correction of anisometropia with - optometry...
TRANSCRIPT
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 1
CORRECTION OFANISOMETROPIA WITH
GLASSES AND CONTACT LENSES
DIPL.-ING.(FH) GUSTAV PÖLTNER, LECT.
VDC/O, ECOO
CL- INSTITUT – MILLER – INNSBRUCK / AUSTRIA
FH-GESUNDHEIT-TIROL – INNSBRUCK / AUSTRIA
HTL-KOLLEG-OPTOMETRIE, HALL IN TIROL / AUSTRIA
UNIVERSITY OF APPLIED SCIENCES – VELIKA GORICA / CROATIA
• Aniseikonia – measuring- andcorrektion methods
• Procedure after Gernet
• Centration of prismatic lenses
• Centration of of reading glasses withvertical Anisometropia
• Macropsy glasses2Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
ANISEIKONIA
ANISEIKONIA
• Ikone: picture
• Iso: similar
• Iseikonie: similar - picture
• Aniseikonia: disparate picture
• Anisometropie: Refractive difference
3Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Bild: Hakentest /Aniseikoniatest ohne Vergrößerungsdifferenz
Bild: Hakentest /Aniseikoniatest mit 7% Vergrößerungsdifferenz
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 2
• Optical AniseikoniaDifference in the retinal picture size of both eyes
Difference in the eye lenght
Refractive differnece of the optical medias
• Retinal or anatomical AniseikoniaVariation of the different raster structure of both Retinas
• Functional AniseikoniaSensoric caused Aniseikonia
Disparate correspondence
Cortical and retinal compensation mechanism – to prevent Diplopia4Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
ANISEIKONIA
Figure 4 uncorrected pair of eyes
OD: -1,50 sph = -1,50 cyl 10°, OS -19,50 sph = -1,0 cyl 180°
25,16 mm
H H´
OD
32,54 mm
H H´OS
5Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Figure Corrected with glasses
OD: -1,50 sph = -1,50 cyl 10°, OS -19,50 sph = -1,0 cyl 180°Calculated Aniseikonia 32,9%
32,54 mm
25,16 mm
OD
H H´
OSH H´
glasses - full correction
6Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 3
CONSEQUENCES OF THE ANISEIKONIA
• Aniseikonia disturbes the stereoptic view
• Aniseikonia disturbes the sensoric vision
• Aniseikonia generates motoric defective positions
• Horror fusionis
7Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
ANISEIKONIA
• < 1% measurably, but not appreciable
• 1% - 5% Incidence of the stereoptical view. Diplopia possible but not ever appreciable
• >6% maintains ever to incidence the binocular vision
8Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
ANISOMETROPIE• Isometropie = Status of the same distance refraction [5]
• DIN EN ISO 29187 „Disparate power of the two eyes with a difference of 2 dpt“
• Anisometropic difference: [5] ΔS´= S´2 – S´1
Anisometric difference (S´2 = mathematical vertex power of the stronger lens)
• Anisometropic difference - frequency (n=690) [6]
<1,00 dpt 91,2%
1,0 – 1,75 dpt 5,2%
2,0 – 2,75 dpt 2,0%
>3,00 dpt 1,6%9
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 4
ANISOMETROPIE
• Refractive difference
• axial anisometropia
• refractive anisometropia
10Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
11
ANISOMETROPIE / MERKSATZ:
• If the picture size of the more myopic eye is more big, do we have an predominant axial aniseikonia. – Has the more
myopic – or not so much hyperopic eye the smallerpicture size, do we have an predominant refractive
aniseikonia.
