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Thread: Stumped: Minimal Change = Drastic Difference

  1. #1
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    Confused Stumped: Minimal Change = Drastic Difference

    I am a fairly new Optician, my state is unlicensed, so I have learned strictly "on the job". My main training is for fitting and I'm trying to learn more about specific lenses.

    I need some help with a patient.

    Original:

    Ovation 16mm seg ht

    New:

    Varilux Comfort Short 18mm seg ht

    They are the same exact frame.

    The patient had no problems with the Original order and the RX has since changed. The New RX is correct, because they also purchased glasses elsewhere and those are working fine.

    His main problem is that he can't read well out of them. It's not as clear as his glasses from another shop. Oh and let me add that he has the Varilux Comfort in those glasses too.

    I am STUMPED.

    Any help is greatly appreciated. Thank you!

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    Master OptiBoarder DanLiv's Avatar
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    Do you truly have him in a comfort SHORT at 18mm? If his previous was Ovation which is standard corridor length (how he could read at 16mm with all the reading power cut out I don't know), and perhaps the pair from the other place is also a standard length Comfort (appropriate for 18 seg height), then the short certainly minimizes his reading area. He should probably be in a standard Comfort at that height anyway, especially since he isn't in short corridor designs previously or otherwise.

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    Base curve?

    Material?

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    Quote Originally Posted by idajade1124 View Post
    I am a fairly new Optician, my state is unlicensed, so I have learned strictly "on the job". My main training is for fitting and I'm trying to learn more about specific lenses.

    You might want to invest in your career and check out Opticianworks.com

    http://opticianworks.com/

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    Quote Originally Posted by DanLiv View Post
    Do you truly have him in a comfort SHORT at 18mm? If his previous was Ovation which is standard corridor length (how he could read at 16mm with all the reading power cut out I don't know), and perhaps the pair from the other place is also a standard length Comfort (appropriate for 18 seg height), then the short certainly minimizes his reading area. He should probably be in a standard Comfort at that height anyway, especially since he isn't in short corridor designs previously or otherwise.
    How he saw out them, I don't know either. That's why I've been SO confused. I do see the advantages of going with a standard Comfort. I think this will probably be my course of action. My company tends to do a Short automatically if it's 18mm or less, so this should help I would think.

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    Quote Originally Posted by Fezz View Post
    Base curve?

    Material?
    CR39 in both orders

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by idajade1124 View Post
    I am a fairly new Optician, my state is unlicensed, so I have learned strictly "on the job". My main training is for fitting and I'm trying to learn more about specific lenses.

    I need some help with a patient.

    Original:

    Ovation 16mm seg ht

    New:

    Varilux Comfort Short 18mm seg ht

    They are the same exact frame.

    The patient had no problems with the Original order and the RX has since changed. The New RX is correct, because they also purchased glasses elsewhere and those are working fine.

    His main problem is that he can't read well out of them. It's not as clear as his glasses from another shop. Oh and let me add that he has the Varilux Comfort in those glasses too.

    I am STUMPED.

    Any help is greatly appreciated. Thank you!
    Dot the old and new lenses at the 34mm apart engravings. Overlay the lenses. Do the dots match up? If not you may have a decentration and/or height issue.


    What are the engraved add powers of the old and new? If the old ones are say +1.50 adds and the new ones are +2.00 then the place the patient looks through the corridor and/or distance the material to be focused is held may need to be adjusted. This can also be influenced by the sphere power so if you don't know how, have someone show you how to calculate this overall difference in focal length while taking into account any distance sphere or cyl changes.

    What do you come up with?
    Last edited by Uncle Fester; 05-13-2014 at 02:32 PM.

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    Quote Originally Posted by idajade1124 View Post
    His main problem is that he can't read well out of them. It's not as clear as his glasses from another shop. Oh and let me add that he has the Varilux Comfort in those glasses too.
    Varilux Comfort, or Varilux Comfort short? I can envision a scenario where the add is too strong, but might be acceptable to the wearer if a standard length corridor was fit at or below 18mm.

    To check, have the client hold the reading card closer to see if the acuity improves. If so, cut the add to the appropriate power for their typical work distance. If the acuity is poor regardless of where the card is held, then the problem is probably is due to aberration created by poor positioning, improper base curve, etc.

    Include the client's age as well as the old and new Rx when troubleshooting.
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



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    No need to use a short style lens with a 18mm seg ht.

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    Master OptiBoarder NCspecs's Avatar
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    Quote Originally Posted by idajade1124 View Post
    Original:

    Ovation 16mm seg ht

    New:

    Varilux Comfort Short 18mm seg ht

    They are the same exact frame.

