To help in getting back on topic,
The only thing I consider to be a prescription is a measurement of the refractive state of the eye. Or, said another way, the effective power of a lens to correct lower order aberrations. ANYTHING ELSE on an rx is extra information which may or may not be helpful.
I will routinely agree or disagree with extra notes on an rx, however, I will never (99.99%) attempt to change effective powers. Mind you, I may certainly change actual powers of a lens to achieve the result desired by the refractionist -- readers, computer glasses, etc.
Example:
New Rx:
R -2.00 -0.75 090
L -1.75 -1.00 080
ADD +2.50
Rx states "Nikon i"
Old Rx:
R -3.00 DS
L -3.00 DS
ADD +2.00
Patient is wearing Ess. Natural.
Patient wants lowest possible price.
Patient states no problem with current lens design.
I will put him in Natural.
In the above example, the patient will always complain. And I guarantee it's because of reduced minus at distance and increased plus at near. Not because of the progressive design.
After I fill this disasterous rx, I will send him back to the prescriber.
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