Will pd change on an adult?

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10-19-2017, 09:58 PM
Xiatian123

Will pd change on an adult?

I had a patient who got progressive lenses from our place since 2009, the PD was 62, today he came in and got a pair of eyeglasses, he is a elder around age 75, I guess? The PD I got was around 65. Is it possible for the pd change? One of his eye is nearsighted, the other one is far sighted.

By the way, he has few pairs of eyeglasses, most of them are from our place, so I think keep PD 62 is better since he is gonna switch glasses. The lasted eyeglass he got was from last year. It was 62 Pd on file.

Thanks��
10-20-2017, 04:43 PM
Tallboy

Cataract surgery? Do they have a history of amblyopia? If you were measuring with a corneal reflex pupilometer and they have had an IOL implant there will be a reflection off the implanted lens that is different than a healthy cornea would provide. Does he have an old orbital socket injury that is "settling" in his old age?

If he is having some kind of shift from his muscles weakening and is amblyopic, change only a little bit at a time. Less is more, but in that case the change is warranted.
10-20-2017, 07:11 PM
Xiatian123

Thank you. I asked patient's daughter, she said he didn't do the surgery, so I was surprised.
He had a history of amblyopia.
10-21-2017, 10:39 AM
Robert Martellaro

Quote:

Originally Posted by Xiatian123

I had a patient who got progressive lenses from our place since 2009, the PD was 62, today he came in and got a pair of eyeglasses, he is a elder around age 75, I guess? The PD I got was around 65. Is it possible for the pd change? One of his eye is nearsighted, the other one is far sighted.

By the way, he has few pairs of eyeglasses, most of them are from our place, so I think keep PD 62 is better since he is gonna switch glasses. The lasted eyeglass he got was from last year. It was 62 Pd on file.

Thanks🙏

Quote:

Originally Posted by Xiatian123

Thank you. I asked patient's daughter, she said he didn't do the surgery, so I was surprised.
He had a history of amblyopia.

The current study also demonstrated that IPD increased by 4.19 mm in males and 3.11 mm in females from the young adults (20–30 years) to older adults (51–70 years), and then a decrease (2.6 and 0.19 mm for males and females, respectively) occurred between 70 and 89 years of age. This result can be explained by orbital involutional changes and the increased laxity of soft tissues in the elderly subjects.

https://www.dovepress.com/evaluation...t-article-OPTH

I've occasionally seen increases in the distance IPDs with my older clients of about 1mm to 2mm O.U., generally from middle age through their senior years, along with changes in the vertical position of the eyes.

Always measure the IPD for new Rx lens(es), especially if the frame has changed, and expect to see more height disparities. Measure with the fellow eye occluded if the amblyopic eye turns.

Best regards,

Robert Martellaro
10-21-2017, 10:40 AM
Tallboy

That is really interesting Robert, thank you for that article.
10-23-2017, 03:41 PM
Quince

That is an interesting article. I do wonder if different races produce different results, as it specifies that this particular study was done with a Turkish population. Not that I think it would effect the overall answer of 'yes, there is change between certain age ranges' but it makes me think of the tells that archaeologists can read to identify age/ sex/ race from bone structure.
10-23-2017, 04:45 PM
Robert Martellaro

Quote:

Originally Posted by Tallboy

That is really interesting Robert, thank you for that article.

Your welcome.

Quote:

Originally Posted by Quince

That is an interesting article. I do wonder if different races produce different results, as it specifies that this particular study was done with a Turkish population. Not that I think it would effect the overall answer of 'yes, there is change between certain age ranges' but it makes me think of the tells that archaeologists can read to identify age/ sex/ race from bone structure.

They do- one study shows no change. I see primarily European females.

Best regards,

Robert Martellaro
11-07-2017, 07:15 PM
dima

Hello everyone.

I'm an optometrist student from Italy, sorry for my bad English... I'm improving :)

this thread is Very interesting.

The questions sometimes Is (I think so..) Do I use old Pd or "upgrade new pd?" (in all lenses...single vision like progressives)

the optical science says.. with exact true Pd I cut off unwanted prism.... but the patient is get to used the "old" pd... maybe from years... have the habit maybe with those little prism effects...

Am I "mad"??? I saw some people with new glasses that in single vision lenses prefer the old wrong pd on the old glasses..
11-08-2017, 11:50 AM
Quince

Quote:

Originally Posted by dima

Hello everyone.

I'm an optometrist student from Italy, sorry for my bad English... I'm improving :)

this thread is Very interesting.

The questions sometimes Is (I think so..) Do I use old Pd or "upgrade new pd?" (in all lenses...single vision like progressives)

the optical science says.. with exact true Pd I cut off unwanted prism.... but the patient is get to used the "old" pd... maybe from years... have the habit maybe with those little prism effects...

Am I "mad"??? I saw some people with new glasses that in single vision lenses prefer the old wrong pd on the old glasses..

This is another good thread about 'updating' a PD.

https://www.optiboard.com/forums/sho...-It-s-me-again

While it is true that patients can become accustomed to a mismeasured PD or Seg, I find most people in the field agree that you should always try to use the most accurate measurements unless there are documented past issues.
11-11-2017, 04:04 PM
dima

Quote:

Originally Posted by Quince

This is another good thread about 'updating' a PD.

https://www.optiboard.com/forums/sho...-It-s-me-again

While it is true that patients can become accustomed to a mismeasured PD or Seg, I find most people in the field agree that you should always try to use the most accurate measurements unless there are documented past issues.

Thanks Quince :)

ps... also I... hate poly very much ;)
11-11-2017, 05:42 PM
Quince

Quote:

Originally Posted by dima

Thanks Quince :)

ps... also I... hate poly very much ;)

There is a secret society of us poly haters! Welcome!
11-11-2017, 07:26 PM
Barry Santini

Always remember it's the binocular PD that matters most, not monocular
11-12-2017, 09:27 AM
dima

Quote:

Originally Posted by Barry Santini

Always remember it's the binocular PD that matters most, not monocular

Thanks Barry.

I'm wondering (sorry I start my studies from few months) if I have a person (no amblyopia or binocular defect) with a strong "ocular dominance" (sorry for my English) It is the same? the pd meter will be correct?

My OD because I have a little lack on the left eye (strong ocular dominance on the right eye) take mono pd and after take binocular after I blink for fusion.

It is correct or madness? hahahha :)
11-12-2017, 11:22 AM
Tallboy

Quote:

Originally Posted by Barry Santini

Always remember it's the binocular PD that matters most, not monocular

This is not a true statement in a +2.25 progressive though is it?
11-13-2017, 12:18 PM
Quince

Quote:

Originally Posted by Barry Santini

Always remember it's the binocular PD that matters most, not monocular

Maybe this is a good segue or maybe I should look up a thread that already discussed this, but I would think the opposite. I use binocular PD for all line segmented multifocals- mainly for cosmetic reasons, but aside from that always use monocular measurements.
11-14-2017, 06:58 AM
Barry Santini

Quote:

Originally Posted by Tallboy

This is not a true statement in a +2.25 progressive though is it?

Absolutely!!