Hi, we have come across a rare Rx of a 6 years old child as follows: RE: +0.75/-3.25 x 145 xxx LE: Plano xxx BE: Add + 3.00 xxx The Ophthalmologist has recommended for an Executive Bifocal in Transitions. Since this is a distinct possibility in Executive. Does anyone know of any possibility in digital lens surfacing with similar/better visual performance then an executive for a rare case as this, specifically considering that it was for a child. Thanks.
I would say up to 20 years ago and after many ce credits....to me it is better to put the line in front of the child and measure a little bit high. The child will adjust quicker, to the bifocal, and be out of them quicker. My own daughter had some reading problems, when she was little, mom wanted a noline, Dad said flat-top. No round segs, or progressive. If it were me, I would put a flat-top on the child instead of the weight of a exec and safety concerns. Gonna have a lot of people chiming in, that is just my humble opinion. Also remember not to change the rx or type without talking to the Dr, who wrote the RX first!
Grateful to be what I am, and not pretending to be someone I am not!
Call the doc for clarification. Have seen loads of these over the years. Often the prescriber wants the line to bisect the pupil. No-lines won't work in those cases obviously.
I have always measured to bisect the pupil for the measurement. Don't change out of executive w/o dr. approval....but if the child is small enough sometimes a ft 35 is almost all the way across....jus' sayin"
A FT45 will also cover a wide variety of kids sized eyewires as well...
I feel like the Doctor wants the child in a Executive lens style for easy adaptation. However, I would offer a Round seg or flat top preferably because an Executive is usually only available in PGX Glass material. Way too heavy and easily prone to breakage for a 6 year old child. So with that said, Poly Trans FT/Rd Seg would be my choice. Again, check with the Doctor for clarification before you proceed.
That's not going to happen. You can probably get a clear poly exec, or a clear poly or trivex ST35. I know that you can get (Hoya and others) a ST28 Trivex with Transitions, and that width should be sufficient (can't look around the seg when reading) for a small eye size that is fit close to the eyes. BTW, this isn't rare at this age.Originally Posted by 2040
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
I dont believe a Poly Executive lens Exists. If it does, correct me if I'm wrong.
But there is no manufacturer noted. Maybe NOS?
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
Thanks to all for your inputs. Your feedback and suggestions are much appreciated.
Digital Eye Lab offers their Sector lens, backside digitally surfaced round segs up to 42mm, and in poly Transitions. I've done a few for my formerly ST wearers and they love them. Look great too.
Folks - in general docs want the seg to bisect the pupil when fitting kids like this. Round segs won't cut it if that is indeed the case.
I'd suggest checking with the prescribing doctor for permission to use a ST35 rather than an Exec. I've had very good success with this width, especially in a child's eye size. Most Ophthalmologists don't know a lot about lens design and usually appreciate the suggested change.
three rivers optical offers a poly blened RD 24 that is a digital lens
One can bisect the pupil with the apex of the curve. Now if the doc is worried about the kid dodging the reading area by looking out of the lower periphery, and that's why he Rx's the executive, I'd make the same argument as for ST35; in a small frame a 40+mm round seg, apex set to bisect the pupil, is going to cover a whole lot of the bottom of the lens.
Thanks Sir. This could be of much help. Would it be also possible to provide further details of Digital Eye Lab: email ID, contact person, etc. Thanks in advance for your assistance.
Still seems much easier to simply call the prescriber and clarify - rather than guessing their intent doesn't it?
Not just easier, it's the professional thing to do.
Dear Daniel, I would be grateful if you provide me some contact details at Digital Eye Lab, if you have. Of course it's possible to get the email ID from their website but often the mails sent through this ID are ignored and may hit the junk mail folder. Thanks in anticipation for your favorable reply & have a great day.
In many similar cases, I will Rx an Ultex bifocal. Works very well. The digital round seg sounds good too, but is probably a lot more expensive.
Absolutely, the digital round segs are functionally the same for purposes of multifocals, but they have the added benefit of digital atoricity, base curve selection, and excellent thickness control, perfect for my high plus patients.
Our Optiboard sponsor, Vision-Ease Lens, offers a D35 poly LifeRx photochromic that would seem a good choice for this child. Yes, bisect the pupil, and this size of segment should provide adequate near coverage.
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