Exam 2 Flashcards
What is a prism?
A prism is formed by two flat surfaces inclined at an angle to one another and the image is distorted towards the apex. rays going through a prism bend towards the base but the image forms at the apex
What is the focal power of a prism?
prisms have no focal power. they deviate light but does not change its vergence
what is the angle of deviation formula?
d=a(n-1) deviating angle= apical angle(index of refraction-1)
the prism diopter formula
P= displacement in cm/ distance in meters
how does the prism diopter relate to the angle of deviation?
P=100tan d
OR
P= 100 tan [ a(n-1) ]
how does a plus ophthalmic lens behave?
like stacked prisms with their bases toward the center of the lens. so BD when you look above the midline and BU when you look below the midline.
how do minus ophthalmic lenses behave?
stacked prisms with their apex toward the center. BU when you look above the midline and BD when you look below
What prismatic effect is at the center of prism ophthalmic lenses?
there is no prismatic effect at the center
What is the prentice rule?
P=cD
P= Prism diopters
c= distance from OC in cm
D= the dioptric power of the lens in the meridian
the amount of prismatic effect an observer experiences through a particular point on a lens depends on how far the point is from the OC of the lens.
What are the possible outcomes of a prismatic effect?
When a patient is looking through any point other than the optical centers of the lens, the induced prism may have two possible effects:a. both eyes rotating the same amount and the same direction, may cause distortion.b. eyes rotates different amounts in different directions, will cause the pt discomfort (aka. Asthenopia)
What happens to the visual system when the eyes move in opposite or same direction in different amounts?
the visual system has to perform fusional vergence so they dont see double and this causes eyestrain or asthenopia.
what is a cancelling effect of prisms?
both eyes rotate the same amount in the same direction
ex: both lenses cause 3 BU so both eyes rotate down. There can be partial cancelling too. There is no fusional vergence in cancelling. Subtract the smaller prism from the larger prism, and assign the prism base direction to the
lens originally having the larger prism amount
what is the compounding effect?
the eyes rotate different amounts in different directions (leading to asthenopia). Add the two prism amounts together
What prism combinations do cancelling occur with?
BU and BU
BD and BU
BI and BO
What prism combinations do compounding occur with?
BU & BD
BI & BI
BO & BO
What are the ANSI standards?
American national standards institution sets the standards and tolerances for error in spectacles.
Vertical = 1/3 or 0.33
horizontal = 2/3 or 0.66
What is the visual perception of a unwanted BD prism?
Floor seems concave, people and objects seem taller/ skinnier and floor seems to slant uphill
What is the visual perception of a unwanted BU prism?
Floorseemsconvex
Peopleandobjectsseemshorter/fatter Floor seems to slant downhill
What is the visual perception of a unwanted BI or BO prism?
Horizontal expanses are sloped walls/ vertical expanses curve in or out
Where on the lens is Prisms prescribed?
on the PRP or MRP
For a single unmounted lens where should the prescribed prism be?
with in 1mm of the intended position or the prismatic effect must not be more than 1/3
For a mounted pair of lenses the distance between the PRPs must be what?
2.5 mm of the requested PDs. or the horizontal prisms should not total more than 2/3 prism diopters
How is the resultant prism calculated?
solve for hypotenuse of the triangleby using pythagorean theorem. P= sq(H^2 + V^2) H = BI or BO
V= BU or BD
Tan a= Opposite / adjacent
Where is angle a formed?
with the longest side of the triangle and the hypotenuse
How do we resolve a prism?
resolving prism is to put everything back into vertical and horizontal components.
V= P (sin a)
H = P (cos a)
How is obliquely crossed prisms calculated?
A = smaller base meridian
B = larger base meridian
0 = angle between base directions
tan y= B sin 0 / A+B cos 0
What is the difference between a prism diopter and a prism centrad?
a ray that is displaced 1 cm at a distance of 1 m from a prism on the arc of a circle with a 1 m radius (1 cm arc displacement) for small angles of deviation, prism centrads and prism diopters and almost equal.
