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Anisometropia and progressive lenses

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Anisometropia and progressive lenses

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Anisometropia and progressive lenses

  1. 1. Anisometropia and progressive lenses Author: Irina Jagiloviča E-mail: optometristiem @ gmail.com WWW: www.optometristiem.lv
  2. 2. Definition <ul><li>Ametropia difference >/= 1.00D on spherical equivalent or vertical meridian </li></ul>
  3. 3. Anisometropia <ul><li>Particularly/ Problematic </li></ul><ul><li>- Binocular instability, Near prismatic differential </li></ul><ul><li>- Aniseikonia </li></ul><ul><li>- Accommodative instability </li></ul><ul><li>-near acc. demand more convex </li></ul>
  4. 4. OD +1,50-0,50x90 add 1.00 OS +3,50-1,50x100 add 1.00 <ul><li>+1,50 </li></ul><ul><li>+3,50 </li></ul>15mm 15mm Vertical Anisophoria: 3,00 Δ base up P=d(cm)xD
  5. 5. Anisometropia <ul><li>Main Therapeutic considerations </li></ul><ul><li>History </li></ul><ul><li>- nature of anisometropia </li></ul><ul><li>- time of correction </li></ul><ul><li>- level of correction </li></ul><ul><li>Binocular level </li></ul><ul><li>- Best VA </li></ul><ul><li>- Degree of fusion </li></ul>
  6. 6. Anisometropia <ul><li>Main Therapeutic considerations </li></ul><ul><li>Poor BV </li></ul><ul><li>- Essentially monocular status </li></ul><ul><li>- Don’t rock the boat </li></ul><ul><li>- Usual fitting process </li></ul><ul><li>PL indicated! </li></ul>
  7. 7. Anisometropia <ul><li>Main Therapeutic considerations </li></ul><ul><li>Good BV </li></ul><ul><li>- Refraction </li></ul><ul><li>- Acceptable Rx Δ </li></ul><ul><li>- Avoid under Add </li></ul><ul><li>- Unequal Adds </li></ul>
  8. 8. Anisometropia <ul><li>Main Therapeutic considerations </li></ul><ul><li>Good BV </li></ul><ul><li>- Trial Rx: potential effects of Rx </li></ul><ul><li>- Comfort at near </li></ul><ul><li>- Symptoms </li></ul><ul><li>- Vertical fusion (level and capacity) </li></ul><ul><li>- Motivation </li></ul>
  9. 9. Anisometropia <ul><li>Main Therapeutic considerations </li></ul><ul><li>Good BV </li></ul><ul><li>- Lens consideration </li></ul><ul><li>- Short progression, who has problem dealing with Δ effect </li></ul><ul><li>- Long progression, who has no problem with Δ effect </li></ul><ul><li>- Base curves </li></ul><ul><li>- Degressives (Interviews) </li></ul>
  10. 10. Thinning Prism 15mm 15mm OD Plano ADD 1,25 OS +1,50 ADD 1,25 OD Plano ADD 1,25 OS – 2,75 ADD 1,25 Low Δ differential High Δ differential
  11. 11. Statistics <ul><li>41 patient: </li></ul><ul><li>21 total success </li></ul><ul><li>6 PL daily; preferred readers near </li></ul><ul><li>7 intolerance </li></ul><ul><li>7 failed pre-test </li></ul>
  12. 12. References <ul><li>Based on Varilux University course 04.2009. Progressive Lenses Prescribing in Special Cases. </li></ul>
  13. 13. <ul><li>Thank you </li></ul>

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