Hey all!

We have a client that has a distance and near rx:

Dist
+1.50 +0.50 *090
-2.50 +4.00 *095

Near
+2.50 +0.50 *090
-0.75 +4.00 *095

She's tried progressives before but said that she could not get used to them. At first, I thought that this might be a combination of poor expectation-management and or bad measurements/lens design. But upon analyzing the rx my coworker realized that there is a substantial amount of vertical imbalance taking place close to the 90 degree meridian. He calculated about 3+ diopters of prism at 10mm(which is generous considering that the reading seg would be even lower). This, including any size difference, may be the reason that she had trouble adapting... but we simply don't know. Do modern progressives have some way to deal with and assuage this imbalance?

Thank for any help!