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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
20222826
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OPTICIAN FOR OVER 20 YEARS AND HAVE NOT RUN INTO THIS

Customer Question

I AM A OPTICIAN FOR OVER 20 YEARS AND HAVE NOT RUN INTO THIS BEFORE. MY PATIENT BOUGHT HER FIRST DEFINITY PROGRESSIVE. HER RX IS OD +0.25 -0.25 090 OS PL -0.25 85 ADD +1.50. SHE HAS WORN FOR A FEW WEEKS AND CAN SEE WELL AND DISTANCE AND 18". SHE CAN SEE COMPUTER RANGE WELL FROM HER RIGHT EYE ONLY. HER MONO PD AND SEG HT OF GLASSES IS ALL CORRECT. IF SHE TURNS HER HEAD TOWRDS HER RIGHT SIDE LOOKING VERY TEMPORAL SHE CAN SEE BETTER AT THE COMPUTER RANGE OUT OF HER LEFT EYE. ANY IDEAS ON THE PROBLEM. SHE IS A 46YO WITH NO KNOWN MEDICAL PROBLEMS.

THANKS
DORA FITZGERALD
Submitted: 8 years ago.
Category: Eye
Expert:  Dr. James replied 8 years ago.
Thank you for the question.

To clarify, she cannot see the computer with the left eye, but can do so when looking to the far left? Is this through the reading add?
Customer: replied 8 years ago.
Hard to say for sure.. I believe she is looking through the intermediate. She can see through the reading area with both eyes. I am sending her back to her O.D. and I am wondering if a visual field test may be a good idea?
Expert:  Dr. James replied 8 years ago.
With her age, it is difficult to say how much accommodation she has. The +1.50 tells me that her OD thinks she has enough left to see intermediate well using the distance. With these types of complaints, it is always easier and usually faster to just start with a new refraction.

It is possible that the prescription may be inaccurate or not balanced with the left side possibly being over-minused. I wouldn't suspect field loss. The nerve damage would likely be advanced in that case and should have been picked up on exam, even without dilation.

Remember to press the green accept button. It was a pleasure helping you with your question. Best wishes to you.
Customer: replied 8 years ago.
She has had a second refraction and with a 0.25sph change in the OS. I guess I will just give it back to her eye doctor again and hope for a resolution. Thanks
Expert:  Dr. James replied 8 years ago.
You're welcome.

Please remember to press accept.