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Thread: RGP Fitting Questions!

  1. #1
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    RGP Fitting Questions!

    Hey all Optiboarders, I have a question concerning Topography.

    How many of you use Topography to successfully fit RGPs??

    Since we do not do CRT, and have no plans to do so, this isn't the question.

    We fit a lot of Tangent Streak, MF, Monovision and some Bi-torics.

    Is it as easy as sending the map to the consultants and having them make the lens, AND is there less chair time, since we are a billion times more accurate.

    This is actually an argument between my wife and I, so feel free!!!!!

    :bbg:

  2. #2
    Is it November yet? Jana Lewis's Avatar
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    Quote Originally Posted by bigeyejim View Post
    Hey all Optiboarders, I have a question concerning Topography.

    How many of you use Topography to successfully fit RGPs??

    Since we do not do CRT, and have no plans to do so, this isn't the question.

    We fit a lot of Tangent Streak, MF, Monovision and some Bi-torics.

    Is it as easy as sending the map to the consultants and having them make the lens, AND is there less chair time, since we are a billion times more accurate.

    This is actually an argument between my wife and I, so feel free!!!!!

    :bbg:
    I would say it's much easier, we have a program on ours that sends the topo and k's/power, rarely have an issue. Meaning directly to the lens mfg. to make the lens.
    Jana Lewis
    ABOC , NCLE

    A fine quotation is a diamond on the finger of a man of wit, and a pebble in the hand of a fool.
    Joseph Roux

  3. #3
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    Quote Originally Posted by Jana Lewis View Post
    I would say it's much easier, we have a program on ours that sends the topo and k's/power, rarely have an issue. Meaning directly to the lens mfg. to make the lens.

    Thanks, Jana, that helps. I feel like we need one based on what the the mag articles and "gurus" say, but in the trenches is more important to me. Why trust an Autorefractor/K machine (we have a Zeiss 5015), when you can get down to a thousand points of reference.

    Does it cut the chair time down, basically do they have fewer follow up visits?

    We have a lady who has seen us 6 times for follow up visits, and lens changes. Talk about a money loser.......I do not want to calculate the loss!

    :drop:

  4. #4
    Is it November yet? Jana Lewis's Avatar
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    Quote Originally Posted by bigeyejim View Post
    Thanks, Jana, that helps. I feel like we need one based on what the the mag articles and "gurus" say, but in the trenches is more important to me. Why trust an Autorefractor/K machine (we have a Zeiss 5015), when you can get down to a thousand points of reference.

    Does it cut the chair time down, basically do they have fewer follow up visits?

    We have a lady who has seen us 6 times for follow up visits, and lens changes. Talk about a money loser.......I do not want to calculate the loss!

    :drop:
    I would say that it cuts down massively on chair time. It also provides the pt. with a sense of trust, no remakes, no more refractions/over refractions....etc...etc.. It's hard to swallow ( the price ) but if you fit a lot of RGP's it's worth it. We work on a medimont e300, it's kind of the "cadillac" of topos. It took about a year for us to "pay it off" but we do alot of Ortho-K so it worked itself out.
    Jana Lewis
    ABOC , NCLE

    A fine quotation is a diamond on the finger of a man of wit, and a pebble in the hand of a fool.
    Joseph Roux

  5. #5
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    You and your wife are both right!!! How's that for cross-border diplomacy....?

    Topography is a fantastic tool...often assists in decision-making or breaking choices. Consultation also. I wouldn't completely trust measurements sent to mfg. to completely replace tried and true methods, .... often surprises occur, theory doesn't apply, etc.

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    HAHAHA, Uncut! basically, "if you can't bill it, we ain't getting it!" that's the battle.....

    I agree - you must take the 15 years fitting experience, couple that with 2000s technology, and produce a better fitting, clearer vision RGP lens. The more info we have on the cornea, the easier it is to fit. That should be a given!

    Consultation from the distributor said, it isn't needed - won't really help. Makes me wonder if we need a new consultant. When you do 6 round trips on a patient, how much is enough! All the while, they tell us if we get involved with CRT, we get the Topo for free......hmmmmm

    thanks!

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    I take a k reading. then I select a trial lens based on that. then I look at the fluorescein pattern and over-refract.
    Then I make decisions about BC, diameter, thickness and flexure, peripheral curves, etc. based on what I see.

    Topography might be nice to show you subtle corneal abnormalities such as keratoconus, but does it really FIT the lens?

  8. #8
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    I agree. A good fitting set and an over refract and use fluorescein. There's a new keratoconus lens that is 14 mm -looks almost like a scleral lens

  9. #9
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    Topograhy is valuable in helping to explain lens behavior, as well. Often radiuses beyond the K region would assist your fit decisions. In follow up, the lens influence is immediately detected. A guidance tool.

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