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.)