We're keeping it simple. Ordered her another Essilor Small Fit. Even though she has no intermediate, and the optics are questionable, she "likes" it enough to be her current go to lens. So - whatever she wants. If she's happy working 8+ hours a day on a computer, with a lens that has no usable mid range clarity to speak of, good for her. It's already in her head that this is the only lens for her. So good luck to you lady!
Why the condescending tone, If she cant see she's the one who's frustrated.Originally Posted by Uilleann
We're keeping it simple. Ordered her another Essilor Small Fit. Even though she has no intermediate, and the optics are questionable, she "likes" it enough to be her current go to lens. So - whatever she wants. If she's happy working 8+ hours a day on a computer, with a lens that has no usable mid range clarity to speak of, good for her. It's already in her head that this is the only lens for her. So good luck to you lady!
Isn't the small fit similar to the Ellipse? I had that lens before and while it wasn't my favorite, it had enough intermediate and near to work fine on the computer and for reading.
Let eat us know how it turns out!
Been fitting the high plus in Shamir Intouch. Had several tell me its the only lens they really liked and could read with. Regardless I have found a shorter corridor is optimal for most of them regardless of which lens design.
[As Optical24/7 pointed out, high plus/high add PALs perform better when the progressive optics are on the front.
When someone has a moment, would appreciate an explanation on why high plus/ high adds do better with the progressive on the front vs. the back?
thanks,
Trip
Its the geometry. In a backside Add lens the front base curve is effected by the add on the back. So ideally you want a min of 1 base on the back of most lenses for a concave curvature (And to avoid patent issues most Backside add lenses are all concave, Seiko has the only convex backside on 2 of their lenses), so combine the add power, so lets say +2.50 and the sphere, lets say +10 for fun. That is 1 +2.5 + 10 =13.5 ... Now I need an minimum 13.5 base blank to start with. A base that steep looks kind of crappy. So we can fudge that a bit, but in high plus power moving the add to the front gives you the ability to use a 10.5 base instead with the same RX, maybe even a 10.25 if I wanted to be daring. The base curve on a front side add lens is separate from the Add power. It gives you a little more freedom.
Its wrong to say that all Plus powers do better in a front side add lens, but you reach a point where over a +8 combined add and sphere where a front side add gives you some room you don't have on the back. Most low to mid hyperopes still do better in a back add, it just decreases as the lens gets flatter on back, and in a pure backside free-form it gets flatter faster in higher adds.
Ah .. simple enough. I was trying to figure out if for some reason due to the shorter axial length or magnification of the lens power was leading to more challenges for the hyperope in FBS. .... thanks
Trip
Strong hyperopes are very sensitive to abbe value, so I would try and fit them with 1.60 index that has an abbe value of at least 41. Trivex will obviously work, but will be a lot thicker than a 1.60. Zeiss Individual 2 or Hoya Lifestyle/MyStyle in 1.60 are good lenses for strong hyperopes. A large B height helps in most cases. I have some personal experience with this, as I am +5.00 with +2.50 add.
Strong hyperopes are always more sensitive to abbé. Reason? DV + NV multiplies the lateral chromatism effect of abbé. Mopes with adds reduce it.
b
my goto lately for these types is the Shamir Intouch. Has worked every time. Err narrow on PD. I usually take .25 off each eye for binocular PD. just below pupil center. I had one lady hug me after she could see well and many lenses later.
Never posted what was the reading Add ?
I would love an update!
I've since left the practice I was with when this order was initially placed. We simply replicated everything for her as it was before, and she seemed satisfied enough at dispense. Some people just love poly in scripts that even I wouldn't suggest, and PALs in stupid short B frames. *shrug* And no, don't recall the add power off hand - sorry.
In other news, the new practice I'm with now is a night and day step up from previous offices. :)
Auto 3 is my go to lens also, i am curious of which fixed fitting ht did you order. For high plus our Reps recommend lower fixed fitting ht. If a pt seg is 18mm ordering an Auto 3 fixed 13 might work better. Also the Variable Fitting ht is recommended. Another cheat which i have heard other opticians do is lower seg ht.(ie. 18 seg ecp orders 16seg). i have not had any problems with high hypers with the auto 3. i always take panto measurements, vertex distace and frame wrap measurement too.
I have friends that use Definity Pal on High Hypers and they give me great feedback. Gonna try it one of these days.!.
Well Good Luck
Such as which brands? Whenever I have an unreasonable amount of trouble with a PAL; it's a fairly high hyperope. I use mostly HOYA brands but can use others.
Thanks
P
~Follow Your Bliss~
Hoya LifeStyle 2 freeform lens has add power on the front, and everything else is backside. Works well for me (+5.00 with +2.25 add). The LifeStyle 2 comes in Harmony and Clarity designs, and probably the Harmony would be best for most strong hyperopes (long corridor, soft design). The Hoya 1.60 material has an abbe value of 41, which makes it a good choice for strong hyperopes that seem to be more sensitive to chromatic aberration.
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