Avoid potential GLCKs by listening to the patient’s chief complaint. The patient’s age and lifestyle are important factors in determining a satisfactory add. If it’s the patient’s first time needing a reading correction, keep these things in mind:
1. Prince’s Rule: A guide for add according to the patient’s age (loss of accommodation)
Age:
42-45: +1.00 to 1.25
45-50: +1.50 to 1.75
50-65: +2.00 to +2.50
Over 65: +2.75 to +3.00
These values are guides and dependant on the reading distance preferred by the patient.
2. If the patient takes plus in the distance refraction, be conservative with the add amount (Don’t over plus - check at 16-18 inches).
3. If the patient is taking a myopic shift in the distance refraction, avoid over-minusing, and try and push plus in the add (patient’s are used to a certain amount of magnification effect in the add, so try and maintain the total reading power from the previous RX - and in this case check at 14 inches).
4. We rarely give more than +3.00 add, unless the patient is considered to be a “Low Vision” (20/200 or less), then +3.25 and up can be given, according to your best judgement.
