Optician Troubleshooting: Problems WIth Plus Powers

[@hirmaguma6958]

So helpful explanation.

[@luisgomez1211]

Hello Laramy, good theme...thank you...

[@erodas8899]

As always, awesome and very helpful video. Very thankful to all your hard work for our optical community. Will we be seeing a video in the future like this but for minus power?

[@LaramyKOptical]

No because minus power doesn't act that way. In fact you can toss minus on and people love it! John

[@kamalsharma9313]

Pls share objective and subjective refraction step by step to get the patient accurately prescription. Tnx

[@LaramyKOptical]

Opticians in the US don't do refraction. That is done by doctors of optometry. I'd look for a textbook online.

[@kariturks4381]

I have a patient who wears a +3.00 sph in the right eye, and a +3.25 sph in the left. He uses them for everything! We tried a progressive (he's 50) and since he has always worn single vision plus lenses, he did not like them at all. We recently made him new lenses for his own frame and he loved them. They were a little small (he's a big guy) and since the new script worked well, we picked out a newer, larger frame for him for a second pair. He picked out a Fatheadz. He came to pick up his glasses yesterday and although the vision was good, when he tried to look at a piece of paper it was slanted (that's the best way I can explain it) The base curve was the same. OC height was not the same. I had him pick out another, smaller frame and I'm marking for OC. What caused the slanting? Too big of a frame, thus thicker lenses in the center?

[@LaramyKOptical]

Sounds like you are doing some good troubleshooting on your own. Before tossing out the baby with the bathwater I'd just try some frame bending. Look at the old pair and try to match tilt and wrap - you might be surprised. Slanting could indicate a little perceived cylinder which you might be able to bend out of it (so to speak). If the OC was placed correctly for the new pair I wouldn't think that size alone would not account for it. If he is a big guy and needs a big frame you may want to look at doing a surfaced lens, maybe even a free-form with POWs. That would certainly eliminate all the possibilities. John

[@kariturks4381]

I should have mentioned that I did adjust the frame to match. Forgot to mention that.

[@LaramyKOptical]

Thought you might have.

[@EShelby2127]

Enjoying your videos! I'm a 55 year eyeglass customer, now 60 years old. Getting ready for my eye exam by doing some measuring of my normal working & distances and asking for specialized prescriptions. How about a guide for end customers on how to judge, measure, chart what to ask for in prescriptions? I know that there are many variables with each patients eyes, but a general preparation for eye exam video would be nice. I have several frames (very much alike - titanium Autoflex, which along with high index lenses changed my life in the 90s!) that I intend to have filled for specific tasks at my next exam. My biggest issue with the current prescription is my long term astigmatism. I find myself closing one eye when I try to concentrate. I'm not sure if this is just a result of my condition or a problem with my prescription. Thanks!

[@LaramyKOptical]

If you have a specific working distance that you need to be spot on perfect then do what you are doing. Measure that distance and bring it along with you. They should do what is called a "trial frame" where they can add and remove power in units as small as 1/8 diopter steps to fine tune your needs. As to the rest, well, getting old stinks doesn't it! (I'm 58) But as they say the alternative... John

[@EShelby2127]

@@LaramyKOptical - Thank you John, yes it does beat the alt! Another pre-prescription question after measuring & looking at alternatives. I have taller lined bifocals now and am looking at some small frames (which I can look over for distance) @28mm in height, planning to use them as computer/reading glasses. I work in a library and my main distances are @20" & 30" - I saw mention of "short corridor" progressives. with this short of lens height and with those distances, would lined bifocals be the best option, or the progressives? The other question is pricing on both progressives and lined with this short of lens vs using frames with taller lenses. Thanks! Murphy/Seattle

[@LaramyKOptical]

@@EShelby2127 There are four videos on how to choose progressive lenses. I cover short corridors and office style there. Same place you found this video. John

[@rockz719]

Hello Sir, could I get your email.

[@alieuconteh5192]

Hi ...How can I have opticiian online classes

[@skibickiadrian]

Hello. How do You set the pupil distance in the reading glasses and ffa = 0? By distance or near distance?

[@LaramyKOptical]

No idea what ffa=0 means. True reading glasses would be laid out and finished using the near PD. Distance PD - 4. Intermediate would be distance - 2.

[@skibickiadrian]

@@LaramyKOptical FFA is Face Form Angle or wrap. Usually the frames have an FFA = 4 degrees, but for near vision glasses it should be around -8 degrees. I am asking out of curiosity, because in the US You do some things a bit differently. I heard that glasses with FFA = 0 degrees should be centered pd for far vision. The reason is the way the lenses are designed, not the prismatic effect.

