Patient having problems with transition to AS lenses

[SergeyAS]

Previous lenses were: thin sph Crizal easy uv n 1.5
OD 70 +2.00 -1.75 ax 175
OS 70 +1.00 -1.75 ax 5

New lenses: AS Transitions Crizal easy uv n 1.61
OD 70 +2.00 -1.75 ax 175
OS 70 +0.75 -1.75 ax 5

lens centers were marked by me

Patient description: Peripheral blur anywhere except center. Great vision outdoors, but he has troubles working on a computer, becouse he have to move his head to follow the eyes or else he cant read text clearly. His glasses costed a lot, so he is a little mad. I rechecked his prescription and it is all correct. By his words he spent 2 weeks trying to get used to it.
I found about 2 or 3 topics in the internet with the same problem, but there were no real answer to that.
What might be the reason here?

[Tallboy]

I would refer to Martin's rule of tilt, frame fit and PDs. Aspheric lenses are much less forgiving than spherical ones if optical center placement is incorrect, even more so with that pair.

Could also be difference in vertex distance from lenses or they may have more or less wrap to them than the previous pair. With an RX like that and in an aspheric lens sub optimal vertex distance from eye to lens will absolutely give this effect.

[SergeyAS]

I would refer to Martin's rule of tilt, frame fit and PDs. Aspheric lenses are much less forgiving than spherical ones if optical center placement is incorrect, even more so with that pair.

Could also be difference in vertex distance from lenses or they may have more or less wrap to them than the previous pair. With an RX like that and in an aspheric lens sub optimal vertex distance from eye to lens will absolutely give this effect.

Thanks for the answer.

His new frame is very close to the old one
OLD carrera 8810
NEW carrera ca6630



I also sent him to a frame master and they tried to change the position as well as front frame curve for several times for no actual vision change by patient words.

[Don Gilman]

Thanks for the answer.

His new frame is very close to the old one
OLD carrera 8810
NEW carrera ca6630

Overkill, Just make a new pair with stock lenses. Should be available in photo with HMC from any stock house. I bet the problem goes away



I also sent him to a frame master and theyCost comparision Lab vs FG 2 pair per day 264 days per year tried to change the position as well as front frame curve for several times for no actual vision change by patient words.

Overkill. Just make a new pair with stock lenses. Should be available with photo and HMC from any stock house.

[drk]

I think you want atoric lenses. Is that what you ordered?

I notice you went from 1.5 to 1.6. That could be the issue right there.

His symptoms are the opposite of what you'd expect from digital design. Therefore I suspect the material.

[Tallboy]

His symptoms are the opposite of what you'd expect from digital design. Therefore I suspect the material.

I think they were just aspheric 1.60 FSV. Either the vertex is too long, or the OC is off correct placement (probably too low) Or both.

I agree with you that the benefit to the patient of digital atoric lenses for this patient would be great and probably create a loyal patient/client for life

[Avalanche]

Just googled martins rule of tilt and came across this: http://www.alliedacademies.org/artic...mart-9803.html
So according to this chart, 7 degrees of tilt is equivelant to 1DPT Sph? Interesting.

[drk]

For that lens power.

[Robert Martellaro]

Just googled martins rule of tilt and came across this: http://www.alliedacademies.org/artic...mart-9803.html
So according to this chart, 7 degrees of tilt is equivelant to 1DPT Sph? Interesting.

The chart above is for HOAs. The way I read it, it's only the 2nd and 4th order aberrations that are affected by panto tilt. That's good because spherical aberration is generally not a problem for vision due to our small pupils. The lower order aberrations (myopia, hyperopia and astigmatism) are addressed with Martin's formula.

From our study, we found that the pantoscopic tilt increases 2nd and 4th order aberrations significantly. Surprisingly there was no statistical significant correlation for 3rd order aberrations with pantoscopic tilt. This needs further work to understand the absence of significance for 3rd order aberrations.

Best regards,

Robert Martellaro