Results 1 to 13 of 13

Thread: anisometropia in a single vision lens

  1. #1
    OptiBoard Apprentice
    Join Date
    Feb 2021
    Location
    Maryland
    Occupation
    Optometrist
    Posts
    17

    anisometropia in a single vision lens

    Patient rx has changed from OD-1.75 OS-3.00 to OD plano OS -3.00, she had cataract surgery OD, always took off glasses for near and happy with that. She notices in the new glasses that vision straight ahead all is well but if she moves her head up or down it looks "funny". Obviously induced prism. What to do? Go to a smaller frame size? Would something like a Shaw lens work, I think that would just even up image size (which she is not bothered with) not induced prism.

    Appreciate any thoughts (she is not interested in contacts with readers over top)

  2. #2
    What's up? drk's Avatar
    Join Date
    Mar 2004
    Location
    Ohio
    Occupation
    Optometrist
    Posts
    8,552
    OD: plano
    OS: -2.00

    Start there...

  3. #3
    OptiBoard Apprentice
    Join Date
    Feb 2021
    Location
    Maryland
    Occupation
    Optometrist
    Posts
    17
    Or maybe OD-1.00 and keep OS at -3.00; trial frame it each way and see what she prefers.

    Any other thoughts?

  4. #4
    Master OptiBoarder optical24/7's Avatar
    Join Date
    May 2006
    Location
    Down on the Farm
    Occupation
    Dispensing Optician
    Posts
    5,559
    Yea, #1 get the other eye’s catx done, wear one cl to balance, tell the patient they need to turn their head and nose point.

    #1 she should have been advised prior to surgery the can of worms that would be opened by having a 3 diopter power imbalance post surgery. ( The OMD is the one who really needs counciled.)

  5. #5
    OptiBoard Apprentice
    Join Date
    Feb 2021
    Location
    Maryland
    Occupation
    Optometrist
    Posts
    17
    Quote Originally Posted by optical24/7 View Post
    Yea, #1 get the other eye’s catx done, wear one cl to balance, tell the patient they need to turn their head and nose point.

    #1 she should have been advised prior to surgery the can of worms that would be opened by having a 3 diopter power imbalance post surgery. ( The OMD is the one who really needs counciled.)
    There is no cataract in the other eye. Yes it would have been nice if the patient was informed, but here we are

  6. #6
    Master OptiBoarder
    Join Date
    Feb 2016
    Location
    usa
    Occupation
    Dispensing Optician
    Posts
    749
    24/7's reply are the only viable solutions. There are no magic glasses to fix this.

  7. #7
    What's up? drk's Avatar
    Join Date
    Mar 2004
    Location
    Ohio
    Occupation
    Optometrist
    Posts
    8,552
    Typically what a better surgical strategy would have been a target OD of -1.00. Then in the future OS can be made plano.

  8. #8
    What's up? drk's Avatar
    Join Date
    Mar 2004
    Location
    Ohio
    Occupation
    Optometrist
    Posts
    8,552
    Quote Originally Posted by Michael Davis View Post
    Or maybe OD-1.00 and keep OS at -3.00; trial frame it each way and see what she prefers.

    Any other thoughts?
    No, I don't like that. Who likes overminus? Nobody. Who likes underminus? Not nobody.

  9. #9
    One eye sees, the other feels. OptiBoard Silver Supporter
    Join Date
    Jul 2002
    Location
    Wauwatosa Wi
    Occupation
    Dispensing Optician
    Posts
    5,249
    Quote Originally Posted by drk View Post
    OD: plano
    OS: -2.00

    Start there...
    Yes, or let the pt. dial it down until accepted. Or try no eyeglasses for distance, and try OTCs for near.

    I wonder if she's bilateral or unilateral, VAs, work and hobby history, etc.

    Quote Originally Posted by optical24/7 View Post
    Yea, #1 get the other eye’s catx done, wear one cl to balance, tell the patient they need to turn their head and nose point.

    #1 she should have been advised prior to surgery the can of worms that would be opened by having a 3 diopter power imbalance post surgery. ( The OMD is the one who really needs counciled.)
    I'd do more than recommend counseling if she was unilateral with otherwise healthy eyes!

    Michael

    Assuming failed adaptation of about ten days, and must have the fellow eye corrected w/o CLs, one could manipulate the base curves and thicknesses to minimize image size disparity and prism imbalance, but the cosmesis will be poor and cost spendy, similar to Shaw's design.

    Robert
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    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.



  10. #10
    Master OptiBoarder optical24/7's Avatar
    Join Date
    May 2006
    Location
    Down on the Farm
    Occupation
    Dispensing Optician
    Posts
    5,559
    Quote Originally Posted by Michael Davis View Post
    There is no cataract in the other eye. Yes it would have been nice if the patient was informed, but here we are
    Couldn’t she still have an IOL put in the OS? (Even if it’s out of pocket).

  11. #11
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
    Join Date
    May 2000
    Location
    Seaford, NY USA
    Occupation
    Dispensing Optician
    Posts
    5,912
    Try Shaw SV lens

  12. #12
    Master OptiBoarder OptiBoard Silver Supporter
    Join Date
    Jan 2007
    Location
    Massachusetts
    Occupation
    Dispensing Optician
    Posts
    1,367
    How about one CL for the left eye as 24/7 suggested? Then she could wear PALs or OTC readers. That's pretty simple.

  13. #13
    What's up? drk's Avatar
    Join Date
    Mar 2004
    Location
    Ohio
    Occupation
    Optometrist
    Posts
    8,552
    The problem with a SV lens is that neither eye can accommodate (typically) and the glasses would have to come on/off all day long. Nope, spectacle monovision is the "simplest" answer.

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. Enhanced Single Vision Lens?
    By eryn in forum General Optics and Eyecare Discussion Forum
    Replies: 13
    Last Post: 09-16-2019, 12:35 PM
  2. single vision lens no axis
    By maid52 in forum General Optics and Eyecare Discussion Forum
    Replies: 6
    Last Post: 08-23-2019, 08:25 AM
  3. Polarized single vision as stock lens?
    By Dah3500 in forum General Optics and Eyecare Discussion Forum
    Replies: 11
    Last Post: 06-20-2013, 09:27 AM
  4. Do you use a single vision lens as a balance lens for progressives?
    By Happylady in forum Progressive Lens Discussion Forum
    Replies: 23
    Last Post: 11-18-2011, 09:31 PM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •