Lynn Lawrence, CPOT, ABOC, COA, OSC
Continuing Ed Opportunity
Online Continuing Education Program
Continuing education (CE) allows the Paraoptometric to stay
current within the eye care field and is especially important in the
study of direct patient care and office competency. Additionally,
certified paraoptometrics must obtain 18 hours of CE credit from
approved education providers to maintain certification
designation. The Pararoptometric Section (PS) provides FREE 6
articles each year (one every other month) for PS members that
are worth one hour of CE. You read the article, successfully
answer the exam questions, and you will receive your CE slips by
mail.
The following articles were designed to cover a broad scope of
patient issues ranging from patient care, disease treatment, to
ophthalmic dispensing. Participants should review each article
and complete the accompanying continuing education
examination. Each accurately completed examination is worth one
hour of paraoptometric continuing education credit. The
corresponding CE exams expire December 31, 2008. Please
allow four to six weeks to receive proof of CE.
Objectives
Optical Cross
Put on the cross
Take off the cross
Transposition
Plus cylinder
Minus cylinder
Spherical Equivalent
Convert to near and intermediate Rx
Decentration
Create a number line
111 111 111 111 111 111 111 111 111 111 111 111 111 111 111 111 111 111 111 111 111
10 9 8 7 6 5 4 3 2 1 0 1 2 3 4 5 6 7 8 9 10
Insert 3 hash marks between every number
Determining cylinder power
Two questions should be asked to determine
the cylinder power:
1. In what direction on the number line is
travel occurring (on the number line) from the
sphere to the cylinder (either in the negative
direction or in the positive direction)?
2. What is the distance traveled from the
sphere to the cylinder power (the amount of
cylinder present in the prescription)?
Answers on presentation
Some of the answers in
this presentation are
intentionally incorrect, so
be prepared to defend
your answers…
Prescriptions: Optical Cross
Optical cross is a diagram that
denotes the dioptric power in
the two principal meridians of a
lens.
Hint: Think of the value of the numbers as they
are read off of the lensmeter wheel.
Optical Cross Steps
Step 1 draw a number line -
-----------------------
3 2 1 0 1 2 3
+
Step 2 read the question (plus or minus
cylinder)
Start in the direction of the less power…
document it
Document the axis of this power
Calculate the distance traveled from set
number to termination
Prescriptions: Optical Cross
Optical Cross Example
+ 3.00 Plus cylinder notation:
+3.00 +2.00 x 090
+ 5.00
Minus cylinder notation:
+5.00 -2.00 x 180
Hint: The sphere is “married” to the axis; the cylinder
is the distance between the numbers on the cross
Optical Cross
- 4.50 - 2.50
- 1.25 +1.50 121
090
180 031
To take an RX off the Optical Cross in Minus Cylinder
Form:
Step 1 Start with the most plus sphere power (use your number
line)
Step 2 Your axis is “married” to your sphere
Step 3 Your cylinder is the distance traveled between the
sphere and number 90 degrees away
Find the answers to the above equations
Take off the Cross
-4.50 +1.25
+2.50
180 -1.25 _____
_______ 123
Put on the Cross
-2.00 -1.00 x 080 -3.00 –
2.50 x 107
Axis Alignment
Note: Optical meridians (axis) can only lie
between 0 and 180 degrees.
Example: The following prescription will be
placed on the cross: -2.00 -1.50 X 180
1 Minute Optical Cross
- 4.50 - 2.50
- 1.25 +1.50 121
090
180 031
To take an RX off the Optical Cross in Minus Cylinder
Form:
Step 1 Start with the most plus sphere power (use your number
line)
Step 2 Your axis is “married” to your sphere
Step 3 Your cylinder is the distance traveled between the
sphere and number 90 degrees away
Find the answers to the above equations, you 1 minute
Prescriptions: Transposition
Transposition
Step 1 = Combine the sphere and cylinder
power mathematically
Step 2 = Change the sign of the cylinder
Step 3 = Change the axis by 90 degrees
Hint: When combining positive and negative numbers,
think in terms of money. Example: -2.00 combined
with +0.50 If you are $2.00 “in the hole” and you
deposit $0.50, what is your balance?
Answer: $1.50 “in the hole”, or -1.50.
