Aphakic lenses

[optilady1]

It's time for me to maybe do the once-a-decade update of my mom's aphakic glasses. She's wearing a traditional lenticular lens, and she's finally adapted over the last 10 years to be able to wear it around the house for a good 5 hours or more at a time. I'm wondering if anyone thinks she could adapt to something a little less ugly now that she's adapted (finally) to the lenticulars. I tried her once in a beautiful pair of aspheric bifocals before I non-adapted her into the lenticulars, but I'm wondering with all the free form stuff on the market now if maybe the time is right to try out something new. She doesn't mind the weight of the lenticulars but for being a pastor who makes no money, she's extreemly aware of her looks and as she's getting old and drying up, I'd like to provide her with glasses that she could wear in public (maybe. Probably not, but she'll look hot while caring for my 88 year old grandfather at home).

So brainiacs (I know who you are and WILL private message you if you don't give me your nerdy advice), any advice? Or at least explain to me why I shouldn't take her out of the lenticulars? She's only about a +13 or +14 with very mild cyl.

Thanks for all the wonderful advice I know you'll flood me with!!!

[optical24/7]

ft, rd, or sv? I use Ice-Tech on orders like the one above. Lenticulars are only available in CR. Ice can make aspherics in most any material. (super thin)

[Jason H]

How daring do you want to be? I'm working on a digital progressive in a +14.75 with a little cyl.

[optilady1]

That is far too daring. There aren't enough years left in my mother's life to get her used to a progressive. She is EXTREMELY visual and any change to this sense can drive her over the edge. She had cataracts until the age of 11 and 12 (right eye, left eye) and didn't actually achieve depth perception until her late 20's. She is an artist at heart, doing a lot of graphic designs to fund her ministry, and if she couldn't see edge to edge out of a pair of glasses, even if only to brush her teeth she'd go nuts.

I hate to change what's working, it just seems like there should be something out there that would improver the look and vision out of her glasses. I'm thinking some kind of free form flat top, probably in cr-39 (did I mention she is also a everything but plastic/glass non adapt too?). Not sure about a/r. She clames to be able to see the color difference in the coating.

I guess my main question is: Why would a lenticular lens give her more comfortable vision than an aspheric design?

[optical24/7]

I guess my main question is: Why would a lenticular lens give her more comfortable vision than an aspheric design?

Neural adaption.

[optilady1]

So if she can stick it out with something different she'll adapt?

[Fezz]

Contacts?

Long shot, I know, but I had to throw it out there!

[Bev Heishman]

I guess a secondary implant is out of the question. When did she have surgery originally?

[uncut]

It's time for me to maybe do the once-a-decade update of my mom's aphakic glasses. She's wearing a traditional lenticular lens, and she's finally adapted over the last 10 years to be able to wear it around the house for a good 5 hours or more at a time. I'm wondering if anyone thinks she could adapt to something a little less ugly now that she's adapted (finally) to the lenticulars. I tried her once in a beautiful pair of aspheric bifocals before I non-adapted her into the lenticulars, but I'm wondering with all the free form stuff on the market now if maybe the time is right to try out something new. She doesn't mind the weight of the lenticulars but for being a pastor who makes no money, she's extreemly aware of her looks and as she's getting old and drying up, I'd like to provide her with glasses that she could wear in public (maybe. Probably not, but she'll look hot while caring for my 88 year old grandfather at home).

So brainiacs (I know who you are and WILL private message you if you don't give me your nerdy advice), any advice? Or at least explain to me why I shouldn't take her out of the lenticulars? She's only about a +13 or +14 with very mild cyl.

Thanks for all the wonderful advice I know you'll flood me with!!!

First: A good book to read, if you can find a copy(Fezz?): Spectacles for Aphakia, by Curtis D Benton, Jr, and Robert C Welsh. You will get a lot of answers to your mom's reaction to your beautiful eyewear answer, and what she prefers. It will give you some further insight into aspherics, lenticulars, and full-field, how to use them and when not to.

Remember preference and success with your mum's fitting revolves around the frame shape, size, her resultant pupil shape, IPD monocular, and power. Multifocals, including trifocals are almost useless in her power range.....and remember that lens thickness revolves around the highest power required, in multifocals!

Secondly:
Revisit ophthalmologist re: re-implant possiblilities, maybe some of the new toric implants can be adapted.

Thirdly;
Revist a gas permeable contact lens for best vision, and over-correct with a multifocal with residual cyl and read power.

If she has ever used a contact or tried, this might work. Manual dexterity is important. I have had some wearing a extended wear soft, with removal visits in office, too. They were quite happy to visit to have their contacts replaced on schedule and inserted/removed by a family member, or their contact lens fitter.

