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Thread: It's me again.

  1. #1
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    It's me again.

    It's me again, so I had a patient come back for a new pair glasses. Her prescription didnt change compare to last year, it was roughly -6.00 and -7.00 on both eyes with slightly astigmatism. She had a prescription paper from doctor, the PD is 59, on our file,her PD was 59. Today I double check, the PD is 28/29.5. My coworker who double check for me, it's the same number. I check the dot for seg height, two sides are not balanced. She got her glass from last year in our place, the PD was 59, 29.5/29.5. Should I use the PD that I double check, or keep the old one?
    Thanks!






  2. #2
    Master OptiBoarder OptiBoard Gold Supporter
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    If it was me Xiatian, I would do 28.5 and 29.5.

    If you are confident in your measurements the patient is not getting the best use of their PAL corridor in the right eye because it is off. If her ADD has increased she will notice the PD being off more this time than last, but moving it too much at once may cause issues. I probably wouldn't move it all the way to 28 this year, save that for next time.


    Someone can wear a +1.00 add easily if the seg PD is off a bit, but as that ADD increases to 1.50, 1.75, 2.00 or even 2.50 the corridor gets smaller and smaller and must be situated more and more precisely. Ease her back into her true PD, split the difference.

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    On the ABO exam as well as the Florida state boards, there is a question pertaining to this exact situation. You match what the Pt. has in previous glasses provided they were not having problems with those glasses.

    If it isn’t broken, do not fix it.

  4. #4
    What's up? drk's Avatar
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    Use the new measurements.

  5. #5
    Ghost in the OptiMachine Quince's Avatar
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    I always go with what I get unless there has been past issues. My step-father for example, has a drifting eye and has been a terrible one to fit and though I got drastically different measurements, I went with the ones the doctor provided after I was told that he checked and rechecked six times! To my delight, he now sees better than he has in years.
    Have I told you today how much I hate poly?

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    Master OptiBoarder AngeHamm's Avatar
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    I trust my measurements above what's on file. I don't know who took the previous PD.
    I'm Andrew Hamm and I approve this message.

  7. #7
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    Quote Originally Posted by AngeHamm View Post
    I trust my measurements above what's on file. I don't know who took the previous PD.
    I'm the same way... if I know the past optician and it was someone I knew did reliable measurements, I would use them and not do new ones depending on the situation. Otherwise, I always use my measurements. If I make a significant change, I warn the patient that there may be some adjustment to the new lenses.

  8. #8
    One eye sees, the other feels OptiBoard Silver Supporter
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    Quote Originally Posted by Klean View Post
    On the ABO exam as well as the Florida state boards, there is a question pertaining to this exact situation. You match what the Pt. has in previous glasses provided they were not having problems with those glasses.

    If it isn’t broken, do not fix it.
    Hello Klean, I'm reasonably sure that they're teaching us to match the optical center position only when neutralizing and duplicating the old lenses for a new pair of lenses, when the Rx is unknown, the idea being that we can't know if there is prescribed prism or not. Somewhat common in nursing homes. By statute, allowable in Wisconsin, but not in all states.

    https://docs.legis.wisconsin.gov/sta...es/449/_1?up=1

    New RXs should receive new measurements, ideally with an optimally adjusted frame in situ.

    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.



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    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    a simple way to tell if moving the PD from 29.5 to 28.5 will benefit the patient is to hold a 1/2 diop prism base out in front of old glasses right lens and ask the patient if they notice any improvement.

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    Master OptiBoarder OptiBoard Gold Supporter
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    Quote Originally Posted by rdcoach5 View Post
    a simple way to tell if moving the PD from 29.5 to 28.5 will benefit the patient is to hold a 1/2 diop prism base out in front of old glasses right lens and ask the patient if they notice any improvement.
    Will this affect the corridor being misplaced in a progressive though?

  11. #11
    Master Jedi King of the Lab's Avatar
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    Quote Originally Posted by AngeHamm View Post
    I trust my measurements above what's on file. I don't know who took the previous PD.
    Exactly. It's not you......it's me.
    Erik Zuniga, ABOC.

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