Px came back from the optomologist and was recommended a Progressive lens. I was just wondering if there are any special fitting parameters I should take into account with this or any special fitting tips that you guys would have. Thanks
Px came back from the optomologist and was recommended a Progressive lens. I was just wondering if there are any special fitting parameters I should take into account with this or any special fitting tips that you guys would have. Thanks
As a general rule of thumb (therefore not pertaining to exotropic factor) I like to try and put minors in anti-fatigue lenses if their ADD power is +1.25 or lower. It is more of a training-wheel into PALs and can make the transition into multifocals much easier.
Pertaining to the exotropic nature- this is one of the very few instances I will use the Dr's PD measurement. It usually does not match my own but is somehow more accommodating. (Given that it is a Dr I trust.)
Have I told you today how much I hate poly?
It is a +2.00 Add. I was just asking mostly pertaining to seg ht and panto vetex ect. I know with Bifocals for children with strisbismus you fit the seg at pupil ht so I wasnt sure with a progressive if I fit it center pupil or what is recommended(I havent done one in awhile so I am having a brain fart at the moment). Sorry I should have been more clear about that in the initial post
No worries! Thought I'd give my 2 cents!
Have I told you today how much I hate poly?
Use a design that has a shorter corridor, as opposed to a longer corridor.
Segmented multifocals, where the segment bisects/splits the pupil, are typically used specifically for convergence excess esotropia.
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.
Rather than use a PAL, have you considered the Shamir Duo? Is the recommendation for a PAL for intermediate use or to deter from a line that creates image jump? The Duo accepts prism better and less likely to encounter the prism conflicts PAL's endure.
At a +2.00 add it is at the upper limit for PALs and their increased distortion over the lens.
Why not give a 16 year old some clear vision throughout the lens.
Use an invisible Bifocal. Shamir Duo is the best, as Optical Dinosaur suggested!
As Robert mentioned, the purpose of an add in an exotropia is different than an esotropia. (In an esotropia you use a seg and split the pupil.)
In an exotropia the very likely cause is accommodative insufficiency, a much more mild situation, and it is amenable to PALs.
As to the type, with a +2.00 add (which is quite high for an accommodative case) you would treat it as any other case. Short corridor is fine. Blended/invisible bifocal is fine. I'd probably just look at the distance refractive error and wear recommendations and decide from there.
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