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Aniseikonia test with 8,5% picture size difference
12Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 5
ANISEIKONIA-QUOTIENT
15
AQ=1 + e * ARr
1 + e * ARl*
Ir
Il
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
AQ = Aniseikonia - quotiente = vertex distance (fill in in meters)ARr= Refraktive power ODARl= Refraktive power OSIr = length of the right eyeIl = length of the left eye
ANISEIKONIA-QUOTIENT
• Vs = 1 + e * Ar
• e = S´ to P (Gullstrand) = 1.348 mm bei Cl
• e = S´ to P (Tamajo) = 1.50 mm bei Cl
• e = S´ to P+Vertex Distance = 13.50 mm glasses (vd 12mm)
16Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
CONSEQUENCES FOR THE CLINICAL PRACTICE
• Axial anisometropia
• Refractive anisometropia
17
AQ=
AQ=1 + e * ARr
1 + 0 * ARr
1 + e * ARl
1 + 0 * ARl
glasses: AQ unequal 1
Cl: vertex distance nearly 0, retinalpicture size nearly equal
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 6
CONSEQUENCES FOR THE CLINICAL PRACTICE
• Axial anisometropia with glasses
• Refractive anisometropia with contact lenses
18Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Exampel:OD = -6,00 dptOS = -2,00 dptVertex distance = 13,0 mm
AQ=1 + 0,0145 * -6,00
1 + 0,0145 * -2,00= 0,940 = 1 - 0,94 = 6% difference
AQ=1 + 0,0015 * -6,00
1 + 0,0015 * -2,00= 0,9938 = 1 - 0,9938 = 0,0062% difference
25,16 mm
H H´
OD
32,54 mm
H H´OS
Figure : axial aniseikonia, corrected with contact lenses
OD: -1,50 sph = -1,50 cyl 10°, OS -19,50 sph = -1,0 cyl 180°OD Galifa 7,50 / -2,50 / 9,8 / Ne 0,6 / Alberta Vcc.: 1,0
OS Galifa 7,45 / -16,25 / 9,8 / Ne 0,4 / Alberta Vcc.: 0,6
19Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
• Anisometropia
• Measuring methods
• Options for correction
23Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 7
MEASURING METHODS OF ANISOMETROPIA
• Estimate at Hook-test / Aniseikonia-test
• Optical picture size assimilation with iseiconic glasses
• Mathematical method
• Phases contrast haploscop
• Variable magnification changer after Miller
• Compuvist, Visucat, Multivisus electronical picturesize assimilation. Result is in % percent picture sizedifference
• Different Eiconometers
24Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Bild des Hakentest mit 8,5% Größendifferenz. Originaleinstellung des Hakentest
25Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
• Anisometropia
• Measuring methods
• Options for correction
26Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 8
ANISOMETROPIA CORRECTION
• 1. Iseiconic glasses
• 2. different base radii
• 3. different optical indeci
• 4. differnet vertex deepnesses
• 5. Combination out of 1,2,3,4
• Contact lenses RGP / soft
• Procedure after Gernet
27Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
ANISEIKONIA GLASSES FOR LENGH ANISOMETROPIA
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 28
Figure test glasses with different vertex deepnesses
ANISEIKONIA GLASSES FOR LENGH ANISOMETROPIA
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
29Figure Iseiconic glasses with 4% bzw. 6% magnification
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 9
Figure Full correction with glasses
OD: -1,50 sph = -1,50 cyl 10°, OS -19,50 sph = -1,0 cyl 180°Calculated Aniseikonia 32,9%
32,54 mm
25,16 mm
OD
H H´
OSH H´
Full correction with glasses
30Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Figure Iseiconic glasses with different vertex distances
OD: -1,50 sph = -1,50 cyl 10°, OS -19,50 sph = -1,0 cyl 180°
32,54 mm
25,16 mm
OD
H H´
OSH H´
Iseiconic glasses with different vertex distances
31Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
25,16 mm
H H´
OD
32,54 mm
H H´OS
Figure 18 Correction with contact lenses and after IOL-OP
OD BIAS / Hecht 7,60 / -1,25 / 9,6 / Ne 0,6 / BoES Vcc.: 1,0
OS BIAS / Hecht 7,45 / -0,25 / 9,6 / Ne 0,6 / BoES Vcc.: 0,6
Correction with contact lenses
32Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 10
25,16 mm
H H´
OD
32,54 mm
H H´OS
Figure 19 Correction with contact lenses and after IOL-OP
OD BIAS / Hecht 7,60 / -1,25 / 9,6 / Ne 0,6 / BoES Vcc.: 1,0
OS BIAS / Hecht 7,45 / +5,50/ 9,6 / Ne 0,6 / BoES Vcc.: 0,6
Mono vision
33Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Revers Gallilei-System to reduce the magnification on one side
25,16 mm
32,54 mm
OS
Figure 20 Correction with glasses and contact lenses and after IOL-OP
OD: -1,50 sph = -1,50 cyl 10° Achse Vcc.: 1,0
OS: Meine 6 / 8,6 / +6,5 / 14,0 Soft lens = Objektiv of the revers Galilei-system
