old design or new?

[tolpuppy]

I have a patient who for five years has been wearing a sola lens (I think so, but marking were hard to see) with fitting cross above the pupil, for mostly computer and near work. Rx is minimal distance with +2.50 add.

after 1 remake and discussion, patient states that she does not wear glasses for distance vision, just for computer and near and needs to see person sitting in front of her desk. Monitor is at eye level and arms length. I made computer rx in varilux ellipse. This works but patient now states that she DOES need to see distance and walk around comfortably.

I still feel patient will need computer glasses but she insists on one pair and says she will adjust her monitor.

Would you fit her in what I think was a Sola xl above the pupil like her old ones or a newer Definity? Trying for a wide intermediate. Seg height in new frame will be 21 at mid pupil.

Thanks for input! Very nice patient and I'm going extra mile.

[Uncle Fester]

I'd go back to the XL.

Many will argue otherwise but it looks like trying to fix what wasn't broken has already cost you.

My 2 cents.

[Fezz]

patient states that she does not wear glasses for distance vision, just for computer and near and needs to see person sitting in front of her desk.


This works but patient now states that she DOES need to see distance and walk around comfortably.

I still feel patient will need computer glasses but she insists on one pair and says she will adjust her monitor.

Very nice patient and I'm going extra mile.

Your patient is being unreasonable. PERIOD! You made a pair for her to fill the NEEDS EXPRESSED BY HER!!!

Charge her for this redo! If she doesn't like that...tell her to beat it!

[HarryChiling]

I have a patient who for five years has been wearing a sola lens (I think so, but marking were hard to see) with fitting cross above the pupil, for mostly computer and near work. Rx is minimal distance with +2.50 add.

after 1 remake and discussion, patient states that she does not wear glasses for distance vision, just for computer and near and needs to see person sitting in front of her desk. Monitor is at eye level and arms length. I made computer rx in varilux ellipse. This works but patient now states that she DOES need to see distance and walk around comfortably.

I still feel patient will need computer glasses but she insists on one pair and says she will adjust her monitor.

Would you fit her in what I think was a Sola xl above the pupil like her old ones or a newer Definity? Trying for a wide intermediate. Seg height in new frame will be 21 at mid pupil.

Thanks for input! Very nice patient and I'm going extra mile.

I am assuming that the definity would cost more if you were to make that the option, why not give her the XL at the same cost as the definity and offer her a second pair in the computer like you suggested with the difference, that way the patient can have it their way and you can have it your way.

[MarcE]

after five years she can't read with her old specs, right?

She probably wasn't wearing specs at all for distance, right?

You update/fix her distance and up the add and fix her reading and now she can't see the computer as clearly or as widely as before.

She was using her reading area for the computer distance. You could remake again and she won't be happy, but you can do alot better than an elipse for computer (which has almost none)

Fezz is right (and as always, eloquent). I also agree w/ Harry.

[tolpuppy]

The computer rx I made was with the intermediate rx in the distance portion. I often use a short corridor for these and it works quite well. Her complaint was that she could not use these to walk around or (of course) see clearly at a distance.

Thanks for the replies.

[john-atlanta]

The Shamir Autograph office is relatively inexpensive, will give her decent clarity up to 8-10 feet, and awesome intermediate and near vision.

Be sure to specify if she looks up, straight or down for her computer, and whether she does most of her work seated or standing.

Just make sure whoever you get it from has a guarantee against non adapt, as she probably cannot be made happy.

Pt's with minimal distance Rx are always the most difficult.



John

[EyeFitWell]

I second John. I don't understand why people use short corridor progressives for computer/reading when there are so many good office lenses on the market. Especially the Shamir office, which I'd think will provide significantly more width through the corridor, plus longer intermediate/reading zones when measured vertically. (Does that make sense?) Some people don't want the very fast change created by short corridor designs. It pays to use the right tool for the job (though I'm a fan of creative dispensing!).

[Happylady]

I don't understand why people use short corridor progressives for computer/reading when there are so many good office lenses on the market.

Because lots of people like to be able to see distance also while they are at their computers or reading. An office lens will blur the distance, that's fine for many people but not for all.

Right now as I sit here at the computer I can see the entire room and the TV if it was on and also see the computer screen. Of course, my computer screen is placed low enough that if I look straight ahead I look over it.

[GAgal]

Your patient is being unreasonable. PERIOD! You made a pair for her to fill the NEEDS EXPRESSED BY HER!!!

Charge her for this redo! If she doesn't like that...tell her to beat it!

I agree with Fezz. It floors me how many people believe that if they don't like something that they specifically requested, that they should get it replaced for free or refunded.

[OCP]

I have a patient who for five years has been wearing a sola lens (I think so, but marking were hard to see) with fitting cross above the pupil, for mostly computer and near work. Rx is minimal distance with +2.50 add.

after 1 remake and discussion, patient states that she does not wear glasses for distance vision, just for computer and near and needs to see person sitting in front of her desk. Monitor is at eye level and arms length. I made computer rx in varilux ellipse. This works but patient now states that she DOES need to see distance and walk around comfortably.

I still feel patient will need computer glasses but she insists on one pair and says she will adjust her monitor.

Would you fit her in what I think was a Sola xl above the pupil like her old ones or a newer Definity? Trying for a wide intermediate. Seg height in new frame will be 21 at mid pupil.

Thanks for input! Very nice patient and I'm going extra mile.

First of all you made the first mistake by selling a short lens with very narrow intermedia zone. Done is done but always try a longer corridor or select Autograph II that has a very large intermedia zone for smaller frames.
When she now claims she would like to have clear distance vision, then change the lens type with a special discount for the customer. She made a mistake by inform wrong needs, but no need to be unfriendly because of that. This is how we would do it in Denmark :hammer:
-but we get a happy customer.

Regards from Denmark

[jefe]

You could try using the Zeiss RD. I requires a somewhat deep frame, but it provides an area which should be usable up to 14 feet, if my memory serves me correctly. That should be enough distance unless she wants to put up a Snellen chart in her office or be able to read the lips of her coworkers way down the hall.