Originally Posted by
lerral
How do you determine the true POW during fitting, i.e. the position at which the lens will come to rest after nasal geometry, perspiration, body oils, and motion dislodge it from where it was first set on the face? Are there any tricks to determine this natural POW? I'm not talking about sports or other extremes, but the difference between where a patient will initially put on his frame, and the place where a frame will naturally want to come to rest. I've found they're not necessarily the same.
A patient with OD -2.75 -3.00 002 OS -2.5 -2.75 180 add +2.25 chose a snug fitting 46-24-150 retro frame and was fitted with Shamir Auto II fixed 18mm in 1.60 material. On delivery he loved them but returned the next day claiming the reading power (and intermediate, it seems) was "too low". On a hunch I asked him to spend an hour doing ordinary activities with his glasses on before coming to see me again. I told him not to re-adjust the frame position unless necessary for safety. When he came in, I measured and marked the OC. I then asked him to take his glasses off and put them back on in the same position as earlier in the day. I measured OC again. There was a full 3mm difference between the two OC positions, more than enough to be very significant in his rx.
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