Lenses and Frame Advice
Hello, first time poster here. I thought I would share a recent patient's prescription and frame choice and see if my thinking for the lens is appropriate from the experts.
29yr old male patient.
OD:
-4.50 -3.25 x 002
PD: 30.5
OS:
-5.50 -0.75 x 010
PD: 31
The patient has selected Ray Ban RB5277 2007 frames with 52-17-140 and B of 29.9 dimensions.
I am thinking Essilor Thin & Lite 1.67
With Crizal Sapphire UV AR coating.
These would be for daily wear glasses.
Any comments?
A candidate for FFSV. More important is the frame choice appropriate, frame front is influenced by the RX and will lose much of it's pano, this can increase the frame splay. Pre-fit is essential.
Just make sure your client understands that filling this Rx without a face-to-face with an ophthalmic optician is a recipe for failure, a waste of your client's money, and ultimately you'll end up with them back in your chair to sort out the mess.Originally Posted by Monster8
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.
Especially with an RX that imbalanced. Yikes.
I agree with Paul. Also, I don't mean to offend, but does anyone else get a consumer post vibe from the OP?
Is the atomic weight of Cobalt 58.9?
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.
Thanks for the comments.
Patient is cost conscious so FFSV is out. Face to face has already happened, pre-fit will happen.
Crizal Avance is sold most of the time, this will be the first Sapphire.
sapphire is AWESOME ... i do notice a significant difference and have tried other coatings but always go back to that :) especially with that astig they should be very happy.
"what i need is a strong drink and a peer group." ... Douglas Adams - Hitchikers Guide to the Galaxy
If cost conscious, then skip the upcharge on sapphire and go with freeform SV and Avance.
Lens material and coatings are of very little consequence with this Rx compared to lens position. A mispositioned lens will result in diplopia, or at a minimum, some degree of asthenopia.
You're either a young optometrist who slept through the 'Optics of Ophthalmic Lenses' course, or a consumer playing doctor/optician. Post the results of the phoria tests, explain the significance of VI, and we'll talk. Otherwise see a certified healthcare provider.
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.
+1. Any difference in visual quality between Sapphire and Avance (or even Alize or Easy) is irrelevant until you have maximized every variable of material, design, and fit FIRST. Lipstick on a pig and all that.
Ok, ok, you guys caught on to me. I am sorry for misleading, perhaps this was supposed to be in "Just Conversation", I was not aware of that part of the forum. Yes, I am just a consumer trying to learn as much as possible but also at the same time super frustrated with every optician I have spoken with in person.
I have been to my optometrist (at Clayton Eye Center) and had an exam two weeks ago, I specifically asked the optometrist about HD lenses during my exam and he said to talk to his opticians in the optical department because he did not know much about it. I went to the optical department and spoke to, who I thought was, the most knowledgeable optician there. He said the HD lenses are mostly for progressive wearers and he would not recommend it for my prescription.
I have since been to Lenscrafters, Pearl Vision, Wal-Mart Vision Center, and DePoe Eye Center. Everyone I spoke to at these places had a lot of misinformation and none of them recommended FFSV lenses. Lenscrafters, Pearl Vision, and Wal-Mart did not know who made their lenses and could not get Essilor lenses with Crizal or Avance. The optician at DePoe Eye Center did not know what Crizal Sapphire was, he was thinking I was talking about Prevencia and he recommended Avance as a better AR coating. A second optician at Clayton Eye Center did not know there was more than one Crizal AR coating and she thought Crizal Sapphire was made by another company other than Crizal.
So, having spoken with many different opticians in person, I have come to realize that I cannot trust most of them and have had to do my own research. I should not be the one who knows more about several aspects of their field than they do.
At the moment, I have no idea what FFSV lenses would cost me, I also do not have any idea of someone knowledgeable in the Atlanta area I can go to (I'm willing to drive).
The lens design, HD, free-form, brand, AR type, etc., is insignificant if you're seeing double. Proper lens positioning is critical with this Rx, especially with today's larger, deeper frames.
Check the university hospitals, clinics, eye institutes, and private offices. The keywords are anisometropia and vertical imbalance. That's the most I can offer without breaking forum rules.
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.
You can't be cost conscious and expect to get the very best lenses with premium coatings. In my shop we would recommend free form single vision, probably a Shamir design with Crizal Avance or Sapphire if you prefer blue, in 1.67 or trivex. More important would be proper pupil height and pd measurements after the frame was adjusted to fit your face. Try the locator at the Shamir website to find an office who fits these lenses. If I knew of one in Atlanta I would send you there, but I don't. With your Rx you have to be fitted in person by an optician who knows their stuff. Look for an ABO certificate or a GA state license on the wall, and have that person fit you. Good luck.
This forum is for Eyecare Professionals. Consumers are allowed to post in the Just Conversation forum and non-optical topics only. Please be aware that any questions involving optics or eyecare may be removed. These kinds of questions should be discussed with a qualified eyecare professional who has examined you and is familiar with your situation.
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