What Do you this of this I.P.D & Optical Center

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12-16-2017, 01:59 PM
MrOptician

1 Attachment(s)

What Do you this of this I.P.D & Optical Center

Hello,

A Father Visited my store today requested a new eyeglass with his new prescription for his Child

His child is about 5-6 Years and He have Esotropia Left Eye, The Right Eye is Normal

His Father told me that his Son have "Fucosidosis" Which is a very rare disorder "rare genetic disorder"

But He asked me to check his old eyeglass to see if there is a different between the old and the new prescription power and i really do not know what to call it maybe surprised or shocked Because of What i saw on the lenses after checking on my Lens Meter

His RX is -3.00cyl×180 for both eyes and No Prism

The picture Explains more
Attachment 13671

You can see on the picture On The Right Lens the Optical center, the P.D On the Upper spot, And the Left on the very downer

He have more than 3 Eyeglasses they were made the same way with His Doctor.
His RX is -3.00cyl×180 for both eyes all of the 3 eyeglass

Note:
I did not make the eyeglass you see on the picture.

I do not have any problem with the patient i am just wondering what do you think of it if you faced the same case?
Have you ever faced the same?

This topic is to discuss not to solve any problem cause i am not complaining or facing any problem.
It is just a new experience
12-16-2017, 03:37 PM
Tallboy

First off, what is the RX brought to you from their doctor. What is the RX you read in those 3 older pair of glasses. You need to bring a lot more info to the table before anyone here can even begin to talk about it.
12-16-2017, 04:02 PM
tmorse

Quote:

Originally Posted by MrOptician

Hello,

A Father Visited my store today requested a new eyeglass with his new prescription for his Child

His child is about 5-6 Years and He have Esotropia Left Eye, The Right Eye is Normal

His Father told me that his Son have "Fucosidosis" Which is a very rare disorder "rare genetic disorder"

But He asked me to check his old eyeglass to see if there is a different between the old and the new prescription power and i really do not know what to call it maybe surprised or shocked Because of What i saw on the lenses after checking on my Lens Meter

The picture Explains more
Attachment 13671

You can see on the picture On The Right Lens the Optical center, the P.D On the Upper spot, And the Left on the very downer

He have more than 3 Eyeglasses they were made the same way with His Doctor.

Note:
I did not make the eyeglass you see on the picture.

I do not have any problem with the patient i am just wondering what do you think of it if you faced the same case?
Have you ever faced the same?

This topic is to discuss not to solve any problem cause i am not complaining or facing any problem.
It is just a new experience

And what was the complete Rx?
12-16-2017, 04:53 PM
MrOptician

Quote:

Originally Posted by Tallboy

First off, what is the RX brought to you from their doctor. What is the RX you read in those 3 older pair of glasses. You need to bring a lot more info to the table before anyone here can even begin to talk about it.

Quote:

Originally Posted by tmorse

And what was the complete Rx?

Sorry forget to post , now topic is edited

His RX is -3.00cyl×180 for both eyes all of his 3 old eyeglass

I am not complaining any problem and not trying to solve anything ,this topic only for sharing knowledge

Thank you
12-16-2017, 05:54 PM
lensmanmd

A case of prescribed vertical prism
12-16-2017, 08:41 PM
LENNY

or turned upside down left lens
12-16-2017, 10:54 PM
lensmanmd

Shape says otherwise, plus, the OC on the right seems a bit high to be an original fit.
12-17-2017, 07:31 AM
uncut

While ignoring O.C. recorded positions............what is the determined prism imbalance recorded by you, MrOptician?
12-17-2017, 01:51 PM
MrOptician

Quote:

Originally Posted by lensmanmd

A case of prescribed vertical prism

Quote:

Originally Posted by uncut

While ignoring O.C. recorded positions............what is the determined prism imbalance recorded by you, MrOptician?

No Prism Imbalance
12-17-2017, 03:49 PM
lensmanmd

@MrOptician
Unless there is prescribed prism, or a serious manufacturing error, there is no way that there can be such a marked difference in OC heights. How much vertical do you measure at the Datum? What is the power at the 90?
12-17-2017, 05:53 PM
uncut

Quote:

Originally Posted by MrOptician

No Prism Imbalance

Thank you, for your answer MrOptician.

O.C. position noted as such can also mean the lens measure mount is tilted(lensometer), or calibration is needed.

Did you get a similar result by turning the eyewear upside down?
12-18-2017, 10:19 AM
jpways

Reading the NIH description
https://ghr.nlm.nih.gov/condition/fucosidosis
and looking at a google image search
https://www.google.com/search?q=Fuco...BgChwQ_AUICigB
Having a locked head tilt and having a larger than normal difference in pupil heights is not uncommon, it could just be a case of putting the vision where the patient needs it
12-18-2017, 11:13 AM
uncut

Quote:

Originally Posted by jpways

Reading the NIH description
https://ghr.nlm.nih.gov/condition/fucosidosis
and looking at a google image search
https://www.google.com/search?q=Fuco...BgChwQ_AUICigB
Having a locked head tilt and having a larger than normal difference in pupil heights is not uncommon, it could just be a case of putting the vision where the patient needs it

Yep......ruling out prism induced by error fabrication, device error by lack of prism ring calibration and confirmation that there is no imbalance induced, then one must assume that the ocs are where they are supposed to be.
12-18-2017, 01:04 PM
optical24/7

MrOptician, please give the complete Rx, Sphere, Cylider and Axis. There most certainly is prism vertically at datum unless the power is +/- .25 at 90.

