont like them I just buy another pair". So much for saving money. The glasses are still in the the works at the lab, thats going to be a thick heavy pair of eyeglasses. I doubt he will be happy with his vision and comfort.

[kristiekyle]

Thank you for all of your input. :)

[B101875]

Explain something to me. I see an Rx like that and I think Contacts. When I worked for an MD he had pt's w/ very high Rx's wear contacts. The highest I saw from him was a -11. Nothing like what is above. I was told he had pt's in higher Rx's wearing them, and I was told you want a pt w/ and Rx like that wearing contacts. And I would agree. But I come bacck to work for an OD and it's glasses for these people. Do MD's and OD's have differnt contacts to work w/? I know that they don't, but just wondering why.

PS, a1vo, thanks for posting that pic. I am printing it out rite now.

[chip anderson]

A thing to remember is with lenses this strong plus or minus the patient can only see well enough to recognise objects for a narrow distance from OC. Not being much of a mathmatical optician I can't tell you exactly how far but probably no more than 15mm from OC. So anything you do beyond this point to thin the edges is OK visually.
While the patient may believe he can see more from a 60mm lens than he can from a 35, he can't.
Also remember that if this patient has successfully worn contact he is not going to be happy with the acuity from glasses no matter what you do. He will use them only to find the bathroom and his contact lenses. Or if his CL's are not fitted well to get some relief from the discomfort or poor acuity (neither of which should be the case with them.

Chip

[cmarx]

It makes no difference, MD or OD. Let me rephrase that it should make no difference. A patient with that an high RX will see much better less distortion,less, image minification, vastly increased peripheral vision. As long as they have no medical contra indication. That doens't mean they should be without back up glasses.

All 3 of the O's are charged with giving the patient their best option. The patient obviously has the final say.

[chip anderson]

Actually patients with very high corrections should have back-up glasses and back-up contacts.
Remember while they can semi-function with spectacles they can fully function with contacts. A cone, aphake, super-plus or minus patient may be out of work and out of driving, etc. when they lose and are waiting for replacements even if they have spectacles.

Chip

[kristiekyle]

Pt does wear contacts primarily. However, wants back up glasses for evenings and weekends without having to mess with contacts.

[Jacqui]

Crud, I can't remember who (forgive me, it has been a year or so since I ordering lenses) but there is another distributor/manfacturer who makes 1.70. I remember having the "off brand" available for VSP....

Tokai??

[chip anderson]

Cmarx: If you will check past postings on OB, the "the best prescription" and "the best vision" are with many OBer's subservient to cosmetics and the highest price.

And in contacts, the best vision is usually subservient to chair time and patient comfort. Once can appearently sacrifice two or three lines of acuity to slop on a soft lens rather than take the chairtime to fit a slightly less comfortable rigid one.

Chip

[Robert Martellaro]

1.70 is now available at Hoya Chicago.

[price]

I did a patient with -20.00 ou used a - 6.00 front curve 1.67 put in a zyl frame had the back surface ground flat to get read of thickness before edging to fit the frame.Had a total dec of 1mm out. LOOKED GREAT.

[terrance]

how about others brand 1.70 index?are there also has better abbe value compare to hoya?