Specialty lens for Macular Degeneration patient

[Diane]

OK you professionals out there. Give me some of your best suggestions.

I've got a paient that we've made eyewear for, for years. We've always fit her with a progressive addition lens, and she loved them. A few years back, she was diagnosed with dry MD and we have been attempting to assist her. She's a very intelligent woman, and loves to read. We've actually had to refer her to an low vision doctor, and he's doing well, but now I think there is more that we, as Opticians could do.

She's currently wearing SV lenses with telescopic lens for driving around town, and can still do that OK. Inside, she is having to wear SV distant lenses with glue on segs with a power of 8 Diopters for reading. Can't find 6 Diopters or less or we could use it over a PAL and there would be no problem. She really misses her intermediate power. Ideas need to abound here. I've considered a type of ribbin seg with the intermediate requirement in it and use the glue on below that, but it would look bad, I think. I'm still thinking large seg with intermediate power and add the glue on to that, but it makes the add power too strong, then. A press on seg over the glue on seg, looks really bad. We've tried that.

Suggestions, please.

Diane

[Jeff Trail]

First question is why are you using a "glued" on seg on a SV lens? I can get adds up to a 50^! .. and even stock lens up to a 20^ (I have a couple of "low vision accounts) .. If you are "stuck" on that glue thing :) .. then why not use a E-Line and the drop the seg into the E-Line and make your very own FD lens? She would have a wide intermediate field then.
I'll check my books at work in the morning if no one has answered by then and tell you the highest adds available in Tri's and do some digging on the PAL's ..I know already you can get up to the 50^'s in RD's.
BTW the reason round segs work so well in those higher additions is that the "lip of the seg" gets so wide in a flat top that the patients usually have distorted vision when the catch that top surface of the seg.. and I even had one guy who had to have that FT but then went for the round seg because when he was sitting back in his lazy boy watching TV and he would catch the top of that flat seg the images would flip upside down then convert back when he got into the actual seg ..
If no one has posted the higher adds I'll be sure to do it in the morning on the tri's .

Jeff "low vision is fun..specially when it works for someone" Trail