Components of an Optical Prescription
Axis
The number in
the axis block
indicates
where the
sphere
meridian is
located on a
180° circle
Prescriptions: Transposition
-1.00 +2.00 X 160 +1.00 -2.00 x 070
+1.25 -0.75 x 030 +0.50 +0.75 x 120
Plano +1.00 x 090 +1.00 -1.00 x 180
Transposition Examples
Transposition 1 Minute Drill
Step 1 = Combine the sphere and cylinder
power mathematically
Step 2 = Change the sign of the cylinder
Step 3 = Change the axis by 90 degrees
1. + 1.75 – 0.75 X 030
2. – 2.25 + 1.00 X 170
3. – 1.75 + 2.00 X 125
Spherical Equivalent
-Step 1
Take half the cylinder and add
algebraically to sphere
- Step 2
Drop the cylinder and axis and write
sphere only
EX. -2.00 -0.50 X 145
(half the cylinder) -0.25
(add to sphere) 0.25 + 2.00
Answer:
-2.25 Sph
Spherical Equivalent 1 Minute drill
-Step 1
Take half the cylinder and add
algebraically to sphere
- Step 2
Drop the cylinder and axis and write
sphere only
1. – 2.25 – 1.00 X 120
2. + 1.00 – 2.00 X 090
3. + 0.75 – 1.50 X 150
Convert to NV Only Rx
Step 1 -2.50 – 1.25 x 125
Take the add power - 1.50 – 1.00 x 095
and algebraically Add +2.50
add it the sphere
power of the Rx
Rewrite the Rx with
out any add power
Convert to IV + NV Rx
Step 1 -2.50 – 1.25 x 125
Take the ½ the add
- 1.50 – 1.00 x 095
power and algebraically
add it the sphere power Add +2.50
of the Rx
Rewrite the Rx with ½
the add power
remaining in Rx (used
for reading)
* Used with computers or
intermediate work
Convert to SVN or Near Rx only 1 min drill
+ 3.25 – 0.75 X 125 Step 1
+ 1.75 – 1.00 X 090 Add the add power
Add 2.50 to the sphere power
and write it as the
new sphere power
- 4.50 – 1.50 X 035 Step 2
- 1.75 – 1.00 X 150 Write the new
Add 2.00 complete Rx Sph,
Cyl, and Axis
Review Questions 3 minutes
-1.00 -1.00 x 090 transpose
Answer______________ - 2.50 + 1.50 x 103 transpose
Answer______________
- 0.50 -2.00 x 008 transpose
Answer______________ -1.00 + 0.50 x 162 transpose
Answer______________
-1.00 -1.50 x 160 transpose
Answer______________ + 2.50 + 2.50 x 103
transpose
- 5.00 -3.00 x 088 transpose
Answer______________
Answer______________
-3.00 -1.50 x 095 transpose -2.50 + 1.00 x 029 transpose
Answer______________ Answer______________
Review Questions 1 minute drill
Put the following Rx on the Optical Cross
-2.00 -1.00 x 080 -3.00 – 2.50 x 107
Review Questions
Put the following Rx on the Optical Cross
-2.00 -1.00 x 080 -3.00 – 2.50 x 107
090 -3.00
-2.00 080 -5.50 017
107
-300
Review Questions 90 Seconds
Give the spherical equivalent to the following prescripts
-2.00 -1.00 x 080 Answer ____________________
-1.00 -2.00 x 010 Answer ____________________
+2.00 -1.00 x030 Answer ____________________
-3.00 – 0.50 x 070 Answer ____________________
+3.00- 1.00 x 060 Answer ____________________
Review Questions
Convert the following Rx to Near Vision
Only aka NVO, SVN, reading glasses
-2.00 -1.00 x 080
-1.50 -2.00 x 180 -4.00 -0.25 x 090
+3.00 OU
-1.00 -0.50 x 098
Answer ________________
+2.00 OU
________________ Answer ________________
-1.00 – 0.50 x 010
________________
-2.00 -0.75 x 100
+2.50 -1.00 x 090
+1.25 OU
+1.00 -0.75 x 180
Answer________________
+2.25 OU
________________ Answer ________________
________________
Review Questions 1 minute drill
Transpose the following Rx from plus cylinder form to
minus cylinder form
-2.00 +1.00 x 090
Answer ______________
-1.00 +3.00 x 070
Answer ______________
-1.00 +1.50 x 010
Answer______________
- 0.50 +2.00 x 145
Answer______________
-3.00 +2.00 x 095
Answer______________
Review Questions 1 minute drill
Convert the following prescription from minus cylinder to plus
cylinder format
-1.00 -1.00 x 090
Answer______________
- 0.50 -2.00 x 008
Answer______________
-1.00 -1.50 x 160
Answer______________
- 5.00 -3.00 x 088
Answer______________
-3.00 -1.50 x 095
Answer______________
Prescriptions: Decentration
Decentration calculations
Eye size plus distance between
lenses minus patient’s PD divided by
2.
Example: 52-20-145 pt PD 62
52+ 20 – 62 = 10 / 2 = 5
Remember the measurements are in mm
Decentration 1 minute drill
Decentration calculations
Eye size plus distance between lenses
minus patient’s PD divided by 2.
