Rx:
OD -3.00 -0.50 x168 4Out
OS -2.50 -0.50 x014 4Down

Add: 2.00

Pt is wearing a physio enhanced poly. Lenses are made with OD 2 out 2 up, OS 2 out 2 down.

When comparing monocularly, pt feel that "sweet spots" for reading are different by about 2 inches at reading distance: 2 inches higher out of the right than the left eye.

Also, pt feels that the seg itself is slightly high. Distance vision is best if he drops his chin slightly. There is no difference in "sweet spot" height in the distance.

Currently the segs are measured at the same height OU.

I thought about dropping the seg in his right eye by about 1mm, hopefully making the distance better out of that eye and better aligning the reading sweet spots. However, I do not believe that OS pupil is actually physically higher than his OD. This would be a cheap, kind of guesswork fix. Nonetheless, one I contemplated, though one I probably won't pursue.

I feel like the problem is a result of the prism. I am unsure of how to approach the situation if that is the case, outside of an Rx check.

I also blame poly. I did not do the original order, and poly would not have been my material of choice in this rx.

Outside Info: we are talking about a drill mount Tag Heuer frame, and the pt just happens to be an OD.

Any opinions on this matter would be greatly appreciated. Cheers!