Lensometry

What is Lensometry?
Lensometry is the procedure used to measure the prescription of a patient’s patient s existing eyeglass lenses or the power of contact lenses. Although some people t tl Alth h l refer to this as neutralization, this is technically incorrect. The term pp py neutralization applies to retinoscopy.

Lensometry measures four principal properties of lenses:
• Spherical and cylindrical p p y power in diopters • A i if cylindrical Axis, li d i l • Prism amount and direction if Prism, direction, any • Optical centers

How is Lensometry performed?
Lensometry is performed with a specialized instrument know as a lensometer.
Manual Lensometer

Automated Lensometer

Types of Lensometers
• Lensometers may be either manual or automated automated. There are several manufacturers for each. • To perform manual lensometry, the operator should lensometry have a thorough understanding of lensometry as well as optical principles principles. • Performing automated lensometry requires very little kill k littl skill or knowledge of optics. l d f ti • Automated lensometry may be quicker to perform but in most cases the instrument is more expensive to purchase than a manual lensometer.

Performing Manual Lensometry
Although most manual lensometers look p , similar despite a different brand name, the buttons and knobs may be placed differently on certain models and the mires may have a slightly different appearance. The technique is the same for plus and minus cylinder.

The following principles may be applied to all manual lensometers:
The first three steps in performing lensometry on lenses of all types are: 1. Focusing the instrument eyepiece 2. Positioning the eyeglass lens to be measured on the specific table (or frame support platform) of the lensometer 3. Measuring the sphere power and, if present cylinder power and axis either plus or minus axis, cylinder form.

Eyepiece

Focusing the Eyepiece
• Y must focus the eyepiece prior to You tf th i i t using the lensometer, failure to do so could result in erroneous readings • With no lens in the lensometer, look , through the eyepiece of the instrument • Turn the power wheel until the mires (the perpendicular crossed lines), viewed through the eyepiece are totally eyepiece, out of focus

Focusing the Eyepiece
• Turn the eyepiece toward the plus direction • Slowly turn the eyepiece in the opposite direction until the target is clear • Turn the power wheel to focus the mires • The mires should focus at a reading of zero (plano) • If the mires do not focus at plano, repeat these steps from the beginning h f h b i i

Positioning the eyeglass lens
Power wheel

Power wheel

Axis wheel

Platform / table

Gimbal

Measure the sphere power
Align the lens so that the mires cross in the center of the target (if unable consider prism)

Thin, single Thin “single” lines that represent the sphere

Perpindicular, widely spaced thick lines that represent the cylinder

Measuring the sphere power
• Turn the power wheel either direction to focus the mires
if all the mires come into focus at the same time…

Cylinder
if all the mires do not come into focus at the same time

Record the number on the power wheel, This is a spherical only Rx

• Si lt Simultaneously rotate the axis wheel to focus and l t t th i h lt f d straighten the thin sphere lines, record the number on the power wheel, this is the sphere power wheel • Leaving the axis as it is, bring the thick lines into focus by turning the sphere wheel

Cylinder
• Algebraically add the number shown now on the power wheel with the number previously recorded as the sphere, sphere this is the cylinder amount, amount record the axis • To transpose the cylinder, rotate the a s 90 a d start over axis 90˚and sta t o e

Lensometry technique for multifocal lenses
If the glasses are multifocal the first step is to determine the distance Rx. For a traditional lined segment add you would then reposition the glasses so that the center of the bifocal add is in the lensometer gimbal.

The absolute power of the bifocal segment is always p g y more plus (or less minus) than the sphere power in the upper (distance) portion of an eyeglass lens. The add is the total difference in dioptric power. dd i th t t l diff i di t i

Measuring trifocal power
To measure the trifocal segment directly, follow the same procedure as for the bifocal segment, reading the distance segment first, the intermediate segment second and the second, near segment last. It is standard for the trifocal power to be 50% of the bifocal power; 50% therefore the usual protocol would be not to measure the power of the trifocal. trifocal

Progressive add multifocal lenses
•Progressive add lenses are different from traditional bifocal or trifocal eyeglasses in that there are no visible segments dividing the distance and reading portions of the lenses. • In order to create this “no-line” appearance the manufacturing processes often produce unwanted cylinder power, distortion, or blurred transition zones between the distance and near segments. This can make lensometry a little tricky.

Progressive add multifocal lenses
• When performing lensometry on p g p g y progressiveadd eyeglasses try to select the area with the least distortion in both distance and the reading portions of the lenses b f ti f th l before taking a reading. t ki di p g , • Because of the nature of the progressive add, the strongest portion of the add is close to the bottom of the lens, so try to read the add as close to the bottom of the lens as possible. • Other than these issues lensometry is performed the same way as with conventional multifocals.

Placement of optical centers p
• Optimal vision correction is achieved when p looking through the optical center of the eyeglass lens. The lensometer may be used t verify the position of the optical d to if th iti f th ti l center of a lens. • Position the frame in the lensometer as if performing b i l f i basic lensometry, make sure t k the frame is sitting flat on the platform and is lined up properly Focus the mires and properly. center in the target.

Placement of optical centers p

Placement of optical centers
• If equipped, use the dotting device on the lensometer to mark the lens. This mark will be the optical center. • If there is no dotting d i th i d tti device, th use a then nonpermanent marker to mark the approximate center of the lens.

the picture on the left is an example of properly aligned mires and target, at this point you would dot the lens

Placement of optical centers
• Once the optical center of both lenses has been found, a millimeter ruler is used to measure the distance between the marks on the lenses lenses. • This distance should match the patient’s interpupillary distance unless there is p s prism in the lenses. t e e ses

Lensometry technique for prisms •L Lensometry measures not only t t l the power of a prism but also the orientation of the prism base. • The prism orientation may be base in (toward the nose) base nose), out (toward the temple), base up, or base down.

Lensometry technique for prisms • If prism is ground i th l i i d in the lens you will not be able to align the mires with the target. • As mentioned in the previous chapter, chapter regarding optical centers centers, if the pupil measurement is “off” off prism will be induced.

Measuring prism power and orientation • OK, you can’t line the mires up with the g you prism, right? Now , g target…so y have p how do you find out how and what type?...
the picture on the left is a representation of mires that cannot be aligned with the target due to prism (not drawn to scale)

To measure the amount of prism
• Count the number of circles from the central cross of the target to the center g of the mires (each circle represents 1 prism diopter) • Record the direction of the base according to the displacement of the f ( p p mires (example: if mires are displaced down, the prism is base down)

Some lensometers are made to compensate for prism If your prism. lensometer has a feature of this type, please refer to the instruction manual for more information Also some information. lensometers have auxiliary prisms in the case that there is more prism than there are circles on the target.

THE END

Thank Y ! Th k You!

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