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Thread: What Do you this of this I.P.D & Optical Center

  1. #1
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    What Do you this of this I.P.D & Optical Center

    Hello,

    A Father Visited my store today requested a new eyeglass with his new prescription for his Child

    His child is about 5-6 Years and He have Esotropia Left Eye, The Right Eye is Normal

    His Father told me that his Son have "Fucosidosis" Which is a very rare disorder "rare genetic disorder"

    But He asked me to check his old eyeglass to see if there is a different between the old and the new prescription power and i really do not know what to call it maybe surprised or shocked Because of What i saw on the lenses after checking on my Lens Meter

    His RX is -3.00cyl
    180 for both eyes and No Prism

    The picture Explains more
    Click image for larger version. 

Name:	WhatsApp Image 2017-12-15 at 8.53.52 PM.jpg 
Views:	60 
Size:	22.2 KB 
ID:	13671

    You can see on the picture On The Right Lens the Optical center, the P.D On the Upper spot, And the Left on the very downer

    He have more than 3 Eyeglasses they were made the same way
    with His Doctor.
    His RX is -3.00cyl180 for both eyes all of the 3 eyeglass

    Note:
    I did not make the eyeglass you see on the picture.

    I do not have any problem with the patient i am just wondering what do you think of it if you faced the same case?
    Have you ever faced the same?


    This topic is to discuss not to solve any problem cause i am not complaining or facing any problem.
    It is just a new experience
    Last edited by MrOptician; 12-17-2017 at 01:31 PM.

  2. #2
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    First off, what is the RX brought to you from their doctor. What is the RX you read in those 3 older pair of glasses. You need to bring a lot more info to the table before anyone here can even begin to talk about it.

  3. #3
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    Quote Originally Posted by MrOptician View Post
    Hello,

    A Father Visited my store today requested a new eyeglass with his new prescription for his Child

    His child is about 5-6 Years and He have Esotropia Left Eye, The Right Eye is Normal

    His Father told me that his Son have "Fucosidosis" Which is a very rare disorder "rare genetic disorder"

    But He asked me to check his old eyeglass to see if there is a different between the old and the new prescription power and i really do not know what to call it maybe surprised or shocked Because of What i saw on the lenses after checking on my Lens Meter

    The picture Explains more
    Click image for larger version. 

Name:	WhatsApp Image 2017-12-15 at 8.53.52 PM.jpg 
Views:	60 
Size:	22.2 KB 
ID:	13671

    You can see on the picture On The Right Lens the Optical center, the P.D On the Upper spot, And the Left on the very downer

    He have more than 3 Eyeglasses they were made the same way
    with His Doctor.

    Note:
    I did not make the eyeglass you see on the picture.

    I do not have any problem with the patient i am just wondering what do you think of it if you faced the same case?
    Have you ever faced the same?


    This topic is to discuss not to solve any problem cause i am not complaining or facing any problem.
    It is just a new experience
    And what was the complete Rx?

  4. #4
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    Quote Originally Posted by Tallboy View Post
    First off, what is the RX brought to you from their doctor. What is the RX you read in those 3 older pair of glasses. You need to bring a lot more info to the table before anyone here can even begin to talk about it.
    Quote Originally Posted by tmorse View Post
    And what was the complete Rx?
    Sorry forget to post , now topic is edited

    His RX is -3.00cyl180 for both eyes all of his 3 old eyeglass

    I am not complaining any problem and not trying to solve anything ,this topic only for sharing knowledge

    Thank you

  5. #5
    Master OptiBoarder OptiBoard Silver Supporter lensmanmd's Avatar
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    A case of prescribed vertical prism

  6. #6
    Master OptiBoarder LENNY's Avatar
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    or turned upside down left lens

  7. #7
    Master OptiBoarder OptiBoard Silver Supporter lensmanmd's Avatar
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    Shape says otherwise, plus, the OC on the right seems a bit high to be an original fit.

  8. #8
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    While ignoring O.C. recorded positions............what is the determined prism imbalance recorded by you, MrOptician?
    Eyes wide open

  9. #9
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    Quote Originally Posted by lensmanmd View Post
    A case of prescribed vertical prism
    Quote Originally Posted by uncut View Post
    While ignoring O.C. recorded positions............what is the determined prism imbalance recorded by you, MrOptician?
    No Prism Imbalance

  10. #10
    Master OptiBoarder OptiBoard Silver Supporter lensmanmd's Avatar
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    @MrOptician
    Unless there is prescribed prism, or a serious manufacturing error, there is no way that there can be such a marked difference in OC heights. How much vertical do you measure at the Datum? What is the power at the 90?

  11. #11
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    Quote Originally Posted by MrOptician View Post
    No Prism Imbalance
    Thank you, for your answer MrOptician.

    O.C. position noted as such can also mean the lens measure mount is tilted(lensometer), or calibration is needed.

    Did you get a similar result by turning the eyewear upside down?
    Eyes wide open

  12. #12
    My Brain Hurts jpways's Avatar
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    Reading the NIH description
    https://ghr.nlm.nih.gov/condition/fucosidosis
    and looking at a google image search
    https://www.google.com/search?q=Fuco...BgChwQ_AUICigB
    Having a locked head tilt and having a larger than normal difference in pupil heights is not uncommon, it could just be a case of putting the vision where the patient needs it

  13. #13
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    Quote Originally Posted by jpways View Post
    Reading the NIH description
    https://ghr.nlm.nih.gov/condition/fucosidosis
    and looking at a google image search
    https://www.google.com/search?q=Fuco...BgChwQ_AUICigB
    Having a locked head tilt and having a larger than normal difference in pupil heights is not uncommon, it could just be a case of putting the vision where the patient needs it

    Yep......ruling out prism induced by error fabrication, device error by lack of prism ring calibration and confirmation that there is no imbalance induced, then one must assume that the ocs are where they are supposed to be.
    Eyes wide open

  14. #14
    Master OptiBoarder optical24/7's Avatar
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    MrOptician, please give the complete Rx, Sphere, Cylider and Axis. There most certainly is prism vertically at datum unless the power is +/- .25 at 90.

