Dispensing: Prescription analysis – Case #5

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This case was among a series presented by Miranda Richardson FBDO, Assistant Director of Professional Examinations for the Association of British Dispensing Opticians, for peer discussion at the second Specsavers Dispensing Conference (SDC2) in August 2018.

Case #5

Habitual Rx:

Right Left
SPH Cyl AXIS PRISM BASE SPH Cyl AXIS PRISM BASE
+0.75 +0.50 120 Distance +0.50 +0.50 120
Inter
+1.50 Near +1.50

Prescriber’s comments:

  • Bifocals – artist


Looking at the above prescription, consider the following discussion points with your dispensing team:

  • What problems are there if this is a portrait painter?
  • What bifocal would you dispense and where would you position the segment?
  • What would the problems be if this was a landscape artist?
  • How would this affect your lens selection and segment position?

Discussion

Click to reveal
  • If the patient is a portrait painter, consider the following:
    • Their working distance will be room distance and near
    • They will often need to look over the top of the paper / canvas
    • The near portion will be used for drawing.
  • If the patient is a landscape artist, consider the following:
    • Their working distance will be distance and near (or possibly intermediate if painting at arm’s length)
    • The canvas will be positioned upright and the patient will need to look around their art work to review the landscape.

In both scenarios, it is important to consider how segment shape and position will impact the patient’s vision.

Possible recommendations:

  • For a portrait painter, consider:
    • A large, round segment to reduce the prismatic effect at near
    • A reading segment set high for concentrated near tasks
    • Consulting with the optometrist to explore modifying the distance Rx with a +0.50 to make it more of a room-distance lens.
  • For a landscape artist, consider:
    • An E-line bifocal to provide maximum peripheral viewing at distance and near
    • Dispensing more of an intermediate Rx in the near portion
    • Fitting the E-line on its side to reduce sideways head movements for the artist and provide clear vision to the top and bottom of the canvas.


More in the Prescription Analysis series
Case #1 and series introduction
Case #2
Case #3
Case #4
Case #5
Case #6
Case #7
Case #8

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