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Astigmatism
Astigmatism is the most common refractive problem. It is a vision problem that causes objects to appear distorted and blurry. It often affects both distance and near vision. It is the most common vision problem and it may occur with nearsightedness and farsightedness.
Astigmatism
Astigmatism is mostly caused by the cornea having an oblong shape, like a football, instead of spherical shape, like a basketball. A cornea with astigmatism has two curves, one flat curve and one that is steep. Light is then focused at two points instead of one. One point of focus may be in front of the retina and the other behind. This causes images to appear distorted in addition to appearing blurry. Astigmatism may also be caused by an irregularly shaped crystalline lens. This condition is termed "lenticular astigmatism."
More then 40.0% of the population has astigmatism of more than 0.75DS
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Combination cylinder
Back toric lens is recommend to correct this type of cylinder. Front toric is a limited choice
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Size
Up to -1.00DC Any Up to -2.50DC Up to -2.75DC
Back toric lens Prism ballast stabilization Large range of parameters Superb comfort High reproducible rate Excellent visual acuity
NO 1
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Foz = 8.7
Lens mark
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Back toric
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Up thin Down thick
Force the lens Force the back Force the lens down by gravity toric structure down in each to fit the corneal blink astigmatism
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Lens Parameters:
Base Curve Range: Diameter: Sphere Power Range: Cylinder Power: Axis: Effective Optic Zone: 8.1 , 8.4 , 8.7 , 9.0 , 9.3 13.5 , 14.50 , 15.0 mm ANY ANY ANY 9.00 mm
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Extreme comfort
Water retention Low modulus Deposit resistance Durability Increased moisture during wear
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Extreme comfort
High Oxygen permeability Water retention Low modulus Deposit resistance Durability Increased moisture during wear
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Fitting Procedure:
Patient History along with Normal Slit Lamp Evaluation for C/L Corneal / topography measurements Rh/axis , Rv evaluate the type of the cylinder: Corneal, Lenticular or Combination Back toric design works the best where most of the cyl. is corneal. Base curve : Kflat + 0.8 to 1.0mm for the Toric Lite / Trios Kflat + 0.5 to 0.7mm for the SHToric Spectacle Rx
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Correction for the back vertex for the sphere and for the cyl. For hyperops, add +0.25DS to the sphere For accurate results, when fitting hi-myopes or hi-hyperops cases, it is recommend to fit first one day disposable lens with the closest sphere power (B.V.P) and then to do over refraction
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Fitting Example:
Rh= 7.94 (42.50DS) Rv= 7.42 (45.60DS) 42.50 / 45.60 X 165o Rx= -6.25/-3.00x165o Order 7.94+1.0 = 8.94 B.C. = 9.0mm the cyl is corneal. -5.75/-2.50x165o
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Troubleshooting:
When the vision is not satisfactory : 1. Re-check your fitting. 2. Over refract, and calculate Cross Cyl. and order new lens. Where lens does not stabilize - change BC Where lens rotates recalculate according to the L A R S rule
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The L A R S Rule:
Left Add Right Subtract
Left Movement
Right Movement
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Fitting Tips:
The lens can mask axis error up to 8o Order diameter 13.5 / 15.0 when cornea has small / big diameter or according the eye lids space
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Lens Parameters:
Base Curve Range: Diameter: Sphere Power Range: Cylinder Power: Axis: Effective Optic Zone: 7.6 to 9.0 @ 0.2mm steps 13.5 , 14.50 , 15.0 mm ANY 0.25 to -2.75 @ 0.25D steps ANY 9.00 mm
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Lens Care
Daily cleaning Daily disinfecting
with proprietary brands of: - hydrogen peroxide system - one step system - multi purpose solution system
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