Bifocal options for super-hyper hyperope?

[SoopaTroopa]

Mother of a 5 yr old patient called in today asking if we can get bifocals for her daughter, but said the rx was rather strong. "Strong?" I think to myself while flexing my eyebrows, "I imagine we can find something for your daughter, ma'am! How strong are we talking?"

OD: +21.75 +1.00 x090
OS: +22.00
3.00 Add OU

"Wow, you weren't kidding!" I say, as I choke on my glass of water and simultaneously strain both my eyebrow muscles.

I've called 2 labs so far, and what I'm being told is I can get either a lenticular round seg or a supermod, and both only come in CR39. I have never worked with either of these lenses. Can anyone explain the differences between them, or does anyone know of any other options this poor kid might have? They won't be in until tomorrow so I have no idea what kind of frame they're bringing. Thanks optiboarders.

[Robert Martellaro]

We can get a +18 base curve, 44mm bowl lenticular, round 22mm Here.

You'll need a lab that that can surface a convex/saddleback back curve. That's not possible with a free-form generator. Try Epic Labs Inc.

edit: The smaller bowl (34mm) has base curves up to +26D, with adds to +25D.

Hope this helps,

Robert Martellaro

[rbaker]

We can get a +18 base curve, 44mm bowl lenticular, round 22mm Here.

You'll need a lab that that can surface a convex/saddleback back curve. That's not possible with a free-form generator. Try Epic Labs Inc.

Hope this helps,

Robert Martellaro

Don't have to go any further. Call aire-o-lite per Roberts direction.

[Kujiradesu]

Mother of a 5 yr old patient called in today asking if we can get bifocals for her daughter, but said the rx was rather strong. "Strong?" I think to myself while flexing my eyebrows, "I imagine we can find something for your daughter, ma'am! How strong are we talking?"

OD: +21.75 +1.00 x090
OS: +22.00
3.00 Add OU

"Wow, you weren't kidding!" I say, as I choke on my glass of water and simultaneously strain both my eyebrow muscles.

I've called 2 labs so far, and what I'm being told is I can get either a lenticular round seg or a supermod, and both only come in CR39. I have never worked with either of these lenses. Can anyone explain the differences between them, or does anyone know of any other options this poor kid might have? They won't be in until tomorrow so I have no idea what kind of frame they're bringing. Thanks optiboarders.

just a curious question, as I havent done a great many high pluses/minuses in mulitfocal lenses: should the prism experienced at the reading be considered? If the lens is a ST-28 and the above is 3mm, then were talking 15D BU. Its essentially the same between left and right but still.

[Robert Martellaro]

just a curious question, as I havent done a great many high pluses/minuses in mulitfocal lenses: should the prism experienced at the reading be considered?

I would tell the client, if the Rx is new, or if there is a significant change in Rx, that they will feel like they are walking uphill when they look down towards the floor.

If the lens is a ST-28 and the above is 3mm, then were talking 15D BU. Its essentially the same between left and right but still.

Using a round seg will cancel some of the BU prism compared to a ST, but the difference will be only a couple of prism diopters. This is a very difficult Rx to position optimally in front of the eyes, with stability and good physical comfort, and no fun to wear (there will be some degree of adaptation after 10 to 20 days). The only work around is CLs, and eventually IOLs.

Best regards,

Roberts Martellaro

[smallworld]

My advice is to use contacts for as much of the power that you can , although I can't image being able to insert more than a +15.00 in a 5 year old's eyes. Put the rest of the power in the glasses with the bifocal. I started wearing contacts at age 6, so it's a realistic option.

[Robert Martellaro]

Here's an Aire-O-Lite lenticular I just got in. +11 +3.50 add. The bowl measured 37.5, 14 BC, frame is titanium (Europa MR-144) and is overall very light in weight. Right eye is a balance lens, but used the same for cosmetics. UV, Softlite #1, and AR.

The smaller bowl (34mm) has base curves up to +26D, with adds to +25D.