Contact lens/ glasses combo

[Optoanomaly]

Dear Colleagues

I have a situation at which I could use some help/advise

I have a 28 yrs old female client who just had a baby, she's been wearing Toric contact lens for many years with the following Rx:
OD= S-6.00/C-1.75x030
OS= S-6.50/C-2.25x160

She came to me saying that she wanted glasses because of the convenience, so I performed an eye exam without her contacts and got
OD= S-7.00/C-3.50x005
OS= S-7.00/C-3.50x160

Now, for someone that has been on a stagnant Rx for so many years, my eye exam is just going out the window, let's face it, she'll be spinning in lala land.
So i suggested for her to go to see an ophthalmologist and and she came back with the following Rx
OD= S-6.50/C-3.00x180
OS= S-6.50/C-3.00x180

So just to be safe I went on ahead dispensing the Rx for her pair of specs. And the end result is she still having her headache.

I measured her using my autoref and it came out
OD= S-7.50/C-4.50x004
OS= S-7.50/C-4.25x165
I assumed the Doc's Rx is a bit in between mine and the autoref reading. Not sure why the Doc's RX isn't working properly

Any help please as of what to dispense and where can i re-start my measurement?

[Diane]

Depends on the lenses...how long a day she wears them, so much more. Probably need to let the eyes rest a bit. I would probably do glasses at vertex'd power from cl including axis, let her wear them a couple of weeks and then re-refract her.

Diane

[Diane]

Just one more thing on the axis...the orientation for the axis on the cl Rx may rotate based upon a lot of factors. The lid position and the relationship of the inner and outer canthus. A photo could help...only of her eyes please. We don't want any HIPAA violations.

Diane

[uncut]

Dear Colleagues

I have a situation at which I could use some help/advise

I have a 28 yrs old female client who just had a baby, she's been wearing Toric contact lens for many years with the following Rx:
OD= S-6.00/C-1.75x030
OS= S-6.50/C-2.25x160

She came to me saying that she wanted glasses because of the convenience, so I performed an eye exam without her contacts and got
OD= S-7.00/C-3.50x005
OS= S-7.00/C-3.50x160

Now, for someone that has been on a stagnant Rx for so many years, my eye exam is just going out the window, let's face it, she'll be spinning in lala land.
So i suggested for her to go to see an ophthalmologist and and she came back with the following Rx
OD= S-6.50/C-3.00x180
OS= S-6.50/C-3.00x180

So just to be safe I went on ahead dispensing the Rx for her pair of specs. And the end result is she still having her headache.

I measured her using my autoref and it came out
OD= S-7.50/C-4.50x004
OS= S-7.50/C-4.25x165
I assumed the Doc's Rx is a bit in between mine and the autoref reading. Not sure why the Doc's RX isn't working properly

Any help please as of what to dispense and where can i re-start my measurement?

If she has just given birth.........there are other reasons to have a headache...I would delay changes. Suggest that she cope with a compromise ophthalmic Rx and wait until infant is older.

[OHPNTZ]

Dear Colleagues

I have a situation at which I could use some help/advise

I have a 28 yrs old female client who just had a baby, she's been wearing Toric contact lens for many years with the following Rx:
OD= S-6.00/C-1.75x030
OS= S-6.50/C-2.25x160

She came to me saying that she wanted glasses because of the convenience, so I performed an eye exam without her contacts and got
OD= S-7.00/C-3.50x005
OS= S-7.00/C-3.50x160

Now, for someone that has been on a stagnant Rx for so many years, my eye exam is just going out the window, let's face it, she'll be spinning in lala land.
So i suggested for her to go to see an ophthalmologist and and she came back with the following Rx
OD= S-6.50/C-3.00x180
OS= S-6.50/C-3.00x180

So just to be safe I went on ahead dispensing the Rx for her pair of specs. And the end result is she still having her headache.

I measured her using my autoref and it came out
OD= S-7.50/C-4.50x004
OS= S-7.50/C-4.25x165
I assumed the Doc's Rx is a bit in between mine and the autoref reading. Not sure why the Doc's RX isn't working properly

Any help please as of what to dispense and where can i re-start my measurement?

1. Agree with the concern about "just had" a baby. She needs at minimum 3 months post delivery to stabilize.
2. Throw out the CL rx. You are assuming too much about it. Don't forget vertex power adjustments and also the axis of the cyl may be compensated for lens rotation.
3. I would hedge my bet on the axis of 004 to 005 being correct for the OD and call the left eye 162-163. Autorefractors are not as accurate in high power range for sphere/cyl powers.
4. Forget the ophthalmologist refraction axis of 180 in each eye. No way it is that in both. Sounds almost like a quick lens rack scope with quick axis estimation with no refinement done at all. That much cyl at axis 180, especially in the OS won't work.
5. I would also trial frame your original findings, hold up some plus lenses before each eye, and also let the patient self adjust the axis if your really are that unsure...

[rdcoach5]

Tell her to quit drinking diet sodas. It can cause headaches.