Lenspowermeasurement 121007031943-phpapp02
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Transcript of Lenspowermeasurement 121007031943-phpapp02
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Lens Power Lens Power MeasurementMeasurement
Walter Huang, ODWalter Huang, OD
Yuanpei UniversityYuanpei University
Department of OptometryDepartment of Optometry
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Methods of Lens Power Methods of Lens Power MeasurementMeasurement
Trial lens hand neutralizationTrial lens hand neutralization
LensometerLensometer Much greater accuracy may be obtained with Much greater accuracy may be obtained with
the lensometer than with trial lens hand the lensometer than with trial lens hand neutralizationneutralization
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
Two lenses neutralize each other when Two lenses neutralize each other when placed in contact with each other so that placed in contact with each other so that the combined power of the two lenses is the combined power of the two lenses is equal to zeroequal to zero
An unknown lens is neutralized by a An unknown lens is neutralized by a known trial lens of equal power but known trial lens of equal power but opposite in signopposite in sign
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
This is performed in the absence of a This is performed in the absence of a lensometerlensometerIt is used qualitatively as a means for It is used qualitatively as a means for estimation in many clinical and dispensing estimation in many clinical and dispensing situationssituationsIt often involves simply identifying if it is a It often involves simply identifying if it is a plus, a minus, or a toric lensplus, a minus, or a toric lensIt more accurately estimates low power It more accurately estimates low power plus and minus lenses than toric lensesplus and minus lenses than toric lenses
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
It is used to measure the It is used to measure the front vertex front vertex power power of the lensof the lens
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
View a large distant cross target through View a large distant cross target through the lensthe lensHold lens on visual axis, at arm’s distanceHold lens on visual axis, at arm’s distanceAlign lens such that the cross target is Align lens such that the cross target is continuouscontinuousMove lens vertically, observe motion of Move lens vertically, observe motion of horizontal linehorizontal lineMove lens horizontally, observe motion of Move lens horizontally, observe motion of vertical linevertical line
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
For a plus or a minus lens, linear motion is For a plus or a minus lens, linear motion is used to neutralize power used to neutralize power If observe “against motion,” use plus lensIf observe “against motion,” use plus lens If observe “with motion,” use minus lensIf observe “with motion,” use minus lens
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
For a plus or a minus lens, linear motion is For a plus or a minus lens, linear motion is used to neutralize powerused to neutralize power
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
For a toric lens, rotational motion is used For a toric lens, rotational motion is used to find the axisto find the axis If observe “against motion,” use plus cylinder If observe “against motion,” use plus cylinder
axisaxis If observe “with motion,” use minus cylinder If observe “with motion,” use minus cylinder
axisaxis
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
For a toric lens, rotational motion is used to find For a toric lens, rotational motion is used to find the axisthe axis
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
Place known trial lens against front surface of Place known trial lens against front surface of unknown lensunknown lens
No movement indicates neutralityNo movement indicates neutrality
A minus or plus lens (i.e., a spherical lens) has A minus or plus lens (i.e., a spherical lens) has the same speed and direction of motion in both the same speed and direction of motion in both the vertical and horizontal meridiansthe vertical and horizontal meridians
In the case of a toric lens (i.e., spherocylindrical In the case of a toric lens (i.e., spherocylindrical lens), neutralize one limb of the cross target at a lens), neutralize one limb of the cross target at a timetime
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
ExampleExample An unknown lens is neutralized in the An unknown lens is neutralized in the
horizontal meridian with +3.00D and the horizontal meridian with +3.00D and the vertical meridian with +2.00Dvertical meridian with +2.00D
Prescription of unknown lens:Prescription of unknown lens:+3.00 -1.00 x 180+3.00 -1.00 x 180
Power cross:Power cross:
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
Large distant cross target Large distant cross target
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
Plus lensPlus lens
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
