for near add

[redwoodmb]

Hi, everyone,
I am a student currently taking UK examination. gratefu for any suggestion from here
-
- for near add (5 min) : we are required to answer : what history is the essential? how do you explain to the pt about the near add prescription? what is the instruction for your prescription?
and do you guys test both eyes together or one by one? in 5 min!!

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[KHE]

It is exceedingly rare that you need to do monocular add testing at near.

Regarding history, the biggest one in my opinion is the working distance. Not everyone works at 25cm. So I just give the patient an iPad and ask them to hold it where they want to hold it.

 

[Commando303]

Hi, everyone,
I am a student currently taking UK examination. gratefu for any suggestion from here
-
- for near add (5 min) : we are required to answer : what history is the essential? how do you explain to the pt about the near add prescription? what is the instruction for your prescription?
and do you guys test both eyes together or one by one? in 5 min!!

To determine ADD power, I go by age and by patient-history. That is, what is the patient's habitual correction, and what, if any, are her complaints? I also strongly consider needs, such as whether the person works extensively on a computer screen, on a tablet computer, in dim lighting, at a shooting range, in athletics, etc.

I really do not perform testing such as crossed cylinder, N.R.A./P.R.A., near acuity, etc.

With respect to patient-education, a very important aspect, especially for someone new to near correction, is explaining that she will naturally require slightly stronger power for near-vision over time, up to a limit (usually in the sixth decade of life). It's imperative to relay that wearing or not wearing of spectacle-correction will not foster "spectacle-dependence" or "worsening of vision." Trying to accomplish this retrospectively, in a patient who already has become distrustful of the situation and maybe of the practitioner, can be insurmountable.