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Thread: Yoked prism for glaucoma patient...

  1. #1
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Yoked prism for glaucoma patient...

    Seventy five year old women has glaucoma and is being treated by an MD. As so often happens she assumes a new refraction can fix any vision problem.

    I have her slowly accepting the loss of vision in her right eye (especially) but she says if she lowers her chin and covers her left eye she gets some vision which is definitely better than a straight ahead gaze otherwise.

    I'm wondering if I might suggest to the MD I try a simple sv yoked base up rx to see what happens. My doc (OD) who caught the glaucoma says she'd be surprised if it works. She noted how the patient tends to bob her head around trying to find optimum vision.

    r -4.50 -2.50 x 28
    l -4.25 -2.50 x 168
    add +2.50

    She's in a physio short so I want to get her out of that as well.

    Before I call the MD any thoughts from my peps would be appreciated.
    Last edited by Uncle Fester; 03-04-2020 at 03:04 PM.

  2. #2
    One eye sees, the other feels OptiBoard Silver Supporter
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    Frustrating to have some degree usable vision so close. AMD is similar. For this to have any chance to work you'll need a lot of prism to redirect the image, at least 5 to 10 PD BU minimum, probably more. The floor will look uphill, and stairs/steps will be murder. Try before you buy.

    If interference from the right eye is intolerable, consider a clip-on occluder, Fresnel Min occlusion lens, etc.

    Best regards,
    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.



  3. #3
    Master OptiBoarder optical24/7's Avatar
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    Also keep in mind 1D of prism displaces an object only 1/2 degree (exp; 10D displaces an object 5 degrees, ect.) And each prism diopter only displaces the pupil about a third of a mm. They make a Fresnel in 40D that would displace objects 20 degrees (displace pupil about 6.5 mm) But the LCA's would be killer in that much prism. ( Even 10 D, the LCA's are considerable ). But you never know till you try it. I would think Fresnel's would be a better way to experiment since she can wear them on her current glasses instead of a *simulation* thru a trial frame.

  4. #4
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Thanks guys especially for my up down mix up!

    You guys are the best!

  5. #5
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Just dispensed a pair of simple sv cr39 with no obvious improvements so she is coming to realize we've done about all we can refractive wise and the issue is internal.

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