Minus lensMinus lens
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Trial Lens Hand NeutralizationTrial Lens Hand Neutralization
Toric lensToric lens
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LensometryLensometry
DefinitionDefinition ““Lenso” = lensLenso” = lens ““metry” = measurement ofmetry” = measurement of
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LensometerLensometer
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Lensometer PurposeLensometer Purpose
NeutralizingNeutralizing a pair of glasses a pair of glasses To determine the prescriptionTo determine the prescription
VerifyingVerifying a pair of glasses a pair of glasses To confirm the accuracy of fabricated glassesTo confirm the accuracy of fabricated glasses
DuplicatingDuplicating a pair of glasses a pair of glasses To determine the prescription, and the lab To determine the prescription, and the lab
duplicates the exact prescriptionduplicates the exact prescription
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LensometerLensometer
It is used to measure the It is used to measure the back vertex back vertex powerpower or or front vertex power front vertex power of the lensof the lens
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LensometerLensometer
To find the back vertex power, place the To find the back vertex power, place the concave side of lens against lens stopconcave side of lens against lens stop
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LensometerLensometer
To find the front vertex power, place the To find the front vertex power, place the convex side of lens against lens stopconvex side of lens against lens stop
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LensometerLensometer
In the case that the lens is a sphero-In the case that the lens is a sphero-cylindrical prescription, the lensometer is cylindrical prescription, the lensometer is used to determine the cylinder axis used to determine the cylinder axis
It is used to locate the optical center of the It is used to locate the optical center of the lenslens
The lensometer is used to measure the The lensometer is used to measure the amount of prism in the lensamount of prism in the lens
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Lensometer SystemsLensometer Systems
Observation system (Keplerian telescope Observation system (Keplerian telescope with two plus lenses, an inverted target with two plus lenses, an inverted target image)image) Objective lensObjective lens Eyepiece (ocular lens)Eyepiece (ocular lens) Reticle (concentric circles and cross hairs Reticle (concentric circles and cross hairs
focused by eyepiece)focused by eyepiece)
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Lensometer SystemsLensometer Systems
Focusing system (Badal lens system)Focusing system (Badal lens system) Light sourceLight source Target (cross hairs)Target (cross hairs) Standard lens (+20.00D)Standard lens (+20.00D) Lens stopLens stop Power wheelPower wheel
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Lensometer SchematicLensometer Schematic
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Observation SystemObservation System
The Keplerian telescope consists of an The Keplerian telescope consists of an objective lens, an eyepiece, and a reticleobjective lens, an eyepiece, and a reticleThe two plus lenses are positioned so that The two plus lenses are positioned so that their two focal points coincide with each their two focal points coincide with each otherotherThe unknown lens whose power is to be The unknown lens whose power is to be measured or neutralized is positioned at measured or neutralized is positioned at the lens stop (the location of the the lens stop (the location of the secondary focal plane of the standard secondary focal plane of the standard lens)lens)
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Lensometer OperationLensometer Operation
With the instrument set at zero, an With the instrument set at zero, an illuminated target (light source) is illuminated target (light source) is positioned at the focal length of a plus lens positioned at the focal length of a plus lens (standard lens) usually a +20.00D lens(standard lens) usually a +20.00D lens
Diverging rays of light from the illuminated Diverging rays of light from the illuminated target are bent by the standard lens and target are bent by the standard lens and parallel light emerges from focusing parallel light emerges from focusing system into the observation system, which system into the observation system, which is viewed through the telescope by the is viewed through the telescope by the observerobserver
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Lensometer OperationLensometer Operation
When the lens of unknown power is When the lens of unknown power is introduced, the image of the illuminated introduced, the image of the illuminated target is thrown out of focustarget is thrown out of focus
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Lensometer OperationLensometer Operation
