I have a patient for whom I am considering prescribing a pair of reverse multifocals (PALs). I have not prescribed nor dispensed a pair previously (only ever reverse bifocals), and wondered what experiences others may have had with reverse PALs. On the few occasions I've suggested these as an option previously, most patients have thought it a bit bizarre, and have baulked at the idea.
The patient is a hair and makeup artist for film and television, often on outdoor sets. She is a low myope who has resorted (age 44) to looking over the top (she is relatively short and many of the actors are taller than her) of her glasses to inspect her work, but is now finding her near inadequate. She still needs to be able to see the distance clearly when on set.
Rx is R -0.75/-0.25x90 L -0.75/-0.25x90 (Full) Add +1.75 @40cm
Even though she is essentially orthophoric, I thought a small amount of base in and base up* prism may be beneficial for sustaining near fusion in up gaze (*ordered base down before reversal), without interferring with her distance fusional capacity. I am thinking of going for a relatively short corridor lens fitted at he top of the pupil, in order not to create too much distance blur when the head is lowered. I have told the patient that she should consider these glasses as work glasses, and that they may not be suitable for general purpose. As the prescriptions and mono PDs are equal for right and left, I will be able to order the lenses like a standard order from the lab without confusing them and ordering in reverse.
What are my chances of success? Are there any other options anyone may like to suggest as an alternative?
I'll let you know how I get on.
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