[@LaramyKOptical]

@@skibickiadrian I've never heard anything about specific degrees of face-form or wrap for certain distances. 0 is never a good thing and should be avoided as much as negative wrap. Beyond that IMO just "give 'em some face form" and move on... You might try OptiBoard where someone might have much stronger feelings on the subject than I do. Like the rest of POW stuff I think we make mountains out of mole hills. John

[@skibickiadrian]

@@LaramyKOptical I think usually the starting point for the design of single vision lenses is FFA = 0 but FFA = 5 should not be a problem for the wearer. Negative FFA for near glasses only (same when switching to near in phoropter). Anyway, thank You for the answer.

[@rkelmy]

This is the answer I have been looking for. My last prescription my add went up to +2.5 and the new glasses seem to have more distortion throughout my progressive lens. My prescription is OD +4.75 -1.50x120 OS +5.00-1.75x51 with +2.50 add. What lens manufacturer would be best for a progressive lens with this prescription? Would I be better switching to a bi-focal vs progressive?

[@LaramyKOptical]

Yeah that's quite a bit of plus power there... look for a good independent optician that offers progressives using the Camber design. Camber really shines with the higher plus powers. Sadly if you have been wearing progressives for years and years you might not find switching to a lined multi-focal all that easy. You can find good solid information (not sales mumbo-jumbo) about Camber online. John

[@urbanimage]

@@LaramyKOptical I have a similar proscription to Russ Elmy, so that's a very interesting suggestion. My experience is that opticians do tend to want to over + plus, not really their fault as I think it's in the nature of subjective refraction. I shall have to see if I can find an optician here in the UK that's experienced with Camber's lens blanks. They do seem to be available from labs, here for example lenstecopticalgroup.co.uk/lens-options/ Reading through this discussion at the moment 8--) www.optiboard.com/forums/showthread.php/63147-The-truth-about-Camber

[@rockz719]

I have been going through the videos. They are great and you are awesome. I really like your explanation and method of teaching and presentation. I am yet to go through all the videos . Bit I will eventually. I was wondering that I could share a few ideas that might help me , us, all the Optometrist community to dispense the lenses easily. I would like to share few thoughts with you. Could you help.me out. Thanks and regards, Nilanjan. Optometrist. Kolkata, India.

[@keithsr.]

Helloooooow , I'm recently new to glasses and went from none to progressive lenses. I'm finding the reading zone to be ok in size and the distance zone more than ample. It's the intermediate zone I'm really struggling with. The area is just way too small for my needs. I'm wondering if the add power for the reading zone was decreased,would that increase the intermediate zone size? Right now my reading clarity distance is about 8" to 16" closer than 8" gets blurry. Sphere. Cyl. Axis. Add. OD. -0.75 -1.00 150 +1.75 OS. -0.75 -2.00 013 +1.75 Question 2 , My left eye just won't focus as pin sharp as my right eye (its good just not as good ) . Is this do to the worse astigmatism in my left eye or is it the left lens is off ? My left has always been noticeably worse even before glasses. I've read that I should have gone with trivex over polycarbonate for the higher abbe value of trivex and increased clarity . I also read it is better for astigmatism too. I'm using semi rimless and wanted the eye protection of these 2 materials . I'm a bit annoyed that I wasnt told about trivex at the eye doctors. Especially when the brand lens we went with offer trivex. I've also experienced a slight haze like effect on the edges of things in the distance. Would trivex help with any of these issues ? Optical clarity is #1 for me . Thank you for any help and I'm really enjoying your videos.

[@LaramyKOptical]

1) No. You might gain 0.5mm of width going with a high-end free-form if you aren't already in one. The narrow intermediate is the nature of the beast. Get a SV 2nd pair for long term intermediate work. 2) Yes Trivex is a far optically superior a material and perfect for your lens powers. Yes it is the higher astigmatism that will alway have your left worse than your right.

[@keithsr.]

@LaramyKOptical thank you very much. I'm about 10 days into glasses . I really wish I researched before getting them. I honestly didn't think I would be getting progressive lenses so I had no idea what was good, bad,etc . I blame myself and the optician for not giving me choices. I should have asked more questions. I've always done some research beforehand when making an important decision. He just picked everything for me, saying this is the brand /style we use. But never went into the material thier lenses were made of. Not one mention of anything other than polycarbonate as an option for me. They put me in the Varilux X even though the new one is the Varilux XR . I really think I'm just gonna get a SV pair for now. And get another cheap pair for reading . Definitely will be trivex though.