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Thread: Soft vs Hard Design

  1. #1
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    Soft vs Hard Design

    I have a man with:

    OD -.75 /-5.25 X 90
    OS -1.25 /-4.75 X 96
    Add +2.75 ou Pd 61 Seg 20 in rimless

    Based on all I have read here on lenses for high astigmatism, I am now pretty confused. Previously (before I "learned" so much) I was involved with a similar script for lady who ended up getting Summit CD and was happy.

    Soooo, should I suggest Summit again or maybe ID, or would a harder design be better. We could do GT2 or Physio 360. I've read about the trade offs for each, but don't know what to make of the information.

    Many thanks as usual.

    Ox

  2. #2
    ATO Member HarryChiling's Avatar
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    Here are my tips for hard designs:
    -Sedentary Lifestyle
    -Eye Mover
    -Higher Add / Previous PAL Wearer

    Tips for soft designs:
    -Active Lifestyles
    -Head Movers
    -Low Add / New PAL Wearer
    -Sensitive to Vertigo

    Please add as necessary.
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    Thanks Harry. I've learned alot from your posts! This guy has an active lifestyle and is probably a head mover. He is adapted to PALS but currently has CR 39 in metal frame and now wants rimless. Does the 2.75 add trump all else and say he should have a harder design? Which lens would you choose for him?

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    ATO Member HarryChiling's Avatar
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    All that power is horizontal and vertical so that's actually a plus for you. I have been personally liking the seiko lenses lately but I think they are out of range on an Rx like this, but then again what isn't. If you can get a lab to go outside of the range on a digital product the Seiko Surmount goes to a 5.00 cyl so it's almost there, you might even consider talking to the prescriber seeing if they can dial is back a bit. If not the GT2 is going to be the next best lens in line I have personally had great success with the GT2 and would recommend that one as well.

    Tricky Rx either way this is the kind of job you earn your keep on. Good luck.
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    Seiko Surmount is a great lens with high cyl, it has a feature called " MPAC" multi polar astigmatic correction" (compensates for distortion when eye looks away from the astigmatic axis), it also has an automatic variable inset for a smother transition to the add power.

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    Is he happy with the progressive he is wearing? With that script I would keep him in the same one.

  7. #7
    One eye sees, the other feels OptiBoard Silver Supporter
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    Quote Originally Posted by oxmoon View Post
    I have a man with:

    OD -.75 /-5.25 X 90
    OS -1.25 /-4.75 X 96
    Add +2.75 ou Pd 61 Seg 20 in rimless

    Based on all I have read here on lenses for high astigmatism, I am now pretty confused. Previously (before I "learned" so much) I was involved with a similar script for lady who ended up getting Summit CD and was happy.

    Soooo, should I suggest Summit again or maybe ID, or would a harder design be better. We could do GT2 or Physio 360. I've read about the trade offs for each, but don't know what to make of the information.

    Many thanks as usual.

    Ox
    Modern lenses are neither hard nor soft, but do have localized areas that might have softer or harder boundaries, enough so that one could label some as softer or harder. That said, a myopic high astigmat would probably prefer a slightly harder design, and if they're an avid reader, a higher than average placement of the full add. The Autograph 2 fixed 18 should be on the table, as well as a Comfort 360, Comfort, and VIP Gold.
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    Hi Robert. Wow, I'm getting to talk to so many of the board celebrities! I've learned alot from you too.

    I've read alot of good words about the autograph, but didn't know it came in a cylinder that high. And I though comfort stopped at 4 and only physio went out to 6. Is my information old?

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    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by oxmoon View Post
    Hi Robert. Wow, I'm getting to talk to so many of the board celebrities! I've learned alot from you too.

    I've read alot of good words about the autograph, but didn't know it came in a cylinder that high. And I though comfort stopped at 4 and only physio went out to 6. Is my information old?
    Your information is correct but labs can go outside of those limits. With FF processed PAL designs the software may be limiting the lab, but you won't know until you ask. I agree with Robert going with a traditionally molded design is a good option as well, BTW the VIP Gold and the Image are true hard designs if your going to go for the extremes. I think with the astigmatism presented here the inset would be better managed with a FF designed PAL like the Surmount, in this particular case since the meridians are oriented vertically then you might not have issues with the "sweet spot" migrating in unpredictable ways but as a general rule of thumb a good FF designed PAL will maintain the intended design.
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  10. #10
    One eye sees, the other feels OptiBoard Silver Supporter
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    Quote Originally Posted by oxmoon View Post
    Hi Robert. Wow, I'm getting to talk to so many of the board celebrities! I've learned alot from you too.
    Optiboard is all about learning IMO. And I'm no celebrity. But there are folks here who have a depth of knowledge in ophthalmic optics that's downright scary.

    I've read alot of good words about the autograph, but didn't know it came in a cylinder that high. And I though comfort stopped at 4 and only physio went out to 6. Is my information old?
    All of the above can be had up to about 6 DC.

    Quote Originally Posted by HarryChiling View Post
    BTW the VIP Gold and the Image are true hard designs if your going to go for the extremes.
    I thought it would be good to throw in a few budget options.

    I think with the astigmatism presented here the inset would be better managed with a FF designed PAL like the Surmount, in this particular case since the meridians are oriented vertically then you might not have issues with the "sweet spot" migrating in unpredictable ways but as a general rule of thumb a good FF designed PAL will maintain the intended design.
    Good points. 45 and 135 would be the worse case I suppose. But with or against the rule RXs will still encounter various degrees and orientation of unwanted astigmatism, that at some point must wreak havoc with the intended design. My thinking is that this can be mitigated by the sharper/narrower boundaries of the old school hard designs.
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    I will chime in and add in auto II on this as well. I do not believe that all materials will go to 6 cyl, but I believe 167 does. As to hoya lenses, they wont get their heads out of their rears and still only go up to 4 cyl, which negates ID, lifestyle, etc.

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    Quote Originally Posted by gunner05 View Post
    I will chime in and add in auto II on this as well. I do not believe that all materials will go to 6 cyl, but I believe 167 does.
    I'm getting up to about 6 DC with all materials from Soderberg.
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    Actually I just fit a pair of Hoya Summit CD for a women with a 5 something cylinder. Summit now goes out to 6 as does the lifestyle and ID. Patient was quite happy with the Summit and did not remark on the blueness of the coating, but I noticed it and wondered why its like that. I can see that being a drawback for some people.

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    Quote Originally Posted by gunner05 View Post
    I will chime in and add in auto II on this as well. I do not believe that all materials will go to 6 cyl, but I believe 167 does. As to hoya lenses, they wont get their heads out of their rears and still only go up to 4 cyl, which negates ID, lifestyle, etc.
    All Shamir Free Form designs in all materials go out to a -6.00 cylinder now, including their wrap compensated design (Autograph II Attitude).
    There are rules. Knowing those are easy. There are exceptions to the rules. Knowing those are easy. Knowing when to use them is slightly less easy. There are exceptions to the exceptions. Knowing those is a little more tricky, and know when to use those is even more so. Our industry is FULL of all of the above.

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