The target is movableThe target is movable
By moving the target closer to or farther By moving the target closer to or farther from the standard lens, the refractive from the standard lens, the refractive power of the unknown lens can be power of the unknown lens can be neutralizedneutralized Closer to standard lens for plus lens Closer to standard lens for plus lens
neutralizationneutralization Farther from standard lens for minus lens Farther from standard lens for minus lens
neutralizationneutralization
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Lensometer OperationLensometer Operation
The physical distance forward or The physical distance forward or backward that the target moves indicates backward that the target moves indicates the power of unknown lens for the the power of unknown lens for the meridian being measuredmeridian being measured
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eyepiece
Lens holder Lens stop Axis wheel
Power wheel
Lens stage
Risley prism
Lensometer AnatomyLensometer Anatomy
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LensometerLensometer
reticule
target
123
Sphere line
Cylinder lines
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LensometerLensometer
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Lensometer PreparationLensometer Preparation
Focus the eyepiece of the lensometer for Focus the eyepiece of the lensometer for the examiner’s eyethe examiner’s eye With the power wheel set on zero, turn the With the power wheel set on zero, turn the
eyepiece as far counter-clockwise as possibleeyepiece as far counter-clockwise as possible Then slowly turn it clockwise until the reticule Then slowly turn it clockwise until the reticule
first comes into sharp focusfirst comes into sharp focus
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Lens Measurement PreparationLens Measurement Preparation
Insert the spectaclesInsert the spectacles If testing a pair of glasses, always check the If testing a pair of glasses, always check the
right lens firstright lens first Place the pair of glasses in the lensometer Place the pair of glasses in the lensometer
with the ocular surface away from youwith the ocular surface away from you The lens is held in place by the lens holder The lens is held in place by the lens holder
and is held level on the lens tableand is held level on the lens table Center the lens by moving it so that the image Center the lens by moving it so that the image
of the lensometer target is aligned in the of the lensometer target is aligned in the center of the eyepiece reticlecenter of the eyepiece reticle
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Single Vision Lens Single Vision Lens MeasurementMeasurement
To measure single vision lenses, either To measure single vision lenses, either back vertex powers or front vertex powers back vertex powers or front vertex powers must be found must be found
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Single Vision Lens Single Vision Lens MeasurementMeasurement
Determine which part of the target is used Determine which part of the target is used for determining the spherical component for determining the spherical component and which part of the target is used for and which part of the target is used for determining the cylindrical componentdetermining the cylindrical componentRotate the power wheel until the lines (or Rotate the power wheel until the lines (or the spots) are in clear focusthe spots) are in clear focusIf the power is spherical, all the lines (or If the power is spherical, all the lines (or spots) will be clearspots) will be clearNote the power on the power wheelNote the power on the power wheel
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Types of TargetTypes of Target
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Single Vision Lens Single Vision Lens MeasurementMeasurement
If the spherical and cylindrical lines do not If the spherical and cylindrical lines do not come into focus at the same time, the lens come into focus at the same time, the lens has a cylindrical componenthas a cylindrical component
Rotate the power wheel until the spherical Rotate the power wheel until the spherical lines focus with the lines focus with the less minusless minus (or more (or more plus) powerplus) power
Orient the target rotation dial (axis wheel) Orient the target rotation dial (axis wheel) so that the spherical lines are perfectly so that the spherical lines are perfectly straightstraight
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Single Vision Lens Single Vision Lens MeasurementMeasurement
Read the power and record as the Read the power and record as the sphericalspherical component of the prescription component of the prescription
Focus the cylindrical lines by rotating the Focus the cylindrical lines by rotating the power wheel to power wheel to more minusmore minus (or less plus) (or less plus) power (90 degrees away)power (90 degrees away)
