Spectacles with very different OD and OS add powers.

[3goldbars]

I'm a novice and this is my first post, so I sure appreciate any assistance with my question. I have an 80-year old patient who because of a previous eye surgery has a very different prescription in each eye. My question is, since the add power in the OD lens is significantly higher than the OS lens, will I need to worry about vertical prism...or otherwise need to change the OC heights??

Thank you.

[Robert Martellaro]

I'm a novice and this is my first post, so I sure appreciate any assistance with my question. I have an 80-year old patient who because of a previous eye surgery has a very different prescription in each eye. My question is, since the add power in the OD lens is significantly higher than the OS lens, will I need to worry about vertical prism...or otherwise need to change the OC heights??

Thank you.

The add powers should be the same. Call the prescriber to verify the Rx. If it is correct as written, determine their intentions. Different distance powers on the ninety degree meridian usually requires extra attention with regards to vertical imbalance. Post more details (old Rx and eyeglasses, health, etc.) if you want to delve into this further.

[optilady1]

If there is truly that significant a difference I would discuss a separate reading and distance pair.

[Bok]

Could use a Slab-off Bifocal?

[EvilBoris]

The add itself isn't the problem, moreso that the rate of change across the lens is going to be different for each eye which is probably quite likely to cause some kind of imbalance at some point.

I'd say scrap the progressive bit and just go for a bif or separate pairs.

[Uncle Fester]

I'd call the prescriber and find out why the difference. Explain that because it's so rare to have different add powers you want to be sure it's not a transcription error and your concern for possible need for slab off.

Still would be helpful to have the actual rx.

Aside- Had a pilot years ago who wanted an exec bifocal in the right eye and a 15x35 tri in the left with different adds for the cockpit environment. Yes- He had a very high level of concentration and they worked fine until he moved from our area.

One for the hot shots out there- Would a corneal transplant present this scenario?

[Mr.Powers]

change the prescription, if you can do that ? in denmark the optometrist are the ones who deside the power.

[standarduck]

Would a corneal transplant present this scenario?

Wouldn't that depend on the results of the corneal transplant?

[standarduck]

Back to the OP - what are you planning on dispensing? Can you give us the actual prescription, so we know what's going on?