Teens with Bifocals

[Blake]

We've got another doc filling in this week for our regular doctor. Twice (that I know of) he's prescribed bifocals for a teenage patient. The first was 19 years old, the second 17. Both had distance corrections of about +0.25, and adds of +1.00.
Was it just a weird coincidence that two young patients supposedly have accomodation problems?

*scratching my head*

Blake

[Darryl Meister]

Hi Blake,

Accommodative disorders are not uncommon -- even in younger patients. I believe that spectacles aren't usually prescribed unless the patient exhibits symptoms. Plus power at near reduces the accommodative demand, which in turn reduces accommodative convergence. This can be used to reduce esophoria at near, accommodative esotropia, convergence excess, etcetera.

Best regards,
Darryl

[JennyP]

Hey Blake!
My teen daughter just got her first bifocals too! But she's a -2.00 with -1.75 cyl ou...and the doc gave her a 1.25 add because she said she was having trouble reading, and getting more headaches. She also has a shunt for congenital hydrocephalus and she is paraplegic (always uses a wheelchair) so we decided to put her in st28s...and she is adapting pretty well! I let her keep her old sv lenses as a back up and she has only asked for them once or twice to watch tv from bed! Am very proud of her!!

BTW: do you have that metal EA or GA sunframe, i think it is model 056, that has the little black plastic temple flip pieces? (they fit right at the eyewire...you remember the one, I'm sure). I have a customer giving me grief because she broke that flip piece (she bought it in december and now it has been discontinued, and she thinks it is just awful that I can't just find that piece for her immediately ,,,gotta get a store list I guess.
I love my job, I love my job..
Keep the faith and Core value # 10!
jP at 633

[chip anderson]

There are several "reasons" for bifocals in these cases:
1) correcting a "squint" (strabismus).
2) there is a theory that reducing the patients ability (need) to accommodate will inhibit the progression of myopia.
3) if the prescriber has a financial interest in the dispensary, he may realize that he gets more money for bifocal lenses.
4) it is possible that a young person has an accommodation problem although it is rare.

[Joann Raytar]

Originally posted by JennyP:
BTW: do you have that metal EA or GA sunframe, i think it is model 056, that has the little black plastic temple flip pieces? (they fit right at the eyewire...you remember the one, I'm sure). I have a customer giving me grief because she broke that flip piece (she bought it in december and now it has been discontinued, and she thinks it is just awful that I can't just find that piece for her immediately ,,,gotta get a store list I guess.
I love my job, I love my job..
Keep the faith and Core value # 10!
jP at 633

Jenny:

Have you tried one of the 1/4 sun stores? Is it something that could be sent to Hilco for soldering?

[Blake]

Originally posted by chip anderson:
There are several "reasons" for bifocals in these cases:
1) correcting a "squint" (strabismus).
2) there is a theory that reducing the patients ability (need) to accommodate will inhibit the progression of myopia.
3) if the prescriber has a financial interest in the dispensary, he may realize that he gets more money for bifocal lenses.
4) it is possible that a young person has an accommodation problem although it is rare.

Thanks everyone for your input. As I mentioned, the prescribing doc was only filling in for ours, and neither has any financial interest. One of the patients I mentioned went from a -0.25 distance Rx to a +0.25, so it wouldn't seem it was done to inhibit further myopia. In fact, both patients had plus Rx's. Both said the doc had mentioned an accomodation problem, which as Chip said is rare.
I just found it interesting that I should see two "rare cases" in a week from the same prescriber.

(BTW JennyP - we don't have that frame either.)

Blake

[JennyP]

Thanks anyway Blake, and thanks Jo!
I'll try the 1/4 suns... but as for soldering, the broken piece is totally plastic. I've thought of suggesting superglue to the frame owner, but the curve on the piece where it fits around the placement screw (also where it broke) would probably not hold the shape. ((this from a firm believer that both superglue and velcro were divinely inspired))
jP

[chip anderson]

Never put super glue anywhere on any part of spectacles. Try Epoxy, it works and holds.

[JennyP]

Oh, of course, Chip!
Never any super glue on spectacles....
but on:
vacuum cleaner injured cabinet veneer
loose shoe heel repair (temporary)
hinge repair on my "Sharp Zarus 3000" organizer, etc...
super glue can't be beat...
didn't mean to imply that it ever belongs
on a pair of glasses!
jP