    If it ain't broke, why did you "fix" his progressive and his seg in the exact same frame? Both the Ovation and Comfort are archaic in my opinion- You really aren't giving the patient much of a different lens. You also haven't posted an Rx or a BC. Sort of hard to help you trouble shoot without that info.


    Quote Originally Posted by EyeSore View Post
    No need to use a short style lens with a 18mm seg ht.
    If someone walks in the door wearing a short corridor and the A measurement in their new frame is ball park to the previous frame but the B is deeper, I'm going to fit a short corridor. unless the patient was wearing a old lady Tura frame and all of a sudden wanted hipster frames I'm keeping that presbyope in what they've grown accustomed to wearing.

    Again. IF IT AIN'T BROKE!!! :)
    "Strictly speaking, there are no enlightened beings; only enlightened activity." -Shunryu Suzuki

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    Quote Originally Posted by NCspecs View Post
    If it ain't broke, why did you "fix" his progressive and his seg in the exact same frame? Both the Ovation and Comfort are archaic in my opinion- You really aren't giving the patient much of a different lens. You also haven't posted an Rx or a BC. Sort of hard to help you trouble shoot without that info.



    If someone walks in the door wearing a short corridor and the A measurement in their new frame is ball park to the previous frame but the B is deeper, I'm going to fit a short corridor. unless the patient was wearing a old lady Tura frame and all of a sudden wanted hipster frames I'm keeping that presbyope in what they've grown accustomed to wearing.

    Again. IF IT AIN'T BROKE!!! :)
    This has never steered me wrong!

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    Quote Originally Posted by NCspecs View Post

    Again. IF IT AIN'T BROKE!!! :)
    That's one way to reduce adaptability problems, but if you're capable of preparing and hand-holding the client through a few rough spots, the benefits in vision and comfort make it worth the effort, even when a few hypersensitives slip through the cracks and you have to eat it.
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



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    Master OptiBoarder NCspecs's Avatar
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    Quote Originally Posted by Robert Martellaro View Post
    ...if you're capable of preparing and hand-holding the client through a few rough spots, the benefits in vision and comfort make it worth the effort, even when a few hypersensitives slip through the cracks and you have to eat it.
    True, but I feel that is where lifestyle questions come into play. If I ask Mr Jones about his visual acuity and the amount of room for manuevering that he has with his current PAL and he expresses contentment, I'm not messing with anything. However if I do suss out some disatisfation then that's a different story. And frankly, in this case, there is not enough of a difference between the two designs to warrant a change. It's just exchanging one dinosaur for another.
    "Strictly speaking, there are no enlightened beings; only enlightened activity." -Shunryu Suzuki

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    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by Robert Martellaro View Post
    That's one way to reduce adaptability problems, but if you're capable of preparing and hand-holding the client through a few rough spots, the benefits in vision and comfort make it worth the effort, even when a few hypersensitives slip through the cracks and you have to eat it.
    Said by the man who pays for his own meals and requires reservations beforehand!

    If you work for someone as this poster (and most of us) apparently does than "Don't fix what ain't broke" is a mantra to take to the bank with your paycheck.

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    Quote Originally Posted by NCspecs View Post
    True, but I feel that is where lifestyle questions come into play.
    Collect the data, weigh all of the relevant lifestyle and ophthalmic optics factors, give more merit to some than others as appropriate for the individual, read your client's mind as best as you can, tell the client what you're up to (and why), then make the recommendation.

    Easy peasy.

    Quote Originally Posted by Uncle Fester View Post
    Said by the man who pays for his own meals and requires reservations beforehand!
    Good food, good meat, good god, let's eat!
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



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    Master OptiBoarder NCspecs's Avatar
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    Quote Originally Posted by Robert Martellaro View Post
    Collect the data, weigh all of the relevant lifestyle and ophthalmic optics factors, give more merit to some than others as appropriate for the individual, read your client's mind as best as you can, tell the client what you're up to (and why), then make the recommendation.

    Easy peasy.
    I agree with you 100%.

    I wish you could have been here today when I took a research professor (of Physics and Optical Science) from UNC out of his Costco Ovations (or accolade, whatever, who cares). I would have gotten a real Martellaro pat on the head. ;)
    "Strictly speaking, there are no enlightened beings; only enlightened activity." -Shunryu Suzuki

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    Quote Originally Posted by NCspecs View Post
    I agree with you 100%.

    I wish you could have been here today when I took a research professor (of Physics and Optical Science) from UNC out of his Costco Ovations (or accolade, whatever, who cares). I would have gotten a real Martellaro pat on the head. ;)
    No pats on the head, but maybe a knowing smile and thumbs up. Regardless, this research professor is now in a better place.

    Don't forget to demo computer eyeglasses!
    Science is a way of trying not to fool yourself. - Richard P. Feynman

    Experience is the hardest teacher. She gives the test before the lesson.



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