Happy fitting, family is tough, and never impressed.......they know you're good, only disappointment surprises them!

[optilady1]

She does wear rgp's, she's just super duper sensitive to everything and so they aren't going to work for her for ever. She's cut back the most she has ever in her life. She's actually here right now, so I'll get back to this later.

[Chris Ryser]

Maybe you should look into: They are doing it for myopics, but the way I understand it should be maybe possible for Aphakics

Phakic intraocular lenses, also known as implantable contact lenses (ICLs), are implantable contact lenses that are surgically inserted into the eye where they provide excellent quality of vision with predictable and stable results. The Visian ICL is the latest phakic intraocular lens to receive approval from the FDA for a wide range of myopic (nearsightedness) correction needs. This technology is adapted from the proven lens technology used for cataract surgery, and works by placing the Visian ICL in front of the natural lens inside the eye. The Visian ICL is made of an advanced material that is extremely biocompatible and provides superior optical performance.

See at -------------------> http://www.kellogg.umich.edu/LASIK/phakic.html

[sharpstick777]

ft, rd, or sv? I use Ice-Tech on orders like the one above. Lenticulars are only available in CR. Ice can make aspherics in most any material. (super thin)

+2

[sharpstick777]

That is far too daring. There aren't enough years left in my mother's life to get her used to a progressive.

I fit a first time progressive on a 96 year old woman with mobility (walker) and health issues, and not much time left. She was SOOOO mad. Not at me, but at all the opticians over the years who never put her in a Progressive. "Why didn't they do this sooner?" She would lament over and over again, she literally slammed her hand on the table in anger. "So much of my life was wasted tilting my head up and down fishing for things."

She lived to 98, but she really enjoyed those progressives. She thanked me over and over for improving the quality of her last years. He daughter even called when she passed, just to thank me.

Call Beth at Ice-Tech. PM me for her cel # if you want.

[optilady1]

Believe me, when I first got into optical, I started excitedly talking to my mother about progressives, but she is not interested, and she quite simply is a poor candidate. She had such horrible vision for so long, that she wants the largest amount of vision in one area as possible. I would compare her to an architect. She wants to be able to have as much side to side vision as possible. It just wouldn't work. But I do appreciate that we prejudge people who we don't think will do well who may actually be interested and thrive with them. I just know my mother, actually better than she does, and I know she would hate a PAL.

[Robert Martellaro]

She had such horrible vision for so long, that she wants the largest amount of vision in one area as possible. I would compare her to an architect. She wants to be able to have as much side to side vision as possible.

The lenticular designs tend to use a level of asphericity that maximizes off-axis VA, where the full-field lenses usually have four (Welsh) to five (Bristol) diopter drops, minimizing thickness and magnification, but with much higher levels of off-axis blur. Exceptions are Signet's Hyperaspheric, and maybe Sola/Essilor's Super Mod, although availabilty might be limited or non-exisitant by now.

It's tempting to put SV or round seg hi-index free-form generated lenses on the table, but even with 1.70 refractive index, I suspect that the off-axis blur due to TCA would be troublesome for most folks, especially for those who want the best possible off-axis performance.

Aspheric lenticulars are available according to this source.

http://www.laramyk.com/blog/high-plu...ailable-again/

Hint...I believe the bowl diameter is about 40mm- put these into a roundish 40mm eyesize frame, on center, and you'll lose the carrier.

There is one company that makes non-aspheric lentics and full-fields...don't bother.

[sharpstick777]

Ice-Tech still has two options for you, a Backside Round Seg, and a front Side ST-28, both with digital processing.

We just did a kid who was +18.50, in lenticular. We put him into an Ice-Tech Round Bifocal, bisected the pupil, and it looked like a +11. The parents cried, in the office. It looked SV because the backside seg was almost invisible from the front.

Believe me, when I first got into optical, I started excitedly talking to my mother about progressives, but she is not interested, and she quite simply is a poor candidate. She had such horrible vision for so long, that she wants the largest amount of vision in one area as possible. I would compare her to an architect. She wants to be able to have as much side to side vision as possible. It just wouldn't work. But I do appreciate that we prejudge people who we don't think will do well who may actually be interested and thrive with them. I just know my mother, actually better than she does, and I know she would hate a PAL.

[optilady1]

Ice-Tech still has two options for you, a Backside Round Seg, and a front Side ST-28, both with digital processing.

We just did a kid who was +18.50, in lenticular. We put him into an Ice-Tech Round Bifocal, bisected the pupil, and it looked like a +11. The parents cried, in the office. It looked SV because the backside seg was almost invisible from the front.

Hmmmm. This is very interesting. I'll have to look into.