This should be fun!

[Uilleann]

Oi.

Bring on the weekend! But until then, I've got a treat that's fallen in my lap. Pt presented today: 38 yo male, Videographer by trade. Hx of retinal detachments OU. Scleral buckles performed OU. PC IOL OD only. Vertical imbalance corrected with prism OS only. Inferior coloboma in OD iris. Pt states none of the prior damage was trauma related. Was wearing a 2 year old Proof frame (wood) that looked like it was 10 years old. Held together with tape and super glue - because Proof.

OD was a Zeiss PAL 1.67, OS was SV of unknown indice. History of some awesome aniso. CLs were tried in the past (prior office), but pt rejected due to poor vision and comfort.

Today's spec refraction came back as follows:

OD -1.75 -2.50 x 023 +2.00 ADD 20/25
OS -7.50 -4.75 x 179 4.00 BU (OS Only) 20/30, 20/20- OU, Near J2+ OU

He's looking at a new frame today. PD 34.0 / 31.0 He was looking at 48/18-ish frames, which places his seg/OC nice and close to GC. He likes wood, but is also looking at some nicer zyles. Full frame styles. We were going to look at using his EyeMed for lenses, but it actually ends up cheaper doing the lenses privately - which opens up our options.

I've got a good general idea of where I'm wanting to go with this, but wanted to run it past the collective here. So, where would you all start in designing this masterpiece? :)