http://www.fresnel-prism.com/min-occlusion-lens
The Rx said "Son will paint the lens black". Ped MD. The son had painted her over-the-counter sunglasses. She has worn a patch for the last 8 months for intractable diplopia after falling. Age 87. Her first Rx eyeglasses.
This looks better.
Last edited by Robert Martellaro; 12-22-2016 at 04:57 PM.
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.
Excellent to know about.
Very cool that it has AR on it... other than the fact that it is premade and easy (I like that) and more importantly has AR on it to match cosmetics left and right - is there another benefit to this lens than I would get by sanding the surface of a standard lens?
As far as I can tell. over a sanded lens, the only benefit is cosmetic.Originally Posted by Tallboy
Min's look better than frosting a lens. ( no swirls, not over frosted ). I just wish they made it in poly or trivex ( if protection isn't enough reason, some frames require a stronger material) .
If you need a more impact resistant material you can use transpore tape. I've never done it, ( haven't seen an intractable in a long time) but I heard you can also try a transpore patch. ( about the size of a nickel) .
Great job Robert! She looks great! (You always get the fun ones, and they're lucky to have you....)
Thanks 24/7. Rx was +.25 D +.50 DC, which should clean up the scrolling text on the TV, and the vision in general, especially since she's monocular. She had a cloth/elastic patch with OTC readers over. I won't put it in a rimless, but zyl or full metal jacket :) should be reasonably safe.
Tallboy,
Reproducibility, and cosmetics. This fogs the vision to 20/300, just enough to prevent diplopia, but is mildly transparent for better cosmetics.
Best regards,
Robert Martellaro
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 just love the use of Bangerter occluders, ..............................
I just love the use of Bangerter occluders, if they are properly cut and applied.
Congratulations to the first post on them on OptiBoard.
I have a case like this, right now. I may just try this.
Chris this is a very different product from a press on occluder.
Interesting case I have.
Due to cerebrovascular accident, this patient was left with diplopia, even after multiple attempts to surgically correct her (not surprising).
She is a very high myope, so I elected for "blur occlusion" by leaving the affected eye uncorrected.
A year later, it does help her suppress the deviating eye's image, but she's having a side-effect, she believes: the affected eye is "turning" more noticeably/often than before.
Probably I blurred her too much (about 20/800) and she's lost enough peripheral fusion to let things go haywire.
I backed down the undercorrection to about 20/500 to see how it goes.
Interesting that the Fresnel company has settled on ~ 20/300. There may be a reason for that.
Chris this is a very different product from a press on occluder.
http://www.fresnel-prism.com/min-occlusion-lens
The Rx said "Son will paint the lens black". Ped MD. The son had painted her over-the-counter sunglasses. She has worn a patch for the last 8 months for intractable diplopia after falling. Age 87. Her first Rx eyeglasses.
Tallboy, as per link on first post in this thread this is a Bangerter Occluder, with which I am very familiar, because I was involved in its development a long time ago.
I'm sorry maybe I'm confused, I thought bangerter occluders were cut and applied to a lens.
Search for "bangerter foils".
Right. The bangerter foils are press-on optics, and come in numerous degrees of fogging. As with all press-on optics, they're designed to be more of a temporary solution. My client needed a permanent solution, hence the Min Lens.
Hope this helps,
Robert Martellaro
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.
MIN Occlusion Lens
Login for price
For the long term treatment of Amblyopia and Diplopia
It appears nearly clear to others
CR39 – lens comes ready to be edged at the optical shop to fit into existing frames
Occludes to approximately
20/300
Green Anti-reflective coating
Abrasion resistant coating
Cosmetically superior for long term patching needs
Improved patient satisfaction
A good alternative for patients with Intractable Diplopia
Worked with a lady this morning who had 'binasal occluders for temporary use' listed under her Rx, which prompted me to look into the press-on / foils.
Her Rx also requested a 10-30% therapeutic tint and 0.5 ground in prism.
This is one of the few time I will push someone back to their doctor's office. I explained that I could easily do the ground prism and tint but I was unfamiliar with the occlusion. Once I did some more digging, she explained that a color had not been chosen, but that the doctor had said she should look through some options and that a certain color would stand out to her as being relaxing. She also explained that this treatment was recommend to help her recover from a concussion.
What I'm wondering is if there is a standard procedure here? I do not work at a doctor's office- obviously- so should she come back, for whatever reason, is there a relatively typical placement / density for the foils? Or am I out of my league?
Have I told you today how much I hate poly?
New to me also. Maybe with this device, a call to the prescriber, and a little trial and error. I suspect that we should align the occluder right up to, but not covering the pupil. Frames that provide a text book bridge fit to minimize slipping and a short vertex distance would be ideal.
Let us know how it turns out. Pictures in situ would be nice.
Best regards,
Robert Martellaro
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 was thinking the same thing. This tool looks very helpful! If I end up moving any further with this patient I will be sure to give an update.
Have I told you today how much I hate poly?
Man, I've never done binasal occluders, but it's highly regarded by many.
The idea is to give "negative feedback" (like, you can't see!) when the eyes go too eso (crossed). That'll fix 'em!
So the idea is to vertically split the pupil in primary gaze (distance view) with an occluder (and the frosty occluders/Bangerter "foils" would do the trick nicely).
Guess what you find out, though?
When the patient goes to look down to read, the eyes have to be allowed to converge at least some, because that's natural. So...you actually have to place the foils on at a "tilt"...they have to tilt inwards to allow some convergence for reading.
So I believe the methodology for placing these would be straightforward:
1. Measure the distance p.d. (probably monocularly with a pupillometer)
2. Measure the near p.d.
3. Then, dot the lens where the pupil is (like you're taking a PAL fitting height)
4. (tricky part) draw a horizontal line on the lens at some point in downgaze (like, the top of the near zone of the PAL, if there is one, or just draw the line 10-15 mm below the first dot) and put a dot where the near p.d. is.
5. Then, "connect the dots" with the temporal edge of the foil. (It should ultimately look like a "V" shape.)
6. Undoubtedly you will need to fudge it a little to get it working right. But the goal is to put that edge of the foil just close enough to the center of the pupil that 1. they can see, but 2. they can't converge, or instant blindness.
I would appreciate any other person's correcting what I merely surmised above.
That tool is cool. It's just a p.d. stick, really. It's a way to measure p.d., but you'd have to control where the patient was looking, like you do with a p.d. stick, as well (close the right eye to measure the right eye nasal limbus, close the left eye to measure the left eye temporal limbus, then use parallax to find the near p.d., assuming you're 40 cm away...).
I guess you could use it to trace a line on the lenses, though.
It seems that the angle would always be the same, so you'd be able to simply use a protractor and make your own. But we know that a large p.d. converges more for a set arm's length than a small p.d. does, so individualizing the process like I said above, is probably better.
Like individualized PAL inset.
And downgaze angle is individualized (or forced, by a PAL corridor length).
Maybe Shamir will make a binasal occluder lens!
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