Originally Posted by
Jaketull
1. Low hyperope with low add
Kinda hard to screw this one up. Pay attention to other clues to gleen a design preference, but odds are any reliable design worth selling at all will produce patient satisfaction.
2. high hyperope with low add
Varilux designs (and I see a lot of happy patients like this in Zeiss lenses, too.)
3. low hyperope with high add
Varilux S or Physio W3+; Shamir Autograph 3 for controlling tricky angles or, more likely, high-use contemporary computer/tablet readers.
4. high hyperope with high add
Same as 3, prioritizing the Shamir A3. Again, Zeiss and its 6 drop will likely excel here too.
5. low myope with low add
No PAL is going to make this patient leap for joy. Try to talk him out of it until his ADD climbs up high enough to pay off the aggravation of PAL distortions. Push an inexpensive FT if he really wants a MF that still preserves his familiar lens optics. Make sure he owns the decision of purchasing a PAL instead of you having left any doubt that you preferred not to sell it.
6. high myope with low add
Shamir Autograph 3, or if not a short channel PAL by someone else.
7. low myope with high add (minus into plus)
Shamir Autograph 3; possibly a Varilux depending on Px Hx or peripheral needs.
8. high myope with high add
Shamir Autograph 3; or Varilux Short Channels
9. High astigmatism over +/- 3.00
Don't shake the table, if their powers are stable and ok with what they're in...better not fool with it. If they need to change, the axis could be pertinent to your decision. (Let's hope the OD tried to steer potential Aniseikonias into CLs. If someone has a finely tuned chart of what precise PAL is broken by which cylinder power vector, that'd be pretty cool! But I wouldn't hold my breath. Generally speaking, fancy free-forms could easily end up being less preferable than traditional designs.
10. absolute best peripheral vision
Show me someone dissatisfied with a properly fit Varilux S who liked anything better?
11. absolute widest corridor (and whether the width is only noticeable within a certain rx range)
This used to be easier to discuss when 'hard' v 'soft' designs had more pertinence in lens distinctions. As it is now, I can't really corroborate any hunches here about modern options that carry any significant patient feedback regarding 'comparisons.' I can regurgitate lens rep propaganda here, but I can't vouch for it.
12. go-to office lens (as well as which ones you've tried but are not that great)
Shamir Computer/Workspace
Thanks!!!!
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