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Thread: Hyperopes

  1. #1
    fortwo eye jediron's Avatar
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    Hyperopes

    I have seen a rash of hyperopes with as little change in the dist. as +.25 up to +.75 and add changes from +2.25 to +2.75. All complaining that their distance is not as good as there old. They love the reading but don't like the dist. change. Most recent was a gentleman who went from +1.25 dist. to +1.50 dist. and add from +2.25 to +2.75. Loved the add hated the dist. change. This is just one of many similar ones we have had, especially with hyperopes.
    What have you seen?:shiner:

  2. #2
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    In contact lenses at least, most of the hyperopes I have seen need a little more than the doctor precribed shortly after getting contacts. I attribute this to more of the accomodative reflex relaxing. In any event just add it and forget it. As to add changes what period of time passed between Rx and change? How did add compare to charts for age/add? A lot of doctors are shy when it comes to Rxing add, and shy about trifocals. I suspect they have heard so much fussing about new bifocal Rx's (from the standpoint of patients don't want to admit they are old) that they just don't want to go through this again with a trifocal.

    Chip

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    fortwo eye jediron's Avatar
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    Chip thanks for the great info. Really appreciate it. Again thanks.

  4. #4
    One eye sees, the other feels OptiBoard Silver Supporter
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    Most of my clients are in that age group. Here is what I have done to keep this problem to a minimum. If the Rx's are coming from one group of doctors, it is quite possible that their examining lanes are improperly set up. Another possibility is that in this age group (>55), where there is little if any accommodation left, most folks actually prefer a little extra plus even if the distance clarity becomes a bit soft. This helps the client see at indoor distances where most folks spend 95% of there time. If the client is very active outdoors, and tends to judge their vision quality by the sharpness of road signs, adding a little extra plus is going to be a mistake, even if they admit that objects at five to fifteen feet are less clear. To keep surprises to a minimum, I like to use trial lenses over the clients existing glasses, especially if it is a client and/or doctor that I have not worked with previously. If the problem shows up with the new glasses I will show them the far distance and 10 foot distance with a minus trial lens (-.25 should do). Once they understand that they can not have both distances absolutely clear with one pair of glasses, they accept the doctors judgement and hence the new Rx/glasses.

    Robert

  5. #5
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    there is a great book called Clinical Pearls in Refractive Care by D Leonard Werner & Leonard J Press. I have been qualified for 20 years now - but I learned stuff in that book. They say - change what you have to change and leave the rest alone. Looking at records of people I have refracted over 18 years - the numbers hae got bigger over their life span - people do show more manifest hyperopia. But I think changing the distance focus has got me into more troubles over the years than changing the reading add.

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