Hi all,
I'm experiencing a bit of head-scratcher.
Have a px who presents with:
OD +1.00/-0.25x67
OS +1.00/-0.25x92
Add +2.25
Distance PDs R 31.5 / L 35.5
Near PDs R 29.5 / 32
White-collar desk top worker
He's worn our indoor PALs or occupational progressives for the past 2 years and has been really happy with them.
Given his relative new experience with multifocal lenses, we decided a soft-er design was appropriate given his needs (he wanted to have a carry-along pair to work when he forgets his indoor PALs).
He came back within a few days of pick up to complain that his intermediate and near weren't sharp and very narrow. We explained the nature of the multifocal choice to him again and explained that we can opt for a different design to cater more for his distance and near but would yield on the intermediate.
I'm surprised he didn't complain about his distance as well. So I am thinking, before remaking the glasses, could his case be that he requires a variable inset PAL given his very imbalanced PDs and variable insets which would require varying umbilical angles as he's viewing down into intermediate and near (hence he's problem with intermediate and near, but not distance?)
And if so, of the 3 labs we use, only 1 design implements the variable inset (Nikon See Wide). Does anyone have a similar experience?
What is everyone's thoughts?
Thanking you in advance
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