I have a patient who is complaining of limited distance with the new physios. He claims he can see better in the distance without the glasses which was not the case before and to get the best distance, he has to slide the glasses down literally so he is looking through the very top. RX: OD +1.50 -0.75 x 15 OS +1.75 -0.75 x 165 ADD: 2.00 Last pair was a quarter weaker for sphere and add power and comfort vs physio. I explained that he will be able to see better in the (far) distance vs close but again, he claimed this was not the case with the last pair. When I remeasured, his measurement should have been two higher??? this makes no sense to me. I truly don't feel that I can lower the fitting height and in fact, feel like I should raise it. Wouldn't this make the distance even worse if he feels like he needs to lower the frame to see better??? FYI my lab director weighed in on this and said that in plus prescriptions, it is actually weaker towards the top of PAL's so he might be seeking his old prescription but this is only a +.25 difference. I am leaning towards just changing back to the comforts and seg ht that is appropriate even if it is raised a little which seems counter intuitive.
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