HI, I am current having a PX with O.D +4.00 O.S +1.00 add+2.50
it is an updated RX and he did recheck with doctor,but he complain his left eyes feel weird, muscle keep jumping and feel stress once he put the new lenses on.
I did double check his PD and even did a seg height for him, but issue still occur.
Is there any suggestion for me to solve this problem? thank you
he is currently using Nikon 1.67 S.V
Please let us know what the previous Rx was and what lens he had been wearing. What base curve, what was the PD and seg height in the old pair, how long had he been wearing the old pair?
Hi CCGREEN,
his previous RX wae O.D+3.75 OS+1.00 same add, his last lenses was Nikon 1.67 too, the one he has now was 4 base curve, PD 63, seg height 23. He had been wearing it for 2 years, thanks
Originally Posted by CCGREEN
VAs make a big difference in this Rx.
If the patient is an amblyope it's very tough to figure out how the brain is wired. Habits are hard to break, sometimes better vision is not more comfortable.
If this person is not an amblyope, Consider using a shaw lens.
self delete...Didn't notice it was the left eye.
Yup, especially early on during adaptation.
Although possible, it seems unlikely that a .25 D Rx change would suddenly trigger this level of asthenopia. Rule out changes in lens design; Nikon makes four or five designs, probably with different corridor lengths. It's possible that a frame change from small to large could increase the corridor length, increasing VI at near, with increased magnification overall. Check all POW parameters, especially vertex distance. BCs should be the same if the PAL is the same (compared to old).
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.
What Robert said. It's not a mystery as to why he can't wear the new ones. It's a mystery as to why he could wear the old ones. Find that out.
OP, a reading depth of 15mm will cause the patient to experience 4.5D of vertical imbalance at near.
The patient is using his eyes for more off axis viewing since he's in a PAL, It could very well be the cause of the pulling sensation.
Trial or ask prescribing doctor if patient can tolerate any BD prism in the +4.00 eye to minimize some of the imbalance along with using a shot channel progressive to shorten reading depth.
The Shaw Lens is your friend. Peter used to post on here, but you can find out more info at http://shawlens.com/
Optical Plastics is the Canadian distributor. Paul Fabish is a friend if you need his contact info. pls pm me.
Oo
Last edited by smallworld; 07-11-2015 at 07:06 PM.
If material is the same and basically the same BC, I would look at vertex change, tilt change and wrap change. Check differences in center thicknesses as well. Even bevel position can made a difference as well aseye size change can give a presumption of problems.
Diane
Anything worth doing is worth doing well.
Clearly out of binocular balance. Bet my license on it.
B
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