trouble shooting
Hi all! We (4 opticians) are having a lot of problems with patients complaining of paper "slanting" or "coming to a point". We have had progressive users as well as a bifocal (ST28) wearer with the same issues. We cannot seem to solve the problem. Ideas on how to fix this?
I don't know if any one replied with a pm, but there are two things that can cause this that are simple quick fixes. 1. make sure the segs are strait on the 180 line. 2. For the progressives I had this happen with ovations that where fitted using a mono pd. I hope this helps. Also make sure the fitting height is not to high (ala pt making their own adjustments.)
What are the Rx's?
Any SV having the same problem?
CS
Are you edging in house or lab sending them complete? The reason I ask is because if it's happening in different styles of multifocals across multiple patients, I might look first at the blocking procedure.
Last edited by Java99; 11-30-2013 at 01:43 PM.
The lab sends them to us complete. We have had problems with physio enhanced lenses as well as Varilux 4D lenses, plus now the ST28.Originally Posted by Java99
Do you fit any other progressive lenses besides the Physio Enhanced and the 4D, if so do you use a different starting point to mark your fitting cross (I know the reps at the time told us to mark true pupil center instead of pupil bottom when we were trialing the lenses because their systems did the pantoscopic-segment height adjustment automatically)
Also, are the patients you are having difficulty with new to your office (or even existing patients going into their first multifocal)?
Probably normal if these are emerging presbyopes, or when the add power is ramping up due to age (all PALs create an image with geometric distortion until neural adaptation occurs). Point this out at dispense so that there are no surprises.
But if this is happening with seasoned, absolute presbyopes, I'd recommend reviewing your fitting guidelines- a close as possible wearer's vertex distance, proper pantoscopic tilt, etc., and if all is well, start looking at the prescriber's and/or the fabricator's work.
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.
Defective Jackson Cross or refractor.
If just the Jackson cross or the entire phoropter was defective, then wouldn't you also expect the distance vision, including single vision lenses, to also be blurry (even if it's just one or two letters vs. the subjective best corrected VA). I believe if this is prescriber error, then it would be in not taking the time to make sure they are not pushing too much add on the patient.
Last edited by jpways; 12-02-2013 at 02:31 PM.
It was an insult to the refractionist pushing too much cyl and being liberal with axis changes.
Too much cyl and axis change shows in the periphery more then straight ahead in the exam room.
ie. There's nothing wrong with the Jackson cross just the person that uses it.
i would check Panto
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