OPT505 Clinical Skills: Prescription Analysis

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Questions and Answers

What type of lenses may be considered for Robert, who is presbyopic?

Only corrective lenses for astigmatism

Multifocal lenses such as PPLs or bifocals (correct)

Single vision lenses only

Only reading glasses

What is a major consideration when selecting a frame for bifocal lenses for Robert?

The patient's favorite color

Frame shape design

Sufficient room for the segment (correct)

The frame material's weight

What potential drawback should be communicated to Robert when considering bifocal lenses?

Increased weight of the lenses

Reduced peripheral vision

Limited availability of frames

The possibility of visual jump (correct)

For Robert's prescription, what is an important optical property to consider for the lenses?

Reflectance properties Signup and view all the answers

What specific axis value does Robert have in his spectacle prescription for both eyes?

90 degrees Signup and view all the answers

What should be kept in mind regarding the base curve (BC) and pupillary distances (PDs) when selecting a frame?

They should match for optimal vision Signup and view all the answers

What type of lens material might be suitable for Robert, considering his prescription and reflectance?

1.6 high index plastic Signup and view all the answers

How should the durability, comfort, and cosmetic appearance impact the dispensing plan for Robert's lenses?

They should be considered equally important for the final choice. Signup and view all the answers

What type of frame is recommended to minimize off-axis issues for high myopia prescriptions?

Rectangular frames to even out edge thickness Signup and view all the answers

Which lens material is suggested to reduce weight for prescriptions involving high myopia?

1.74 aspheric plastic Signup and view all the answers

What consideration should be taken into account to address astigmatism while dispensing lenses?

Ensuring mono PD and heights of distance Rx are met Signup and view all the answers

What lens type may help mitigate issues related to aniseikonia in a patient?

Hi-Index lenses for the more positive eye Signup and view all the answers

What is a common issue that may arise when dispensing lenses to a patient with anisometropia?

Intermittent vertical diplopia Signup and view all the answers

In managing differential prism for anisometropia, which technique is suggested?

Introducing a slab-off for the least positive eye Signup and view all the answers

Which factor should be minimized to optimize visual comfort for high myopia prescriptions?

Back vertex distance (BVD) Signup and view all the answers

For a patient with presbyopia and anisometropia at age 45, which option is an effective optical solution?

Using differential segment sizes in bifocals Signup and view all the answers

What is the likely consequence of using a round frame for a teenager with a high myopia prescription?

Increased edge thickness visibility Signup and view all the answers

Which adjustment is important when fitting lenses for a teenager with an astigmatic correction?

Ensuring accurate PD measurements are recorded Signup and view all the answers

What potential issue should be communicated to first-time wearers of multifocal lenses?

Optical jump caused by segment transition Signup and view all the answers

What is the recommended lens thickness consideration for Anita, who requires bifocal lenses?

Minimal size frame to maintain edge thickness Signup and view all the answers

Which lens type is most likely suggested for Julie based on her prescription?

D28 bifocals Signup and view all the answers

What is an important factor to consider when selecting frames for Samuel's lenses?

Size must accommodate segments for bifocals or trifocals Signup and view all the answers

What is the impact of using 1.67 or 1.74 index lenses for Julie?

Increases lens reflectance and reduces TCA (Abbe number) Signup and view all the answers

What additional accommodation is required for Samuel's lenses due to astigmatism?

Matching mono PD and heights of distance prescription Signup and view all the answers

Which option represents a common type of segment layout suitable for presbyopic patients like Anita and Julie?

C or D segment bifocals Signup and view all the answers

Which frame consideration is critical for patients wearing high-index lenses?

Frames must minimize edge thickness without compromising fit Signup and view all the answers

What could be a consequence of not properly discussing lens options with a presbyopic patient?

They may choose a less effective optical option Signup and view all the answers

What type of visual tasks would Samuel's near and distance prescriptions accommodate respectively?

Near tasks for cooking and distance tasks for driving Signup and view all the answers

In which scenario would the E style segment likely provide an advantage?

When minimizing the optical jump is critical Signup and view all the answers

What should be considered regarding the Abbe number when selecting lens indices?

Higher indices typically have lower Abbe numbers Signup and view all the answers

Which visual acuity measurement describes Julie's condition and its implications?

She has 6/5 in distance and N5 for near, indicating good vision overall Signup and view all the answers

Study Notes

OPT505 Clinical Skills and Refractive Management: Prescription Analysis

Course name: OPT505 Clinical Skills and Refractive Management: Prescription Analysis
Lecturer: Claire Wright
Institution: University of Plymouth, School of Health Professions

Core Competencies

Ability to advise on, order, and dispense the most suitable optical correction, considering durability, comfort, cosmetic appearance, age, and lifestyle.

Learning Outcomes

Analyze a spectacle prescription.
Link frame and lens knowledge to suit patient needs.
Describe frame and lens choices for diverse patients.
Develop a unique dispensing plan for each patient.