The difference in power between the two The difference in power between the two principal meridians is the amount of principal meridians is the amount of minus cylinder power minus cylinder power in the lensin the lens
Read the axis of the cylinder from the axis Read the axis of the cylinder from the axis wheelwheel
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Single Vision Lens Single Vision Lens MeasurementMeasurement
ExampleExample +1.00 -2.00 x 120+1.00 -2.00 x 120 Power wheel sphere settingPower wheel sphere setting
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Single Vision Lens Single Vision Lens MeasurementMeasurement
ExampleExample +1.00 -2.00 x 120+1.00 -2.00 x 120 Power wheel cylinder settingPower wheel cylinder setting
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Single Vision Lens Single Vision Lens MeasurementMeasurement
Mark the optical center (OC)Mark the optical center (OC) Make sure that the lens is centered and the Make sure that the lens is centered and the
spectacle is sitting on the lens table evenlyspectacle is sitting on the lens table evenly Use the OC marker on the lensometer to spot Use the OC marker on the lensometer to spot
the lensthe lens Three dots will be markedThree dots will be marked
The center dot marks the OCThe center dot marks the OCThe other two dots indicate the 0 to 180 horizontal The other two dots indicate the 0 to 180 horizontal lineline
Position and read the second lensPosition and read the second lens
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Single Vision Lens Single Vision Lens MeasurementMeasurement
When both lenses have been measured When both lenses have been measured and marked, measure the distance and marked, measure the distance between optical centers of the lenses between optical centers of the lenses (DBOC or geometric center distance)(DBOC or geometric center distance)
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Multifocal Lens MeasurementMultifocal Lens Measurement
To measure bifocal and trifocal lenses, To measure bifocal and trifocal lenses, front vertex powers must be foundfront vertex powers must be found This is especially true for lenses with high This is especially true for lenses with high
distance and near powersdistance and near powers Again, front vertex power is measured by Again, front vertex power is measured by
turning spectacles around with back surface turning spectacles around with back surface of the lens toward the operator (i.e., the of the lens toward the operator (i.e., the convex side of the lens against the lens stop)convex side of the lens against the lens stop)
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Multifocal Lens MeasurementMultifocal Lens Measurement
Measure the distance portion of multifocal Measure the distance portion of multifocal lenses, in the same way as with single vision lenses, in the same way as with single vision lenseslensesTurn the glasses around backward so that the Turn the glasses around backward so that the temples face the operatortemples face the operatorFind the Find the distance front vertex powerdistance front vertex powerFind the Find the near front vertex powernear front vertex powerRecord the addition power (Add), which is the Record the addition power (Add), which is the difference between the distance and near difference between the distance and near prescriptionsprescriptions
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PrismPrism
Changes direction of light going through a Changes direction of light going through a lenslens
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Prism PurposePrism Purpose
To treat a binocular vision problemTo treat a binocular vision problem
To shift the visual fieldTo shift the visual field
To improve the lens appearance through To improve the lens appearance through prism thinningprism thinning
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PrismPrism
It is often divided equally between the two It is often divided equally between the two lenses of spectacles for balance and lenses of spectacles for balance and aesthetic reasonsaesthetic reasons
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Types of PrismTypes of Prism
Horizontal prismHorizontal prism Base in (BI)Base in (BI) Base out (BO) Base out (BO)
Vertical prismVertical prism Base up (BU)Base up (BU) Base down (BD)Base down (BD)
Oblique prismOblique prism A combination of horizontal and vertical A combination of horizontal and vertical
prismsprisms
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Types of Prism and LensTypes of Prism and Lens
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Methods of Achieving Prism in Methods of Achieving Prism in LensLens
GrindingGrinding Usually applied when a large amount of prism is Usually applied when a large amount of prism is
requiredrequired Lens is custom-madeLens is custom-made Optic center is often not on lensOptic center is often not on lens
DecentrationDecentration Usually applied when a small amount of prism is Usually applied when a small amount of prism is
requiredrequired With spherical prescription, it is easier to deal with With spherical prescription, it is easier to deal with
