I'm not the best person to guide you in this, but it would be much easier to help with a written version of the script. There is obviously a lot of prism here and general I gravitate towards splitting between both eyes evenly (both vertical and horizontal) but that is also dependent of the power correction for each eye as well.
Have I told you today how much I hate poly?
I've never seen this represented on grip paper so I might be interpreting this incorrectly.
Eliminate examples #1 and #2 because the horizontal prism is base out.
#3, #4, and #5 are the same, but #3 is written so that the prisms are equally split between both eyes, and this will allow for the best cosmetics and the least negative effects from chromatic aberration (unless the BCVA in one eye is considerably poorer in one eye, if so, split unevenly or put all of the prism in the bad eye).
Best regards,
Robert Martellaro
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.
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.
Because I misinterpreted the grid paper, and that #3 was the only choice that showed prism split.
Using the newly supplied Rx, the grid paper with rectangular coordinates, and the center as a reference point, and each box equal to one prism diopter, shows the right eye (small red square bottom left) as OD 2BD 3BO and OS 2BU 3BO. This contradicts what you stated is the written Rx above. Either the Rx you indicated above is written incorrectly, or I am still misinterpreting the graphic.
Generally yes, but with caveats.Also. can we use progresive lens for example #3 for Presbiopya. thanks
Best regards,
Robert Martellaro
Last edited by Robert Martellaro; 06-26-2018 at 10:26 AM.
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.
You can be dead on with your measurements but the patient might not be able or willing to wear what you find. The habitual Rx, the patient symptoms, if any, past experience, should all guide your decision.
Of the two choices, #1, if the left eye is stuck in the exo position for all angles of gaze. The Rx might say "balance" for the left eye. But if you cover the right eye and the left eye points straight ahead, measure that position and use this value for the left monocular distance PD.
Hope this helps,
Robert Martellaro
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.
I have experienced. found patient (40 yo) MPD R32 L32. with tropia in left eye cause by high blood pressure. during 2 months left eye covered, then when i open & check, found Missalignment 23 diopter prism base out. for temporary i give R 8 diopter base out L 9 D base out. (headache if put full prism). after 3 months check again the eyes back to normal (both eye) no tropia found.
The question is, is that coincidence or normal for high blood pressue patient? thank you
Muscle palsys can resolve, so yes.
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