Case Study
Px prescribed:
+0.50 ds 4.00BU
-2.50 +0.75 080 4.00 BD
+2.75 add
Diplopia is a recent symptom caused by surgery complications. First time prism wearer; historical specs can't really shed any light--but he's currently in a polycarb Varilux Comfort. He's opted for a trivex Varilux Physio in his new pair.
Seg heights for progressives measured in new frames at 24.0/25.0.
The ol' "System" bible tells us to adjust bifocal segs in cases of vertical prism .3mm per prism diopter. In this case I'd be dropping the OD seg to 21.6; or if I broke my habit of adjusting alternate segs lower instead of raising any: OD 22.8/OS 26.2
Insights and experience in this sort of situation is greatly appreciated--whether it confirms B&B or not. Is this seg offset for vertical prism as advisable in PALs? Different answers in conventional versus digital designs?
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