Patient Examples

Robert, 55

Right eye: +2.50 Sph, -0.75 Cyl, 90 Axis, 6/6 VA, +2.00 ADD, N5
Left eye: +3.50 Sph, -1.00 Cyl, 90 Axis, 6/6 VA, +2.00 ADD, N5

Considerations for Robert:

Presbyopic patient (around 55 years old).
Multiple options available (PPLs, bifocals, two pairs single vision lenses).
C or round segment due to hyperopia, C28 most common.
Need to ensure sufficient frame space for segment.
Thickness in the center, so a smaller frame (BC=PDs) minimizes blank size.
May consider 1.6 index or 1.67, but this will increase reflectance and TCA (Abbe number reduced), which needs to be discussed with the patient.

Anita, 50

Right eye: -4.50 Sph, -0.75 Cyl, 10 Axis, 6/5 VA, +1.75 ADD, N5, BVD 11mm
Left eye: -5.00 Sph, -1.00 Cyl, 170 Axis, 6/5 VA, +1.75 ADD, N5

Considerations for Anita:

Presbyopic patient (around 50 years old).
Multiple options available (PPLs, bifocals, two pairs single vision lenses).
C or D segment due to myopia, D28 is most likely, C least visible.
Need to advise patient about jump if first-time wearer.
Consider E-style (could reduce the issue).
Larger range of frames (need to ensure room for the segment).
Consider thicker edges, or higher index (1.6 or 1.67, but this will increase reflectance and TCA (Abbe number reduced)). This needs discussion with the patient.

Julie, 65

Right eye: -3.00 Sph, -2.50 Cyl, 135 Axis, 6/6 VA, +2.50 ADD, N5
Left eye: -4.00 Sph, -2.00 Cyl, 45 Axis, 6/6 VA, +2.50 ADD, N5

Considerations for Julie:

Presbyopic patient (around 65 years old).
Multiple options available (PPLs, bifocals, two pairs single vision lenses).
C or D segment due to myopia, D28 is most likely, C less visible.
Need to advise about the 'jump' if this is a first-time wearer, consider E style for potential reduction of the problem.
Consider larger range of frames, sufficient room for segment.
Consider thickness on the edges, or higher index.
Recommendation of 1.67 or 1.74 but this will increase the reflectance and TCA, which needs to be discussed with the patient.

Samuel, 65

Right eye: +1.00 Sph, -2.00 Cyl, 70 Axis, 6/6 VA, +2.25 Inter, -2.00 inter, +3.50 Near (70WD 50-75cm/70WD 20-35cm) N8/N5
Left eye: +1.50 Sph, -1.50 Cyl, 110 Axis, 6/6 VA, +2.75 Inter, -1.50 inter, +4.00 Near (110WD 50-75cm/110WD 20-35cm) N8/N5

Considerations for Samuel:

Trifocals/varifocals or combination of bifocals or single vision lenses.
Verify calculation of add.
Recommendation of D728 for trifocals - large range of lenses.
Need to consider the thickness on the frame and edges, for rectangular style frames(to even out thickness) or larger for higher index lenses.
CR39 suitable frame to maintain minimal edge thickness with higher index.
Need to ensure mono PD and heights of distance Rx to ensure astigmatism is fully corrected. Should use a stronger frame for steadiness.

Suleman, 15

Right eye: -10.50 Sph, -0.75 Cyl, 90 Axis, 6/6 VA
Left eye: -11.00 Sph, -1.00 Cyl, 90 Axis, 6/6 VA

Considerations for Suleman:

High myopia
No B/VD
Thick edges and lenses, minification
Limited frame and lens choices
Increase usage of 1.74 aspheric plastic lens for possible reduction in lens heaviness and size.
Need to discuss minimal edge thickness.
Need to use smaller frame for minimal decentration, and avoid rectangular frames.

Lucy, 21

Right eye: +1.50 Sph, -0.75 Cyl, 170 Axis, 6/6 VA, BVD: 11mm
Left eye: +5.00 Sph, -1.00 Cyl, 180 Axis, 6/6 VA, BVD: 11mm

Considerations for Lucy:

Aniseikonia
Larger blank size and/or aspheric lenses in the right eye or isekonnic lens.
Smallest possible B/VD as per the patient requirements.
Patient may require adaption time, discuss possible issues.
Consider differential prism, slab off(base up intro. to least pos. eye).
Possible usage of contact lenses for alternative solution.

Janice, 45

Right eye: +4.50 Sph, -0.75 Cyl, 90 Axis, 6/6 VA, +1.00 ADD
Left eye: +1.75 Sph, -1.00 Cyl, 90 Axis, 6/6 VA, +1.00 ADD
BVD 11mm

Dispensing OSCE

The OSCE assesses prescription analysis, frame choice, potential dispensing issues, dispensing knowledge, measurement of bifocal spectacles, and ordering a duplicate copy.
Part 1: 15 minutes for prescription analysis and dispensing knowledge viva.
Part 2: 20 minutes for measuring bifocal lenses (focimeter), and recording segment measurements and OCs.

Summary of Considerations (General)

British Standards for Rx, BVD, no degree signs (BS2738-3: 2004 +A1:2008).
Hypermetropic, Presbyopic, Anisometropia, Aphakia, Keratoconic.
Consider tints/coatings, and why. Lens manufacturing processes, benefits/issues associated with lens choices, frame style, material. Measurements and when, advice to patient.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on analyzing spectacle prescriptions and developing suitable optical corrections for diverse patients. This quiz covers core competencies and patient examples to enhance your dispensing skills. Ideal for students in the OPT505 course at the University of Plymouth.