Customer is....

[Mrmessi]

Compalining when he tilts his glasses or head up his vision is more clear in his progressive lens.


Progressives fit to high or to low???

[SeaU2020]

low

[Fezz]

Maybe the prescription is incorrect!

[mdeimler]

More clear in distance or near ?

[NCspecs]

I assume you mean that when he looks through the intermediate or near portion he feels he has clearer vision. is this what you are trying to articulate? If so, I would grab some loose lenses from an exam room and see if his vision is better when you add (or reduce, we don't know his Rx) power. If he says he notices a difference, check your measurements- if they are spot on then see if the Dr will double check his refraction.

[Mrmessi]

Px is complaining vision is blurry in reading part of the lens.

He has to tilt his head or glasses up to see clearly.

Rx Ou +1.75 Add +2.25

I believe the fit is incorrect, Rx is fine, it's a old rx.

[mdeimler]

Seg too low. He's compensating to get more plus power.

[NCspecs]

Okay a little clearer. But when you say Rx is fine, it's an old Rx- what does that mean? When was the pt's last refraction? how old is the pt?

Furthermore, have all adjustments to the fit been made? Have you double checked your measurements against what the patient is wearing?

[Sledzinator]

Another thing to consider is progressive type. If the patient was previously in a compact progressive and you switched them to a full length corridor they would have to tilt their head more than they are used to.

[Wes]

Mark up the lenses and see if the fitting cross is in front of the pupil. If not, raise the frame by adjusting the nosepads if it has them and check the temples for appropriate fit. Next, check the vertex distance. It should be 13mm or less. Check the pantoscopic tilt. It should be 10-12 degrees (more for a progressive than for a standard pair).

[Barry Santini]

Mark up the lenses and see if the fitting cross is in front of the pupil. If not, raise the frame by adjusting the nosepads if it has them and check the temples for appropriate fit. Next, check the vertex distance. It should be 13mm or less. Check the pantoscopic tilt. It should be 10-12 degrees (more for a progressive than for a standard pair).

But...even if the Rx is appropriate strength, and the position is found low, increasing the pantoscopic tilt will effectively make the eye reach a point *higher* in the corridor, exacerbating the situation.


Rather - retro may be indicated.

B

[Wes]

But...even if the Rx is appropriate strength, and the position is found low, increasing the pantoscopic tilt will effectively make the eye reach a point *higher* in the corridor, exacerbating the situation.


Rather - retro may be indicated.

B

Barry, that's why I suggested the procedures in that order. We don't know yet what is causing all of the blur. It could easily be a combination of problems. A poorly fit frame is often poorly fit in more than one regard. Seg low, pads splayed too much, temple bends too loose, panto not adjusted. When rookies make mistakes, they tend to make more than one.