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Thread: Stumped

  1. #1
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    Stumped

    I am much more of a researcher and don't have much experience to contribute yet, but I finally stumped myself. We have a patient who came in yesterday with OD:-4.25 -3.50 x 109 and OS: -4.75 -2.75 x 078, +2.00 add. Seg height will be 18.5 in a 30 B and 52 eyesize. He was previously wearing a GP wide followed by an Image (about 1mm too high.) Has always had trouble adjusting to new lenses. Mechanic, pilot, and long range shooter but needs something for reading while on the job also. Also want help on a material for this one, want to do trivex, but afraid it will be just too thick. Primary contender is the Spectrum. I have access to Essilor, Hoya, DEL(shamir, seiko, in-house design, and indo.)

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    Cape Codger OptiBoard Gold Supporter hcjilson's Avatar
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    My first choice is always Trivex. I wish they would solve the thickness issue! When circumstances such as thickness arose, I almost exclusively recommended 1.67 index. It maintains the second best drillibility (i think I may have just invented a word-spell checker never heard of it)and the thickness problem has disappeared.

    PS Years back I was in GPWide's I got a pair of DEFINITY'S from J&J. I liked the GP's but there was a marked difference in the lenses. The distance view in DF's was unimpeded and the int/near vision was definitely wider. I have been in DEFINITY's ever since except for my Polaroid's which is out of range. Dying to try Younger's Progressive in a polarzed version but retired now so it's taking a place in priority line. Hope this helps.
    hj
    Last edited by hcjilson; 04-28-2012 at 10:31 AM. Reason: Added PS
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    Bad address email on file fvc2020's Avatar
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    Hey just curious why the change to image? I have to agree with above about Definity's...love love love...............Most of my fits to them never want anything else and hate anything else they are changed too!!!!

    christina

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    Master OptiBoarder OptiBoard Gold Supporter Judy Canty's Avatar
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    Why not move him back into a Hoya design, an ECP perhaps?
    "Jargon is the last refuge of the scoundrel." --Roger Ebert

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    Always learning OptiBoard Bronze Supporter
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    Quote Originally Posted by jmainwar View Post
    We have a patient who came in yesterday with OD:-4.25 -3.50 x 109 and OS: -4.75 -2.75 x 078, +2.00 add. Seg height will be 18.5 in a 30 B and 52 eyesize. He was previously wearing a GP wide followed by an Image (about 1mm too high.) Has always had trouble adjusting to new lenses. Mechanic, pilot, and long range shooter but needs something for reading while on the job also. Also want help on a material for this one, want to do trivex, but afraid it will be just too thick. Primary contender is the Spectrum. I have access to Essilor, Hoya, DEL(shamir, seiko, in-house design, and into.)
    Welcome to OB.

    I'd use the Auto 2 over the the Spectrum for a Myope, but the Zeiss Individual will be slightly easier to adapt to, with sufficient near utility for average frequency of near tasks, for this type of Rx. But a mechanic might have more near tasks at or near eye level- if true, edge to the Auto 2 (less posturing), or consider task specific eyeglasses. Both lenses are atoric (strongly recommended for this level of cylinder), and are optimized for position wear. There are other lenses that might be suitable, but I have more experience with the above lenses.

    I wouldn't hesitate to use Trivex at this power (note you're in the sevens on the horizontal meridian), assuming that the decentration is not significant. Heck, I had two Rxs with a max power of -10.00 last week where I used cr39! One was atoric (Hoya st28 IQ), the other had at least some error correction off-axis (Essilor st28 AB). However, 1.60 would be about 10% thinner. If you want to flirt with some degree of off-axis blur from chromatic aberration because the client has cosmetic concerns, bump the index to 1.67 or 1.74. I have no experience with Hoya's 1.70 refractive index MyStyle as of yet, due to supply problems at Hoya's end, but I suspect this might also be a design (and most definitely a material) worth looking at for this type of application.

    Hope this helps,
    Robert Martellaro
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
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    Cape Codger OptiBoard Gold Supporter hcjilson's Avatar
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    With all due respect to Robert who is an excellent representative of this proffession, there's very little trade off between 1.74 and 1.67 other than the price, which is significant. Thickness difference is negligible!
    "Always laugh when you can. It is a cheap medicine"
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    Always learning OptiBoard Bronze Supporter
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    Quote Originally Posted by hcjilson View Post
    <snip> there's very little trade off between 1.74 and 1.67 other than the price, which is significant. Thickness difference is negligible!
    Right, it's the law of diminishing returns.

    As always, sort it out in a way that's clear to the client, and let them decide if they want to spend $80 or so extra for a .4mm reduction in edge thickness. I recommend Trivex or 1.60, so you know how I feel about that.
    Robert Martellaro
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    “Science is a way of trying not to fool yourself"
    -Richard Feynman
    ~~~~~~~~~~~
    A mime-free zone.

  8. #8
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    I can't explain the change to the Image, we only recently took over the practice and he had purchased the last pair somewhere else. I have considered the ECPiQ as well as the Auto2. Trivex verses 1.6 is only 10%, cosmetics is not an issue, he came in wearing the previous pair in a rimless.

  9. #9
    Ophthalmic Optician Wes's Avatar
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    http://www.discountfreeform.com/hivex-lens/
    Hivex, higher index and abbe than trivex. For very high RX's 1.70 is a much better optical option than 1.67 or 1.74. I learned this from the Dragon(RIP) who had more informed experience on the subject of high myopia than anyone else that I've met.
    Wesley S. Scott, MBA, OO, LDO, ABOM, NCLE-AC

  10. #10
    Rising Star n711's Avatar
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    I would go with the Autograph II over the Spectrum with that much cylinder. As for material... depends on frame selection, excuse me if you mentioned that already, but if he is going with zyl or a "beefy-er" metal then cosmetically Trivex should not be much of an issue ..
    ~N


    "The sands of time have already begun to pour against you.." ~Aaron D Yates

  11. #11
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    Thanks for all the help, will be going with the Auto II in trivex and will see what happens.

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