Left-glas = Ocular -7,00 sph = -1,00 cyl 140° Achse Vcc.: 0,6
OD
H H´
H H´
34Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
• Aniseikonia – measuring- andcorrektion methods
• Procedure after Gernet
• Centration of prismatic lenses
• Centration of of reading glasses withvertical Anisometropia
• Macropsy glasses35Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
ANISEIKONIA
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 11
PROCEDURE AFTER GERNET• Aphakia – Special procedure for system anisometropia
• Combination out of contact lenses and glasses
Cl.: Over correction with +4.0 dpt
Glasses: Minus glas with - 4.0 dpt
Refractive main line change with an revers Gallilei system
36Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
37
Procedure after GernetH H´
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
38
Procedure after GernetH H´
H H´
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 12
39
Procedure after GernetH H´
H H´
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
40
Procedure after GernetH H´
H H´
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
41
Procedure after GernetCase study
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 13
42
Procedure after GernetCase study
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 43
OD CL-RGP = 7,55 /+23,75 / 9,6 / 0,6 / Bo xo2
-4,75 2,50 cm/m B 90° 2,25 cm/m B 0°
OS -5,25 -0,75 160° 3,75 cm/m B 270° 2,25 cm/m B 180°
Addition:
OD +2,50 dpt
OS +1.25 dpt (= 1,25 cm/m B 270° )
44
Procedure after GernetCase study
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 14
• Aniseikonia – measuring- andcorrektion methods
• Procedure after Gernet
• Centration of prismatic lenses
• Centration of of reading glasses withvertical Anisometropia
• Macropsy glasses45Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
ANISEIKONIA
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 46
DIE MESSUNGEN DER WINKELFEHLSICHTIGKEIT
Messglasses – OS mit und OD ohne Polfiltern
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
47
MEASURING FRAME – TESTING GLASSES
0.5 cm/m Divergence
1.0 cm/m Konvergence
0.5 cm/m vertical difference
0.50
0.25
0.250.25
0.25 DIN EN ISO 29187RAL-RG 915
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 15
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
49
Base of deviation
„normal“ situation intest-frames
In the Phoroptersin „normal glasses“ (by correct centered PD)
Maximum od deviation
Wrong centered glasses (PD-mistake)Uncorrect inclination
Prisma only on one side
Minimum of deviation
glasses after PD correction
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 50
Rays must run in theminimum of deviation
PD correction
1 mm per 4 cm/m
decentration
against the prism
base
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
52
PUT IN THE PRISM GLASSES IN THE BASE DEVIATION ONLY
Base deviation
Measuring glasses(the letters and the
numbers must be seen)
OD corret OS uncorrect!
Measuring glasses in the base deviation–Base outside
Measuring glasses in the base deviation–Base intside
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 16
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
53
CORRECT PRISM GLASSES MUST BE ALLWAYS USED IN THE BASE DEVIATION
Messgläser immer mit dem Fähnchen bzw. der Beschriftung nach vorne (sichtbar) einsetzen.
• Aniseikonia – measuring- andcorrektion methods
• Procedure after Gernet
• Centration of prismatic lenses
• Centration of of reading glasses withvertical Anisometropia
• Macropsy glasses54Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
ANISEIKONIA
55
Reading glas centration byAnisometropia (Methode from Wolf)[8]
Multifical lenses have a vertical compensation prism (slab-off-Prisma)
Monofocal reading glassesCorrect centration of the hightCorrect vertical prism
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 17
56
Augendrehpunktsforderung
Z´OB
ZB
OB Nulldurchblickspunkt
ZB Zentrierpunkt
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
57
Vertical prism by standardnear-glas-centration
Z´
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
58
Different vertical prism powers bystandard near-glas-centration
Z´ OD
Z´ OS
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 18
59
CASE STUDY „+PLUS“
OD +3.25 sph = -0.50 cyl 0° A
OS +3.75 sph = -2.75 cyl 180° A
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
60
Case study „+Plus“
HBN
ZB
y VP
HBN = Hight of the near-view-point y = Hight of the standard centration for the long distance (ZB) VP = Vertical prism
