I just had a walk in that's has me questioning myself
The patient is a 9 year old girl with cerebral palsy. She is ambulatory so there is a high risk of her falling. The ocular history includes surgery for a phoria (the mother didn't remember if it was exo or eso and also didn't remember which eye) as well as nystagmus, however nystagmus is still present though the mother said it is a lot less severe.
New RX is
-15.75 -1.25 x 45
-14.00 -3.00 x 135
Add +3.00
Doctor order of a progressive
Old rx neutralized at
-15.50 -1.50 x 43
-14.25 -3.00 x 136
I know the lens is Transitions with AR, my best guess of material (based on thickness, color, and sound) is polycarbonate
My best guess of her distance PDs is R: 28.5 L: 27.5 (I measured at the point that looked like the center of rotation)
The new frames has measurements of
A: 47.0 B: 28.5 ED 49.1 DBL: 15
SH is 15
POW:
VD: R: 11 L: 10 Wrap: 7 Panto: 3
The patient's only requirement on the lenses is she really wants to stay in Transitions
And this job is being done under VSP
I've talked to my lab and we've reached the conclusion that because of needing Transitions we're looking at Shamir Digitals, so I'm leaning towards the Autograph III
Due to lens blank limitations my choices of materials are 1.50 and 1.67 (I can get 1.74 but even if didn't have a high risk of falling I'm extremely hesitant to fit a child in 1.74).
Here's where I'm not sure which way to go, which material is going to give me the best impact resistance (even at the cost of edge thickness) the lab is telling me that if I want 1.67 the minimum CT they would make is 3.0, I would assume it would be a similar CT for 1.50 as I'm assuming Z87.1 standards for the 1.50 lens.
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