Working out the kinks if any!!!

[ituryu]

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Today I had a patient coming with difficulty in reading and poor distance vision.
Now there is a resident, and today's guide was her practicing her Ret. and I take care of the subjective.
She had: +2.00-0.50x90 OU VA 6/5-2
Subjective I had +1.75DS VA 6/4
ADD: +1.00, Range of comfort 17-43cm, and N5.
Patient's age 52.
I was told that my Add was not O.K when I saw higher plus for her was not giving her a good range I hope to bring her back and do an NRA/PRA balancing, but is it a rule that the Add must be a high plus?
NB she wears reading glasses: +2.25DS which got in a free state eye exam.
Also there was a 56years old man who came with the same complainand my final Rx:
RE: +1.75-1.75x90 VA 6/4
LE: +1.00-0.50x90 VA 6/4
Add: +2.25D N5
Spatial Orientation for both patient was acceptable .
Now is there any problem with the ADDs Based on the patients' age?
My OMD seems to have a problem with this ADDs.

 

[ucbsowarrior]

Today I had a patient coming with difficulty in reading and poor distance vision.
Now there is a resident, and today's guide was her practicing her Ret. and I take care of the subjective.
She had: +2.00-0.50x90 OU VA 6/5-2
Subjective I had +1.75DS VA 6/4
ADD: +1.00, Range of comfort 17-43cm, and N5.
Patient's age 52.
I was told that my Add was not O.K when I saw higher plus for her was not giving her a good range I hope to bring her back and do an NRA/PRA balancing, but is it a rule that the Add must be a high plus?
NB she wears reading glasses: +2.25DS which got in a free state eye exam.
Also there was a 56years old man who came with the same complainand my final Rx:
RE: +1.75-1.75x90 VA 6/4
LE: +1.00-0.50x90 VA 6/4
Add: +2.25D N5
Spatial Orientation for both patient was acceptable .
Now is there any problem with the ADDs Based on the patients' age?
My OMD seems to have a problem with this ADDs.

you have not provided enough info to respond to this case.
what are the pt's functional demands? just reading? monitor?

case 1: your nra/pra balance is wrong
case 2: depends on wd

you must first find out which rx produces the subjective '0'

eye + lens = 0

prior to determining the proper add

you have too many flaws in your case.

we'll have to hold you back a year 🙂

just joking 🙁

keep practicing!

 

[ituryu]

you have not provided enough info to respond to this case.
what are the pt's functional demands? just reading? monitor?

case 1: your nra/pra balance is wrong
case 2: depends on wd

you must first find out which rx produces the subjective '0'

eye + lens = 0

prior to determining the proper add

you have too many flaws in your case.

we'll have to hold you back a year 🙂

just joking 🙁

keep practicing!

Well I always thought that the cheif complain of your patient seems to be the functionall demand, and if I am wrong, I woudl really like to learn and take that one year class from you, and I am serious about it.
I thought you make use of the NRA/PRA to refine your near Add for presbyopes?
Eye + Lens = 0 ? Please explain that one to me. And please point out all the flaws for me I want to be really safe out there.
Thanks and I really appreciate this.