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie(A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
61
Case study „+Plus“
OD +3.25 sph = -0.50 cyl 0° AOS +3.75 sph = -2.75 cyl 180° A
Y = 26 mmHBN = 16 mmDiff = 10 mm
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 19
62
Case study „+Plus“
OD +2.75 sph = +0.50 cyl 90° AOS +1.00 sph = +2.75 cyl 90° A
P = S`90 * cP = (+2.75 - 1.00) * 1P = 1.75 cm/m
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
63
Case study „+Plus“
OD +3.25 sph = -0.50 cyl 0° A 1.75 cm/m B 90°OS +3.75 sph = -2.75 cyl 180° A
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
64
Case study „+Plus“
HBN
ZB
HBN = Hight of the near-view-point y = Hight of the standard centration for the long distance (ZB) VP = Vertical prism
OD +3.25 sph = -0.50 cyl 0° A 1.75 cm/m B 90°OS +3.75 sph = -2.75 cyl 180° A
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /InstitutMiller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 20
65
Correct near-glas-centration to get the same prismatic power in the vertical meridian
Z´ OD
Z´ OS
OD +3.25 sph = -0.50 cyl 0° A 1.75 cm/m B 90°
OS +3.75 sph = -2.75 cyl 180° A
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
66
CASE STUDY „- MINUS“
OD -3.50 sph = -0.50 cyl 0°
OS -4.25 sph = -2.25 cyl 175°
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
67
Differnt vertical prismatic powers by standard near glas centration
Z´ OD
Z´ OS
R -3.50 sph = -0.50 cyl 0°
L -4.25 sph = -2.25 cyl 175° A
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 21
68
Case Study „- Minus“
HBN
ZB
y VP
HBN = Hight of the near-view-point y = Hight of the standard centration for the long distance (ZB) VP = Vertical prism
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
69
Case Study „- Minus“
OD -3.50 sph = -0.50 cyl 0°OS -4.25 sph = -2.25 cyl 175°
Y = 26 mmHBN = 16 mmDiff = 10 mm
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
70
Case Study „- Minus“
OD -4.00 sph = +0.50 cyl 90°OS -6.50 sph = +2.25 cyl 85°
P = S`90 * cP = (-3.00 - -5.5) * 1P = 2.5 cm/m
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 22
71
Case Study „- Minus“
OD -3.50 sph = -0.50 cyl 0° 2.5 cm/m B 270°OS -4.25 sph = -2.25 cyl 175°
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
72
Equal vertical prism power by correct standard near glas centration
Z´ OD
Z´ OS
OD -3.50 sph = -0.50 cyl 0° 2.5 cm/m B 270°
OS -4.25 sph = -2.25 cyl 175° A
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
• Aniseikonia – measuring- andcorrektion methods
• Procedure after Gernet
• Centration of prismatic lenses
• Centration of of reading glasses withvertical Anisometropia
• Macropsy glasses73Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
ANISEIKONIA
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 23
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 74
Macropsy glasses
Macropsy:
Psychologic „tele-effect“ by the view in the longdistance only
Function only by parallel eye position
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
75
Macropsy glasses for the near distance
Macropsy-reading glasses:
The parallel eye position weget with 6 cm/m prismwith base inside on botheyes
In combination with addition+2,50 dpt
Optional in combination
with passfilters
6 cm/m Base inside+2,50 dpt
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 81
MACROPSY GLASSES
Measuring frame with Macropsy prismBino 6 cm/m base inside
Gustav Pöltner (c) OCCSEE 2016 14.04.2016
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A) 24
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)
82
MACROPSY GLASSES
Measuring frame with Macropsy prismBino 6 cm/m base inside
+2,5 dpt additionPass-filter 450 nm
Measuring frame with Macropsy prismBino 6 cm/m base inside
Pass-filter 450 nm bzw. 527 nm
83
[1] Diepes, H.; / Refraktionsbestimmung[2] Stollenwerk, G.; Anisometropie: glasses oder Kontaktlinse?, Teil 1 DOZ 03/2013 DOZ-Verlag Heidelberg 2013[3] Stollenwerk, G.; Anisometropie: glasses oder Kontaktlinse?, Teil 2 DOZ 04/2013 DOZ-Verlag Heidelberg 2013[4] Pöltner, G.; Schulskriptum REFL2, HTL-Optometrie / Hall[5] Goersch, H.; Wörterbuch der Optometrie. 3. Aufl. DOZ Verlag Heidelberg 2004[6] Trotter, J.; Refraktionsbestimmung und Gläserauswahl bei Anisometropie. Sonderdruck der WVAO 1967;17:87-95 [7] Fahrner, D.; / Schulskripten[8] Wolf T. Höhenzentrierung von Nahglasses bei Anisometropie; DOZ 9/87[9] Duden, Das Wörterbuch medizinischer Fachausdrücke
Literatur:
Gustav Pöltner (c) OCCSEE 2016 / HTL-Kolleg-Optometrie (A) / VVG (HR) / FHG-Tirol (A) /Institut Miller (A)