Part 06 - Refining the sphere and Astigmatism

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Refining the Sphere

Hold a -0.25 spherical lens in front of the frame and ask the patient whether vision improves.

Repeat the test with a +0.25 spherical lens.

Based on the patient's responses:

If both lenses make vision worse:

    No changes are needed. Proceed to Part 07 - A Prior Prescription Exists, Refining the Astigmatism.

If both lenses make vision better:

    Something is off. Re-test, possibly using ±0.125 or ±0.50 lenses for comparison.
    (Note: Prescriptions are always in 0.25 diopter increments.)

If -0.25 improves vision and +0.25 worsens it:

    Subtract 0.25 from the current sphere. Replace the lens in the back of the frame with one that is 0.25 more negative. Then repeat the test by going back to "Refining the Sphere".

If +0.25 improves vision and -0.25 worsens it:

    Add 0.25 to the current sphere. Replace the lens in the back of the frame with one that is 0.25 more positive. Then repeat the test by going back to "Refining the Sphere".

If -0.25 improves vision and +0.25 makes no difference:

    This is interesting. It does not happen very often. You might test again, and if the results are the same, experiment by subtracting 0.25 from the current sphere and replacing the rear sphere lens accordingly. Then re-test by going back to Part 06 - Refining the sphere and Astigmatism.

If +0.25 improves vision and -0.25 makes no difference:

    This is interesting. It does not happen very often. You might test again, and if the results are the same, experiment by adding 0.25 to the current sphere and updating the rear lens. Then re-test by going back to Part 06 - Refining the sphere and Astigmatism.

Proceed to Part 07 - A Prior Prescription Exists, Refining the Astigmatism.