1. 48 – 22 – 145 pt/pd 64
2. 52 – 22 – 145 pt/pd 66
3. 58 – 20 – 140 pt/pd 67
Remember the measurements are in mm
Conversion
Feet to meters
Multiply the denominator by .3
Meters to feet
Divide the denominator by 3
Add a zero
One meter = 39.37 inches … one inch is equal to 25.4
Optometric Math
MULTIPLICATION AND DIVISION OF LIKE AND UNLIKE
SIGNS
When Multiplying or dividing two numbers with like signs
i.e., both plus (+) or both (‑) the answer will always be a
plus (+) sign. This means that if you multiply or divide two
plus (+) numbers you will get a plus (+) answer and if you
multiply or divide two minus numbers you will get a plus
(+) answer
Optometric Math
MULTIPLICATION AND DIVISION OF
DECIMALS
A decimal number is just a whole number and a
fraction written together in decimal form. Any
multiplication or division by 10, 100, 1000, etc.
simply moves the decimal place to the left or
right. For example, multiplying a decimal by 10
would move the decimal point 1 place to the right
7.75 x 10 = 77.5
Optometric Math
MULTIPLICATION OF DECIMALS. Decimals are
multiplied exactly like whole numbers and then the decimal
point is added. For example, you would multiply 25 x 25 in
this way:
DIVISION OF DECIMALS. Divisions may be written
in the form
a = c c
b or a/b = c or b/a where "a" is the DIVIDEND, "b"
is the DIVISOR, and "c" is the QUOTIENT. As with
multiplication, you divide decimals exactly like you do
whole numbers and then you find the decimal place. For
example: dividing 126 by 6 gives 21 as an answer.
Optometric Math
METRIC SYSTEM
The metric system is based on decimals. Changing from
one unit to another requires only the movement of the
decimal place. The table below shows the meter, which is
the standard unit of length, and the parts of a meter that
we will be concerned with in Optometry. It also shows the
standard abbreviations and the number of units in a meter.
1 meter (m) = 1 meter
10 decimeters (dm) = 1 meter
100 centimeters (cm) = 1 meter
1000 millimeters (mm) = 1 meter
Optometric Math
Dealing with the problem of how many places to
move the decimal is relatively easy. Note in the
table above that there is a difference of 2 zeros
between centimeters and meters, 3 zeros between
millimeters and meters, and 1 zero between
millimeters and centimeters. This means that
when converting between:
a. Meters and centimeters move the decimal 2 places.
b. Meters and millimeters move the decimal 3 places.
c. Centimeters and millimeters move the decimal 1
place
Converting inches into meters
If you need a length, in inches, converted to
centimeters or millimeters, first convert the
inches to meters (divide by 40) then convert
to the desired unit by moving the decimal
place. Conversely, if you wish to convert
from cm or mm to inches, then first convert
to meters by moving the decimal and multiply
by 40 to convert the meters to inches.
Optometric Math
Deciding on which direction (right or left) to move the
decimal requires thinking about whether you should have
more or less of the unit that you desire. For example, if
you are given a length in meters and require the length in
centimeters, then you must have more centimeters than
you had meters because each centimeter is smaller than
each meter. This means that you would move the decimal
2 places TO THE RIGHT. Conversely if you were
converting from centimeters to meters, you have to move
the decimal place to the left 2 places. A meter is much
larger unit of length than a centimeter, thus you would
have to have fewer meters than you had centimeters. All of
the possible metric conversions you will have to make are
listed on the next page: Memorize them; if necessary
Remember Metric
When Converting Move
Decimal
mm to cm 2 places
right
cm to mm 1 place right
m to mm 3 places
right
mm to m 3 places left
mm to cm 1 place left
cm to m 2 places left
Practice converting
1. 42 m _____cm 6. 20 cm _____m
2. 500 mm _____m 7. 25 cm _____m
3. 80 cm _____mm 8. 0.47 m
_____mm
4. 0.025 cm _____mm
9. 10 cm _____in
5. 200 mm
_____in 10. 150 m _____cm
Optometric Math
ALGEBRAIC ADDITION
Algebraic addition is simply combining two or
more numbers together. If you always think of
algebraic addition in terms of dollars and cents
you probably won't make any mistakes. It's really
amazing that people who are terrible in math
always seem to know their bank balance or how
much change they should get back from a
purchase. Throughout this section the examples
will be explained mathematically and where
possible, monetarily
Math Rules
These two rules may be compiled into a table
that should be memorized.
+ x + = + ‑x+=‑
‑ x ‑ = + ‑÷+=‑
+ ÷ + = + ‑÷‑=+
Thank you very much