decentering than with spherocylindrical prescriptiondecentering than with spherocylindrical prescription
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Prism MeasurementPrism Measurement
The purpose is to verify if the prescription The purpose is to verify if the prescription contains the desired prismatic effectcontains the desired prismatic effect
Verification of prism in prescription is done Verification of prism in prescription is done similarly to measurement of lens power similarly to measurement of lens power using the lensometerusing the lensometer
The only difference is in the means by The only difference is in the means by which the target is positioned in the which the target is positioned in the lensometer lensometer
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Prism SpecificationPrism Specification
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Prism VerificationPrism Verification
To verify the prescribed prism when the To verify the prescribed prism when the amount of prism is knownamount of prism is known The center of the illuminated target is The center of the illuminated target is
positioned at the location on the circular mires positioned at the location on the circular mires corresponding to the prism requiredcorresponding to the prism required
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Prism VerificationPrism Verification
Example 1:Example 1: If the right lens calls for 2 prism diopter BU, If the right lens calls for 2 prism diopter BU,
then the illuminated target would be then the illuminated target would be positioned at the “2” ring above the center of positioned at the “2” ring above the center of the miresthe mires
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Prism VerificationPrism Verification
Example 1:Example 1:
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Prism VerificationPrism Verification
Example 2:Example 2: If both lenses contain 1.5 prism diopter BO, If both lenses contain 1.5 prism diopter BO,
then the target would be placed at the 1.5 ring then the target would be placed at the 1.5 ring to the left of the center of the mires for the OD to the left of the center of the mires for the OD lens and to the right of the center of the mires lens and to the right of the center of the mires for the OS lensfor the OS lens
Mark the major reference point (MRP) with the Mark the major reference point (MRP) with the OC marker and measure the distance OC marker and measure the distance between the MRP of the lenses (i.e, the between the MRP of the lenses (i.e, the patient’s distance PD)patient’s distance PD)
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Prism VerificationPrism Verification
Example 2:Example 2:
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Prism MeasurementPrism Measurement
In an unknown lensIn an unknown lens Patient may come in with a prescription that Patient may come in with a prescription that
you are not sure if it contains prism in the you are not sure if it contains prism in the lenseslenses
After power of the lenses are neutralized and After power of the lenses are neutralized and the optic centers are marked, measure the the optic centers are marked, measure the distance between the optic centers (DBOC)distance between the optic centers (DBOC)
If DBOC does not equal to the patient’s If DBOC does not equal to the patient’s distance PD, then there is prism in the lensdistance PD, then there is prism in the lens
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Prentice’s RulePrentice’s Rule
P = d * FP = d * F P = prism power (in prism diopters)P = prism power (in prism diopters) d = decentration (in cm)d = decentration (in cm) F = refracting power of the lens (in diopters)F = refracting power of the lens (in diopters)
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Prentice’s RulePrentice’s Rule
Example:Example: Rx = -4.00DS OURx = -4.00DS OU Patient’s distance PD = 62mmPatient’s distance PD = 62mm DBOC = 72mmDBOC = 72mm P = d * F P = d * F = (72 – 62mm)/2 x 1cm/10mm * (-= (72 – 62mm)/2 x 1cm/10mm * (-
4.00D) 4.00D) = 0.5cm * (-4.00D) = 0.5cm * (-4.00D) = 2 prism diopters BI in each lens= 2 prism diopters BI in each lens
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Prentice’s RulePrentice’s Rule
Example:Example:
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RecordingRecording
Record the prescription for each lens Record the prescription for each lens separatelyseparately
Record the amount of induced prism in Record the amount of induced prism in each lens, if applicableeach lens, if applicable
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RecordingRecording
Example 1Example 1 OD -3.00DSOD -3.00DS Add +2.00Add +2.00 OS -1.50 -0.75 x 180OS -1.50 -0.75 x 180 Add +2.00Add +2.00
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RecordingRecording
Example 2Example 2 OD +2.50 -0.75 x 080OD +2.50 -0.75 x 080 2 prism diopter BI2 prism diopter BI OS +1.00 -0.25 x 110OS +1.00 -0.25 x 110 2 prism diopter BI2 prism diopter BI