Dispensing: Prescription analysis – Case #7

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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 #7

Habitual Rx:

Right Left
SPH Cyl AXIS PRISM BASE SPH Cyl AXIS PRISM BASE
-3.50 -1.00 90 Distance -4.00 -1.25 85
Inter
+2.00 Near +2.00

Prescriber’s comments:

  • Px is 5 years old
  • Bifocals required


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

  • How would you describe this patient?
  • Why would bifocals be dispensed for a child?
  • What type of bifocals would you dispense? Why?
  • Where would you position a child’s bifocal? Why?

Discussion

Click to reveal
  • The Px is a myopic child with early onset myopia
  • Myopic progression and the use of a reading addition should be discussed with the Px’s parents
  • The benefits of round-seg versus D-seg should also be discussed
  • Safety should be a consideration in the dispense
  • There are different considerations when fitting a bifocal to a child. A child’s bifocal should be fitted between the lower limbus and pupil centre to encourage them to use the reading portion
  • Don’t set the bifocals at the pupil centre as they may have difficulties when running around
  • It is possible to dispense a PPL to a child; they often adapt better than adults

Possible recommendations:

  • D-seg bifocals – either D35 or D45 – to ensure it covers the majority of the lens
  • E-line would have been used in the past, but these can be unsightly and bulky
  • Recommend a round frame to ensure the child looks through the lenses when looking up at the world
  • Consider a plastics frame to help disguise edge thickness

Looking for more dispensing professional development?
Registration is now open for the annual Specsavers Dispensing Conference, taking place from 4 to 9 August 2019 as a one-day roadshow-style event across Perth, Melbourne, Brisbane and Sydney.

Specsavers is currently offering 20 free conference entry passes valued at up to $380 + GST to non-Specsavers delegates – five for each city in which the conference is being held.

For your chance to win a free pass and to register for the event, contact Lucy Markus via +61 (0)429 003 379 or lucy.markus@specsavers.com

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