    IMHO, head tilt alone would not call for that much difference. The IPD horizontally looks fairly symmetrical. Rules out a head turned adjustment. That leaves a chin up/down comp. which you wouldn’t comp for because of yoked prism effect.....Unless...there is dis-similar power at 90, which means there is prism at datum.

    ( I certainly hope this poor child wasn’t born with one eye socket 20+ mm off!)

    My guess is there was prescribed prism in the original pairs. The new prescriber either missed it, forgot to write it or doesn’t feel it’s necessary any longer.

  15. #15
    Eyes eastward... Uilleann's Avatar
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    Prescribed prism.
    Check prism drum on lensometer.
    Ask original prescribing doctor for clarification.

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    Quote Originally Posted by optical24/7 View Post
    MrOptician, please give the complete Rx, Sphere, Cylider and Axis. There most certainly is prism vertically at datum unless the power is +/- .25 at 90.

    IMHO, head tilt alone would not call for that much difference. The IPD horizontally looks fairly symmetrical. Rules out a head turned adjustment. That leaves a chin up/down comp. which you wouldn’t comp for because of yoked prism effect.....Unless...there is dis-similar power at 90, which means there is prism at datum.

    ( I certainly hope this poor child wasn’t born with one eye socket 20+ mm off!)

    My guess is there was prescribed prism in the original pairs. The new prescriber either missed it, forgot to write it or doesn’t feel it’s necessary any longer.
    My thoughts, exactly. Thanks for having my back.

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    Quote Originally Posted by uncut View Post
    Yep......ruling out prism induced by error fabrication, device error by lack of prism ring calibration and confirmation that there is no imbalance induced, then one must assume that the ocs are where they are supposed to be.
    Tough for me to concur. Asymmetrical pupil alignment is fairly normal, but this is pretty extreme. AND, the separation is uniform. Based on MrOptician's picture and RX info, the power in the 90 is identical. Even with fucosidosis, I would expect to see asymmetrical OCs.

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    Hello,

    old Prescription is +3.00Cyl*180 for both eyes PD:55 that was like 2-3 years ago Based on his old eyeglass.




    Now the patient is 5-6 years and his new Prescription is -3.00Cyl*180 The difference is ( - ) from the old ,for both eyes PD:55.

    Prescription is only Cylindrical .

    No Prism Value.

    Attention:I am not complaining or trying to solve any problem this topic only for sharing Knowledge and educating and having new experience.

    Thank you
    Last edited by MrOptician; 12-18-2017 at 03:10 PM.

  19. #19
    Eyes eastward... Uilleann's Avatar
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    You're comparing old glasses and not doctors written Rxs? Do you have the chart notes to reference? Have you spoken to the prescribing doctor directly? Do you have any reference for acceptable VAs? Diplopia?

    If not, you're just grasping at a LOT of straws and air...

  20. #20
    Master OptiBoarder optical24/7's Avatar
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    Quote Originally Posted by MrOptician View Post
    Hello,

    old Prescription is +3.00Cyl*180 for both eyes PD:55 that was like 2-3 years ago Based on his old eyeglass.




    Now the patient is 5-6 years and his new Prescription is -3.00Cyl*180 The difference is ( - ) from the old ,for both eyes PD:55.

    Prescription is only Cylindrical .

    No Prism Value.

    Attention:I am not complaining or trying to solve any problem this topic only for sharing Knowledge and educating and having new experience.

    Thank you
    Ok, so I take it both Rx’s were Plano at 90 degrees. Disparaging OC heights of 20+ mm don’t matter. It would have to be sub .05 D of imbalance (1/5th of a quarter D). ( You got one heck of an accurate lensometer!) More than likely the “error” was from surfacing all three pair on the same finer/polisher for that extremely small amount of OC prismatic difference. (Machine pressure difference, left/right sides). I wouldn’t even attempt trying to match this.


    The more interesting aspect of this Rx is the cyl flipping + to - at 180. ( with the same diopteric power). Highly unusual without trauma/surgery. More than likely prescriber error, either former or later. I would recommend talking to the latest prescriber, trial frame if the patient is responsive, auto refract or scoping with an ophthalmoscope with trial lenses to confirm the current Rx.

  21. #21
    Master OptiBoarder optical24/7's Avatar
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    MrOptician, I wanted to add that some of our confusion and or various answers you’ve gotten come from what must be a difference in how Rx’s are written in your country compared to ours. Here, a complete Rx has Sphere, cylinder and axis listed. Your current Rx would be written here as Plano - 3.00 X 180 or 0.00 -3.00 X 180. The spherical is not omitted when 0 or Plano, it’s still written.

  22. #22
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    Quote Originally Posted by optical24/7 View Post
    MrOptician, I wanted to add that some of our confusion and or various answers youve gotten come from what must be a difference in how Rxs are written in your country compared to ours. Here, a complete Rx has Sphere, cylinder and axis listed. Your current Rx would be written here as Plano - 3.00 X 180 or 0.00 -3.00 X 180. The spherical is not omitted when 0 or Plano, its still written.
    Hello,

    I understand this point.

    We write Rxs the same way

    I post this topic while i am at work so i was quick.

    you are right 100%

    Thank you very much optical24

    Thanks to all for sharing knowledge and for posting here.

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