NVF Can I get away with this???

[Uncle Fester]

Patient wants a progressive for computer use with near vision focus same as when he takes his glasses off. Moderate myopia.

R-3.50 -1.00 x 170
L-3.75 -.75 x 35
Add +2.00

The doc's SV computer rx
R -2.00 -1.00 x 170
L -2.25 -1.75 x 35

VSP patient so Unity Office Pro 5' would be my best $ option but I'm thinking I tend to have more success with an Essilor Computer for a monitor at about 30" and its wide smooth progression to near over the Office Pro or Shamir Workspace offerings.

Can I get away with bumping the add to +3.50 so near is extra close as he finds he needs this distance during work and doesn't want to remove his glasses? Or have I opened a can of worms with optics kicking the add this much?

Monitor is at a slight down gaze with some ability to adjust height.

[Robert Martellaro]

The left cylinder power on probably the second Rx has an error. If true, and the +2.00 add is for 16", use about +1.00 for the 30" work distance, and about +4.00 for the equivalent of spectacle lenses removed.

For multifocals, add +1.00 to the distance and +3.00 (+4.00 - (+1.00)) for the new near add power .

Hope this helps,

Robert Martellaro

[drk]

I would not allow a guy a +4.00 add at near, regardless of what he asks for. Maybe a +3.00.

Also, a +1.50 add for a computer is also kinda silly, if you ask me. But whatever.


But why not do a NVF with a +3.00 add used for the Rx that's designed for a close use (you know, one that's dedicated to "screen" or whatever)?

The "5 foot" is probably about a +1.00 at the distance. You could cut the minus in the order by 1/4 D to get your +1.25 at the top zone, then order a +2.75 add with it (or even +3.00 if you must) and the near zone will give a +3.00---+3.25 type add down low.

[Uncle Fester]

My 30" monitor focus is way off as the doc has the computer focus less than 20" which explains the +1.50 add for computer.

I would normally "set it and forget it" and write the regular dist/near rx for an Essilor Computer. But I want the upper power to match the doc's computer powers. So I'll need to adjust my sphere power so the labs automatic adjustment to the rx will give me that computer power but also with an extra, extra close near focus.

Maybe weaken the distance by 0.50D and increase the add to a +2.50?

Thanks for your suggestions so far.

[Robert Martellaro]

My 30" monitor focus is way off as the doc has the computer focus less than 20" which explains the +1.50 add for computer.

That's a pretty wide variance between what the prescriber used for object distance (20") and what you or the client says is 30". You'll need to firm that up some before proceeding.

I would normally "set it and forget it" and write the regular dist/near rx for an Essilor Computer. But I want the upper power to match the doc's computer powers.

The only way you'll get the exact object distance and position in the lens the way you want it is to use a general purpose PAL or segmented, even if you don't try for a 6" work distance on the downgaze.

You might get close though, maybe close enough to work reasonably well without posturing or tromboning by using a computer PAL, but I would strongly recommend putting in a call to E for technical for assistance, unless you're an expert with the E lens.

Best regards,

Robert Martellaro

[Uncle Fester]

Really helpful Robert. Thanks!