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Thread: Monovision help

  1. #1
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    Monovision help

    got a pt who wants to try monovision. said she wore it before in OS. 42yrs, caucasion. this is what she currently wears:
    Air optix astig:
    -4.50-1.25x080
    -4.50-1.25x090

    I want to give her a Air Optix aqua to try for a week to see if she likes. can someone recommend a spherical power?

    Thanks
    Last edited by gogetter; 05-05-2010 at 05:10 PM.

  2. #2
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    Well, I'm no optometrist, but I would assume that we would need to have an idea of what her add is before suggesting a specific power for monovision.

  3. #3
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    You are obviously NOT a contact lens fitter, gogetter...Iwould suggest that your pt see their contact lens professional for this advice.

    Monovision has its advantages and disavantages plus potential occupational hazards that must be professionally explained/discussed before attempting.

    Trying it for 1 week is not part of the normal professional process, IMO!

  4. #4
    bilateral peripheral scotoma LandLord's Avatar
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    Actually, the age is given as 42 years, emerging presbyope. Start with a 1.25 add.
    Diagnostic lens: OS -3.25 -1.25 090
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  5. #5
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    Quote Originally Posted by LandLord View Post
    Actually, the age is given as 42 years, emerging presbyope. Start with a 1.25 add.
    Diagnostic lens: OS -3.25 -1.25 090
    Landlord:
    Poster is asking for a SPHERICAL recommendation...

  6. #6
    bilateral peripheral scotoma LandLord's Avatar
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    why the heck would you want a spherical lens when the px has astigmatism?
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  7. #7
    Ophthalmic Optician
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    caucasion? Hmm...I'll have to think this one out.
    Ophthalmic Optician, Society to Advance Opticianry

  8. #8
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    Landlord:

    I fear that the patient may suffer from a common fitter avoidance condition....of ONLINEITIS!

  9. #9
    bilateral peripheral scotoma LandLord's Avatar
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    oh, caucasion? Sorry, forget the cyl, go with a spherical equivalent of -3.75 and a bottle of Grey Poupon.
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  10. #10
    bilateral peripheral scotoma LandLord's Avatar
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    Quote Originally Posted by uncut View Post
    Landlord:

    I fear that the patient may suffer from a common fitter avoidance condition....of ONLINEITIS!
    that is a horrible affliction.
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  11. #11
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    Quote Originally Posted by Johns View Post
    caucasion? Hmm...I'll have to think this one out.
    Perhaps caucasion'? mon frere.............

  12. #12
    What's up? drk's Avatar
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    This doesn't smell fishy to me. 122 posts makes OP a consumer, not.

    OP wants sphere power for the toric.

    No add needed, my good people.

    +0.75 over BVA.

  13. #13
    OptiWizard
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    Try the Proclear EP -4.50 each eye.

    The EP (emerging presbyope) is a bizarre aspheric that give about +0.75 add at near and corrects about -1.00 of astigmatism.

  14. #14
    What's up? drk's Avatar
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    Just reread post...IS looking for sphere.

    FUGEDDABOUDIT (or try Harry's lens).

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    I agreed with Uncut! Prescribing "monovision" takes a lot of consideration. Explain and discuss first to the patient the "pros" and "cons" before trying to fit one,you cannot fit monovision as easy as that...believe me,it takes a lot of guts,knowledge and patience.

  16. #16
    Optician Extraordinaire
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    Why use a sphere power instead of a toric?

  17. #17
    bilateral peripheral scotoma LandLord's Avatar
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    Quote Originally Posted by Reylynn View Post
    I agreed with Uncut! Prescribing "monovision" takes a lot of consideration. Explain and discuss first to the patient the "pros" and "cons" before trying to fit one,you cannot fit monovision as easy as that...believe me,it takes a lot of guts,knowledge and patience.
    sure, but it also takes trying it
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  18. #18
    bilateral peripheral scotoma LandLord's Avatar
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    Quote Originally Posted by Happylady View Post
    Why use a sphere power instead of a toric?
    exactly what i've been trying to figure out
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  19. #19
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    Trying, yes...but poster mentioned pt tried before....already set up for future failure.
    Perhaps it was too soon, or expectations were too high, or correction was introduced at too fast a level.
    Nevertheless.....there is too much trying going on and not enough attention to fitting.

    It is possible that poster has access to only spherical trials?

  20. #20
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    - I am just curious-
    I have only worked in a licensed state where opticians are only allowed to fit CL's under Dr suppervision after having taken extensive cl fitting course and passing an additional board certification-
    In an unlicensed state can anyone fit contacts with out any supervision from a Dr?
    if that is the case do you need a written RX for contact lenses to buy cl's?

  21. #21
    Master OptiBoarder cleyes's Avatar
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    Use what she's wearing, with that cyl uncorrected VA will be murky, also cosider she's only 42, needs minimal add, maybe she's over minused if she's used monovision before? Check for dominance with handheld plus over each eye, don't assume she or previous practitioner is correct. Find out more history, why DV ou now? Was previous attempt unsuccessful?

    You do realize I meant to use toric cl as basis of any monovision correction? Are you a virgin in this type of endeavor? Sorry to see this question here, this is not a "tip" type of question. If you are not secure in your plan of action, it will soon be evident to the patient.
    Last edited by cleyes; 05-08-2010 at 09:46 PM.

  22. #22
    OptiWizard Yeap's Avatar
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    get a ADD 1.00 on the non-dominant eye and remain the dominant eye Rx. you may want to see her after a week. explain well to her the pro n cons of monovision before dispensed her the pair. all the best..
    Yeap


  23. #23
    Is it November yet? Jana Lewis's Avatar
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    Quote Originally Posted by ih8wlmrt View Post
    - I am just curious-
    I have only worked in a licensed state where opticians are only allowed to fit CL's under Dr suppervision after having taken extensive cl fitting course and passing an additional board certification-
    In an unlicensed state can anyone fit contacts with out any supervision from a Dr?
    if that is the case do you need a written RX for contact lenses to buy cl's?

    Here in Texas it's been grandfathered in, we do have a few contact lens fillers here in town.
    Jana Lewis
    ABOC , NCLE

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  24. #24
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    In my experience, it is best to:
    1. under- correct the cyl in the near eye.
    2. blur the DVA in the near eye to about 20/40,...no worse
    3. Make sure both eyes have roughly equal vision before starting.

    Make sure to determine eye dominancy properly. (I use the +1.50 blur test and/or hand the patient a small camera and see which eye they put it up to.)

  25. #25
    Master OptiBoarder cleyes's Avatar
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    So... does this story have a happy ending? or Still a work in progress?

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