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Hello. I have question about correcting phoria / trophia. let the picture describe the condition. My question is which one prescription is the best?. Attachment 13949
the best mean best for patient adaptation, best for cosmetic, or convenience or anything else.
thank you :smile:
I'm not the best person to guide you in this, but it would be much easier to help with a written version of the script. There is obviously a lot of prism here and general I gravitate towards splitting between both eyes evenly (both vertical and horizontal) but that is also dependent of the power correction for each eye as well.
I've never seen this represented on grip paper so I might be interpreting this incorrectly.Quote:
Originally Posted by redb
Eliminate examples #1 and #2 because the horizontal prism is base out.
#3, #4, and #5 are the same, but #3 is written so that the prisms are equally split between both eyes, and this will allow for the best cosmetics and the least negative effects from chromatic aberration (unless the BCVA in one eye is considerably poorer in one eye, if so, split unevenly or put all of the prism in the bad eye).
Best regards,
Robert Martellaro
thank you for your reply, the condition is left eye is normal 20/20 and right eye 20/20 but with oblique UP 4 Diopter and out 6 Diopter. Im just qurious can we use example 1 or 2 or only 3 is the best. thanksQuote:
Originally Posted by Quince
Thank you for your reply, yes I'm describing with picture because i confuse how to describe it. Can you explain more why we have to eliminate example 1 & 2?Quote:
Originally Posted by Robert Martellaro
Also. can we use progresive lens for example #3 for Presbiopya. thanks
#1 and #2 are the only examples that are equal to OD 4BU 6BO. Neither one is optimal for cosmetics. Examples #3, #4, and #5 are using 360 notation, and are equal to OD 4BU 6BI.Quote:
Originally Posted by redb
Because I misinterpreted the grid paper, and that #3 was the only choice that showed prism split.Quote:
Originally Posted by redb
Using the newly supplied Rx, the grid paper with rectangular coordinates, and the center as a reference point, and each box equal to one prism diopter, shows the right eye (small red square bottom left) as OD 2BD 3BO and OS 2BU 3BO. This contradicts what you stated is the written Rx above. Either the Rx you indicated above is written incorrectly, or I am still misinterpreting the graphic.
Generally yes, but with caveats.Quote:
Also. can we use progresive lens for example #3 for Presbiopya. thanks
Best regards,
Robert Martellaro
You can be dead on with your measurements but the patient might not be able or willing to wear what you find. The habitual Rx, the patient symptoms, if any, past experience, should all guide your decision.
ok thank you for your adviceQuote:
Originally Posted by fjpod
I mean the right eye condition is misalignment. but i understand your explanation and the correct written prescription. thankyou for all your answerQuote:
Originally Posted by Robert Martellaro
more question. how to measure PD for tropia?. which one is correct? #1 or #2. thanksAttachment 13963
Of the two choices, #1, if the left eye is stuck in the exo position for all angles of gaze. The Rx might say "balance" for the left eye. But if you cover the right eye and the left eye points straight ahead, measure that position and use this value for the left monocular distance PD.Quote:
Originally Posted by redb
Hope this helps,
Robert Martellaro
so the measurement is same. using monocular distance. thanksQuote:
Originally Posted by Robert Martellaro
I have experienced. found patient (40 yo) MPD R32 L32. with tropia in left eye cause by high blood pressure. during 2 months left eye covered, then when i open & check, found Missalignment 23 diopter prism base out. for temporary i give R 8 diopter base out L 9 D base out. (headache if put full prism). after 3 months check again the eyes back to normal (both eye) no tropia found.
The question is, is that coincidence or normal for high blood pressue patient? thank you
Muscle palsys can resolve, so yes.
thank you. so thats normal right.Quote:
Originally Posted by drk
sorry out of topic. Its about Myopia control lenses. Is there still many users? is the result works as expectation?