Splitting horizontal prisms
both prisms should be BI or both should be BO.
ex: OD: 3 BI/ OS: 3BI = OD: 2 BI/ OS: 4BI
net effect is the same
Why would you have an uneven split between prisms?
could be because of eye dominance, improve cosmetic appearance, or to equalize lens thickness. IMPORTANT EX: magine a patient has the OD with higher minus (-5.00) and the OS with less minus (- 2.00). You might want to prescribe less prism for the OD which already has a larger edge thickness due to the prescription, and you might want to prescribe more prism for the OS which has a thinner edge thickness due to having less minus power. So you could split the prism between the two eyes so OD has less prism and OS has more prism in order to balance the thickness of the lenses
how should vertical prisms be split?
they should have opposite base directions ex: 3 BU and 3 BD = 2 BU and 4 BD
What is the risley’s prism or rotary prism?
combination of 2 prisms one on top of the other. allows for oblique crossing of prisms.
What is the clinical application of the risley’s prism?
to measure ductions and versions with the phoropter and measure high amounts of prisms in spectacles with lensmeter.
in a Risley’s prism what happens when bases and together?
combined full effect
In a Risley’s prism, what happens when bases are opposite each other with apex to base?
cancel each other out.
How does Risley’s prism work?
when 0 is at 90 meridian, you add BI or BO and when 0 is at 180, you add BU or BD
decentering
never decenter the pupil. only decenter the OC in relation to the pupil. so if OC is moved 5 mm temporally then pupil will appear to be more nasal
oblique decentration
calculate approximate power in the oblique meridian
Foblq = F sph + F cyl sino
o = meridian of interest minus axis f cyl
How much prism is the eye experiencing is the patient’s PD is equal to frame PD?
There is no decentration because pupils are looking through the OC.
How is lens thickness calculated?
P = 100g(n-1)/ d P = amount of prism g = difference in thickness between apex and base n= refractive index d = distance between apex and base.
Why is spectacle correction for anisometropia and presbyopia a problem?
it causes diplopia because the patient is no longer looking through distance OC and they have anisometropia. there will be a vertical imbalance prismatic effect while doing near work.
How do anisometropic patients adjust?
usually adapt by moving their head when looking at different distances to keep view through the OC to avoid diplopia. but when using multifocals, he cant look through the OC to read forcing him to look through neat OC.
what is Bicentric grinding or slab- off and reverse slab-off
The process used to change the amount of prism in the reading portion of the lens w/o defecting prism in the distance portion.
What is special about reverse slab off?
reverse slab-off is molded on the convex (plus side) of plastic lenses and is the exact opposite of regular slab-off. this results in added BD in the reading area. (reduces BU)
What is bicentric grinding
removing BD prism at reading level (adding BU)
What is the easiest way to treat anisometropia and presbyopia ?
using CL and reading glasses or multifocal CLs but this is contraindicated in elderly
how far below OC is a round 22?
11 mm below segment line
Ft-28 and FT- 25/ FT -38
5 mm near OC below segment line
Executive / PAL / Franklin
at the segment line
If a prism was put in the path of light with Base to the left where would you see the image?
to the left.
Prentice rule for multifocals
d= P/D x10 P = imbalance from the distance Rx at reading level D= add power of Rx d= distance needed between the segment OC s to neutralize distance induced imbalance
what is the standard test for determining impact resistance?
drop ball test
drop ball test
5/8 inch steel ball 0.56 ounce must be dropped 50 inches from floor on lens. glass lenses after edged and hardened. plastic tested uncut finished stage.
what type of glass lenses are exempted from testing after hardened?
raised multifocal prism segment multifocals slab off lenses lenticular lenses isekonic lenses
batch testing
done on plastic lenses.
what are the effects of lens coating on impact resistance
when a plastic lens is either scratch resistance coated or AR coated, the impact resistance of the lens decrease.
what are the effects of surface scratching on impact resistance
scratches reduce impact by introducing weak spot on lens. scratches on back reduce impact resistance more