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Thread: Vertex Compensation Questions

  1. #1
    Bad address email on file Alteaon's Avatar
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    Vertex Compensation Questions

    Hello,

    I could be putting myself out there for ridicule, but I'll never know the answer if I don't ask.

    I am one of those "chain store" opticians, and have been for nearly seven years. As you can imagine, there are many things I don't really have experience with on a daily basis. One of these is vertex compensation...

    Last week a patient called asking questions about thier Rx: +24.00 sphere OU, vertex distance of 30 mm. Base curve of 36, and panto of 45 degrees...mind you, this was over the phone..but I realized I'm lacking on this front...and this sounds crazy off the wall to me...30 mm vertex?

    I would think that I would compare where the patient currently wears thier glasses vrs. what the OD wants this Rx to be at 30 mm and compensate it so that the patient gets the same Rx at a more comfortable and more wearable position. Am I within my realm as an optician to do this, since it's not actually changing the Rx the patient will experience.

    Even though I am one of those "chain store opticians", I want to study and learn as much as I can, even with things I don't see daily.

    I guess my question is am I on the right track here? I'd use the vertex compensation formula to figure out the amount to compensate and act accordingly.

    Mind you, we don't have a distometer in our office, so I may even get one on my own...

    Just want some opinions from the more experienced around here

    Thanks much!

  2. #2
    OptiBoardaholic
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    either someone is pulling your leg or your pulling mine. :finger:

  3. #3
    Master OptiBoarder Darryl Meister's Avatar
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    Even though I am one of those "chain store opticians", I want to study and learn as much as I can, even with things I don't see daily.
    Well, there's certainly nothing wrong with learning as much as you can -- with or without a +26 hyperope. ;)

    First question: Do you have any optical manuals or resources available to you?
    Darryl J. Meister, ABOM

  4. #4
    ATO Member HarryChiling's Avatar
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    vertex distance of 30 mm
    I have been called tucan in my days, but this guy's nose must be the size of gonzos if he truly has a 30 mm vertex distance.

    As for would it be within your rights to compensate for vertex distance, of course that should be what you are doing in cases such as this. I personally like to call the doctor out f coutesy and confirm the refracted vertex distance and then read them the compensated power you are going to use and the fitted vertex distance. It is easy to do the calculations on the fly if you are using on of the many calculators that are availablr through the download section and from Darryl's site www.opticampus.com
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  5. #5
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    Patient wasn't Jamie Farr was it?

  6. #6
    Allen Weatherby
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    Vertex Distance or Pupil Distance.

    This sounds to me that the patient does not understand the difference between vertex distance and pupil distance. 30 mm could obviously be a PD but very unlikely is 30mm a vertex distance. Please ask the patient for a written copy of this information from the examining Doctor.

  7. #7
    OptiBoardaholic
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    C'mon guys, a panto of 45 degrees? someone is having alteaon on. A script like that at that vertex would be absurd. It certainly is possible the person on the phone misread everything, but it sounds a bit like the legendary lens stretcher or the box of PDs you send someone to fetch.

  8. #8
    Allen Weatherby
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    Dave, my point exactly. You were not as gentle as I was trying to be. It may have been a compentancy test for the optician.

  9. #9
    OptiBoard Apprentice
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    Alteaon - Your questions are not necessarily subject for ridicule, although, these spec's are not experienced on a daily basis in any ophthalmic environment....chainstore or otherwise. Either the information given over the phone is somewhat incorrect, or the caller was pulling your leg...+24.00 sphere is uncommon (but not completely unrealistic) VD's are generally in the low teens/BC's run somwhere between 0 to 9.... A distometer is a useful tool in compensating an Rx when the VD (during exam) and actual VD (frame fit) differs for higher myopes and hyperopes...it may be a good idea to become familiar with a distometer and have one available if and when a situation such as this occurs....

  10. #10
    Master OptiBoarder Darryl Meister's Avatar
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    it may be a good idea to become familiar with a distometer and have one available if and when a situation such as this occurs....
    You can also use a corneal reflex pupillometer to measure vertex distance, which many retail stores now make available to their opticians.
    Darryl J. Meister, ABOM

  11. #11
    Bad address email on file Alteaon's Avatar
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    Thank you

    Thank you all for your answers. It is good to know that I am not insane w/ seeing the definite abnormalities and unrealisticness of this "rx"... I told the patient that they should bring in thier Rx to me, or allow me to call thier Dr. to confirm some things and get some extra information...

    Other people I've asked about this have also mentioned that maybe I was being tested. I've been chosen as the employee of the quarter for my store, which puts me in the running for employee of the region, so maybe someone was calling to "check me out"? Many of the other opticians where I work don't know what a distometer is, let alone how to use it. This isn't a knock on my co-workers, but more so a comment on where the 'chain store optician' comes from. I learned about many of these things on my own, by reading, ect.

    As for what books I have, I have the ACE study book through the abo, the original abo study guide by Mike DiSanto, System for Ophthalmic Dispensing, two dictionaries ( one for opticians, one for OD's), a math/formulae book, many issues of 20/20, Eyecare business, and Review of Ophthalmology. Thank you for the tip about Darryl's site. It's a great resource and now part of my favorites.

    With vertex calculators....we are only allowed online access to certain sites at work, but I would love to be able to have some of the calculators on my Palm pilot. I do not have internet access with it, though.

    Thank you all for taking my somewhat crazy question with courtesy and helpfulness. There is still so much I don't know, that I don't want to cross off something peculiar only because I may not have a full understanding.

    Thank you all again.:bbg:

  12. #12
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by Dave Nelson
    but it sounds a bit like the legendary lens stretcher or the box of PDs you send someone to fetch.
    I almost shot milk out of my nose when I read this.
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    Bad address email on file Alteaon's Avatar
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    Quote Originally Posted by Darryl Meister
    You can also use a corneal reflex pupillometer to measure vertex distance, which many retail stores now make available to their opticians.
    I give up! Will you please explain how this is done?

    Thank you so much!

  14. #14
    ATO Member HarryChiling's Avatar
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    A pupilometer is nothing but a fancy ruler, if you were to hold the pupilometer to the side of the patients face (while wearing the frame) and set the line to the frame, then set the line to the apex of the cornea. The difference between the 2 readings would be the vertex distance.
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  15. #15
    Bad address email on file Alteaon's Avatar
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    That was almost a "duh!" thing. It makes perfect sense! Thank you much for taking the time to explain it to me...

  16. #16
    Master OptiBoarder Darryl Meister's Avatar
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    A pupilometer is nothing but a fancy ruler, if you were to hold the pupilometer to the side of the patients face (while wearing the frame) and set the line to the frame
    Alteaon, if you look inside the pupillometer, you'll see that there is an extra line in there exactly for that purpose.
    Darryl J. Meister, ABOM

  17. #17
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    A lab can not (or should not) compesate power a with single vertex. Unless you know the Doc or Optician VERY well and They NEVER CHANGE, both a refracted and a fitting vertex are needed

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