Prescribing Considerations And Case Studies

Question 1

The process of prescribing is not only measurement, but

Answer 1

Problem solving

Question 2

Goal is to prescribe a treatment

Answer 2

That satisfies the individual patients visual needs

Pilot vs athlete, know what they do on a day to day basis

Question 3

What are some things you should do before you write a spectacle prescription

Answer 3

• show patient what you plan to give
• if patient is currently wearing glasses, ask them to compare what has just been measured to their glasses-the measurement in the phoropter versus their glasses

Question 4

Factors to consider when changing a prescription

Answer 4

• does pt report difficulty functioning with their present glasses
• magnitude and type of measured change
• do they want new glasses bc of scratches or to get new frame?
• how long the patient has been wearing the present glasses
• cost

Question 5

Importance of trial run

Answer 5

Put the contemplated prescription in a trial frame and have the patient take a short walk before writing the prescription. Walking with the Rx is more likely to identify a problem.

Question 6

When should a trial run be done?

Answer 6

• large change in sphere
• change in cylinder power or axis
• first pair of glasses
• cyl is being prescribed for the first time
• amount of change cant be determined bc they forgot glasses
• any other concern about the new Rx

Question 7

What are a couple myths about getting used to eye glasses?

Answer 7

• you should wear the glasses all the time, if you don’t, you are straining your eyes
• don’t start wearing glasses because your eyes will become weak and dependent upon them

Neither are correct

Question 8

What do you always want to work towards when RXing optical correction

Answer 8

Work towards full correction, however the final choice must be tempered by the clinicians expectations and the patients tolerance

Question 9

General RXing cautions

Answer 9

• avoid increasing subjective symptoms
• avoid large optical changes
• avoid poorly designed lenses and frames
• avoid ineffective communication

Question 10

What is the goal when Rxing for patients?

Answer 10

Single, clear, comfortable, binocular vision and to reduce accommodative demand

Question 11

When RXing each patient should be considered in terms of

Answer 11

• age
• degree of symptoms
• VA
• bino function
• efficiency during the performance of visual tasks
• presence of astig or anisometropia
• previous specs

Question 12

A 37 y/o with a single vision hyperopic correction in their glasses is seeing well at distance, but is having difficulty reading

Answer 12

Weren’t corrected enough. Using accommodation too much. Do cyclo to see how much latent hyperopia is there

Question 13

A 50 y/o who is successfully using OTC reading glasses is now beginning to have trouble with distance vision. Why, and what might you recommend

Answer 13

Uncorrected hyperope. Was using accommodation, but cant overcome now, turned into absolute hyperope. Bifocals needed

Question 14

A 6y/o patient is examined and found to have a refractive error of +1.25 in each eye. Should glasses be given?

Answer 14

Make sure no ablyopia or strabismus, otherwise no RX, just monitor. Will be emmetropizing

Question 15

37 y/o myope seeing well at distance with their glasses is having trouble reading

Answer 15

Overminused, educate them about taking minus away from them

Question 16

55 y/o high myope presents for routine exam. You determine that they do not need a change in glasses and that their eyes are in excellent health. When discussing those results, what she’s should you tell them?

Answer 16

Back up specs.
New frames
Tell them about signs/symptoms of RD

Question 17

30 y/o patient who has never worn glasses is examined and found to have a small amount of myopia. The patient says they do not feel they need distance glasses. Should you RX them?

Answer 17

Let them try a trial frame and make decision. Educate and document

Question 18

35 y/o wearing glasses for myopia is examined and you measure a very slight increase in their myopic correction. Should you make it?

Answer 18

Do trial and let them decide

Educate and document

Question 19

55 y/o patient for whom you perform a meticulous refraction two weeks ago, calls on the phone and says, ‘the new glasses you gave me ar not good. I cant see well with them.” What should you do?

Answer 19

Show them difference of RX
Make sure they are made correctly
Check Rx, PD, BC
Recheck refraction if the rest is correct