IMHO, head tilt alone would not call for that much difference. The IPD horizontally looks fairly symmetrical. Rules out a head turned adjustment. That leaves a chin up/down comp. which you wouldn’t comp for because of yoked prism effect.....Unless...there is dis-similar power at 90, which means there is prism at datum.

( I certainly hope this poor child wasn’t born with one eye socket 20+ mm off!)

My guess is there was prescribed prism in the original pairs. The new prescriber either missed it, forgot to write it or doesn’t feel it’s necessary any longer.
12-18-2017, 01:07 PM
Uilleann

Prescribed prism.
Check prism drum on lensometer.
Ask original prescribing doctor for clarification.
12-18-2017, 01:10 PM
lensmanmd

Quote:

Originally Posted by optical24/7

MrOptician, please give the complete Rx, Sphere, Cylider and Axis. There most certainly is prism vertically at datum unless the power is +/- .25 at 90.

IMHO, head tilt alone would not call for that much difference. The IPD horizontally looks fairly symmetrical. Rules out a head turned adjustment. That leaves a chin up/down comp. which you wouldn’t comp for because of yoked prism effect.....Unless...there is dis-similar power at 90, which means there is prism at datum.

( I certainly hope this poor child wasn’t born with one eye socket 20+ mm off!)

My guess is there was prescribed prism in the original pairs. The new prescriber either missed it, forgot to write it or doesn’t feel it’s necessary any longer.

My thoughts, exactly. Thanks for having my back.
12-18-2017, 01:15 PM
lensmanmd

Quote:

Originally Posted by uncut

Yep......ruling out prism induced by error fabrication, device error by lack of prism ring calibration and confirmation that there is no imbalance induced, then one must assume that the ocs are where they are supposed to be.

Tough for me to concur. Asymmetrical pupil alignment is fairly normal, but this is pretty extreme. AND, the separation is uniform. Based on MrOptician's picture and RX info, the power in the 90 is identical. Even with fucosidosis, I would expect to see asymmetrical OCs.
12-18-2017, 02:58 PM
MrOptician

Hello,

old Prescription is +3.00Cyl*180 for both eyes PD:55 that was like 2-3 years ago Based on his old eyeglass.

Now the patient is 5-6 years and his new Prescription is -3.00Cyl*180 The difference is ( - ) from the old ,for both eyes PD:55.

Prescription is only Cylindrical .

No Prism Value.

Attention:I am not complaining or trying to solve any problem this topic only for sharing Knowledge and educating and having new experience.

Thank you
12-18-2017, 04:45 PM
Uilleann

You're comparing old glasses and not doctors written Rxs? Do you have the chart notes to reference? Have you spoken to the prescribing doctor directly? Do you have any reference for acceptable VAs? Diplopia?

If not, you're just grasping at a LOT of straws and air...
12-18-2017, 10:15 PM
optical24/7

Quote:

Originally Posted by MrOptician

Hello,

old Prescription is +3.00Cyl*180 for both eyes PD:55 that was like 2-3 years ago Based on his old eyeglass.

Now the patient is 5-6 years and his new Prescription is -3.00Cyl*180 The difference is ( - ) from the old ,for both eyes PD:55.

Prescription is only Cylindrical .

No Prism Value.

Attention:I am not complaining or trying to solve any problem this topic only for sharing Knowledge and educating and having new experience.

Thank you

Ok, so I take it both Rx’s were Plano at 90 degrees. Disparaging OC heights of 20+ mm don’t matter. It would have to be sub .05 D of imbalance (1/5th of a quarter D). ( You got one heck of an accurate lensometer!) More than likely the “error” was from surfacing all three pair on the same finer/polisher for that extremely small amount of OC prismatic difference. (Machine pressure difference, left/right sides). I wouldn’t even attempt trying to match this.

The more interesting aspect of this Rx is the cyl flipping + to - at 180. ( with the same diopteric power). Highly unusual without trauma/surgery. More than likely prescriber error, either former or later. I would recommend talking to the latest prescriber, trial frame if the patient is responsive, auto refract or scoping with an ophthalmoscope with trial lenses to confirm the current Rx.
12-18-2017, 10:33 PM
optical24/7

MrOptician, I wanted to add that some of our confusion and or various answers you’ve gotten come from what must be a difference in how Rx’s are written in your country compared to ours. Here, a complete Rx has Sphere, cylinder and axis listed. Your current Rx would be written here as Plano - 3.00 X 180 or 0.00 -3.00 X 180. The spherical is not omitted when 0 or Plano, it’s still written.
12-19-2017, 02:20 PM
MrOptician

Quote:

Originally Posted by optical24/7

MrOptician, I wanted to add that some of our confusion and or various answers you’ve gotten come from what must be a difference in how Rx’s are written in your country compared to ours. Here, a complete Rx has Sphere, cylinder and axis listed. Your current Rx would be written here as Plano - 3.00 X 180 or 0.00 -3.00 X 180. The spherical is not omitted when 0 or Plano, it’s still written.

Hello,

I understand this point.

We write Rx’s the same way

I post this topic while i am at work so i was quick.

you are right 100%

Thank you very much optical24

Thanks to all for sharing knowledge and for posting here.