Optical Math Made Easy

By Brent Sonnier, CPOT & Rebecca Johnson, CPOT

Introduction

Does the thought of optical math make you want to run? Does transposition leave you trembling?
Do optical crosses make you see double? The purpose of this course is to break down the “math
elephant” into bite-size pieces. You will learn basic math formulas along with instances where
you would apply the formulas in everyday practice.

Multifocal Conversions
When a patient wishes to have their reading or intermediate prescription in a single vision lens, it
is necessary to convert the multifocal prescription. The first step is to determine if the desired
prescription is going to be a single vision for near or intermediate.

If the desired result is a single vision lens for near, you would simply algebraically add the full
prescribed add power to the spherical portion of the distance prescription. The result of this
addition is the new sphere power. If the distance portion of the prescription is a
spherocylindrical lens (contains cylinder power), document the unchanged cylinder and axis
behind the new sphere power.

If the desired result is a single vision intermediate lens, algebraically add half of the prescribed
add power to the spherical portion of the distance prescription. In cases where the prescribed add
power ends in a .25 increment, such as +1.25 or + 1.75, round up to +1.50 or +2.00 prior to
taking half of the add power in order to divide evenly. If the original distance prescription
contains cylinder, document the unchanged cylinder and axis behind the new sphere power.
EXAMPLE 1: Patient requests a single vision near lens for reading.

Full prescription is: OD -2.00 -1.00 X 090

OS -3.00 -1.50 X 030
Add +2.50 OU

OD -2.00 (power of sphere)

+2.50 (power of bifocal add)
+0.50 (new sphere power for single vision near lens)

OS -3.00 (power of sphere)

+2.50 (power of bifocal add)
-0.50 (new sphere power for single vision near lens)

Single vision near prescription is: OD: +0.50 -1.00 x 090

OS: -0.50 -1.50 x 030

EXAMPLE 2: Patient requests a single vision intermediate lens for computer use.

Full prescription is: OD -2.00-1.00 X 090

OS -3.00 -1.50 X 030
Add +2.50 OU

OD -2.00 (power of sphere)

+1.25 (power of bifocal add divided by two)
-0.75 (new sphere power for single vision intermediate lens)

OS -3.00 (power of sphere)

+1.25 (power of bifocal add divided by two)
--1.75 (new sphere power for single vision intermediate lens)

Single vision intermediate prescription is: OD: -0.75 -1.00 x 090

OS: -1.75 -1.50 x 030
HELPFUL TIP:
If you struggle when adding a positive and negative number, think in terms of money, with the
first number as the last entry in your checkbook register and the second number the next
transaction. Example: first number -1.50, second number +0.50. If the last entry in your
checkbook was -1.50 you would be $1.50 “in the hole”; because the second number is +0.50, you
would count it as a deposit of $0.50. If you are $1.50 “in the hole” and you deposit $0.50, you
are now $1.00 “in the hole” (-1.00).
Transposition

Transposition involves changing of the cylinder form of the prescription. This can be
accomplished by algebraically adding the sphere and cylinder together. The result of this is the
new sphere power. Document the sphere power and change the sign of the cylinder but keep the
same power originally given. Finally, rotate the original axis by 90 degrees, and the new axis is
what is documented.

EXAMPLE: -4.00 +2.00 x 120 has the same visual effect as -2.00 -2.00 x 030

The only difference between the two prescriptions is that the first is in plus cylinder form and the
second prescription is in minus cylinder form.

Spherical Equivalent

There are instances, such as contact lens fitting, where a small amount of astigmatism is ignored
by using the “spherical equivalent” of the original spherocylindrical lens. The following formula
is used:

Dse=spherical equivalent
Ds=sphere
Dc=cylinder

Dse=Ds+ (Dc/2)

Example: -1.00 -0.50 x 180

Ds= -1.00
Dc= -0.50
Dse= -0.75 (-1.00 + -0.50/2)

Note: Quarter diopter steps such as 0.25 or 0.75 are moved to the closest half diopter value,
usually in the positive direction.

Low Vision Calculations

Magnifiers generally come in “x” powers. To determine the diopter power of a magnifier, simply
multiply the “x” power by 4.

Example: A magnifier that is 10x would be 40 diopters (10 x 4 = 40)

To determine the distance that a magnifier should be held from the page to get the clearest
image, convert the diopters to x by dividing by 4 and then divide this number into 10.
Example: At what distance from the viewed object should a 20D magnifier be held for clearest
vision?

20/4 = 5x
10/5 = 2 inches

Optical Cross

The optical cross can be applied in a variety of ways to help solve inconsistencies in the written
prescription:
 Determine exactly how much power lies in the respective meridian (axis) of a
prescription
 Determine the particular refractive condition the prescription is correcting
 Determine the opposite cylinder form of a given prescription
 Determine the actual prescription based solely on the optical cross diagram
 To help understand the concept of manual lensometry reinforcing the method of
the distance traveled between the sphere and cylinder power.

To understand the optical cross, use three simple rules:

1) The sphere power is consistent in all meridians.
2) The sphere power in the given problem is always associated/ attached to the given
axis.
3) The power of the cylinder is located 90 degrees away from the sphere meridian (axis).

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

-2.00
-1.50 -3.50

+ =
-2.00 0 -2.00

In the above prescription, there is a total of -2.00 diopters of power 180 meridian. In the 090
meridian, the sphere power and the cylinder power are available. The total power found at the
090 degree meridian is -3.50 diopters. After determining the power that corrects the particular
refractive condition, look at the result of each axis on the optical cross. In the above example, at
the 180 degree meridian we have minus (-) power, and in the 090 degree meridian we also have
minus
(-) power. This particular prescription corrects compound myopic astigmatism. If you had plus
(+) power in each axis, you would be correcting a compound hyperopic astigmatism.

Here is a quick reference to help you remember refractive error in relation to optical cross
results:
Compound myopic astigmatism – both meridians contain minus power
Compound hyperopic astigmatism – both meridians contain plus power
Mixed astigmatism – one meridian contains minus and one meridian contains plus
Simple myopic astigmatism – one meridian contains minus power and the
other meridian has zero power
Simple hyperopic astigmatism – one meridian contains plus power and the
other meridianhas zero power

To use the optical cross to determine the prescription in a particular cylinder form (either
positive or negative), use the concept of a number line and the idea of distance traveled. For a
prescription in the negative (minus) cylinder form, take the most positive or least minus power
(total power) of the two amounts listed on the cross; this power is now the sphere power. The
meridian attached to this new sphere power is the axis that will be recorded. At this point, two-
thirds of the optical cross is complete. All that remains is the amount of cylinder present.
Remember the cylinder lies 090 degrees from the sphere 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)?

- 0 +

5 4 3 2 1 1 2 3 4 5

The above number line helps illustrate the concept of direction traveled and distance traveled.
Use the original optical cross prescription: -2.00 -1.50 X 180. At the 180 degree meridian, there
is a total of -2.00D power; at the 090 degree meridian, there is a total of -3.50D power. To take
this off the optical cross in minus cylinder form, choose -2.00 as the sphere power because it is
the most plus or least minus of the two powers given. Look at the number line: -2.00 is closer to
the plus (+) side than -3.50. This establishes that -2.00 is the sphere. The sphere is attached to
the axis. The axis listed on the other end of the line labeled -2.00 is labeled 180. This is the axis
to document. The sphere power is -2.00.

Now travel from -2.00 to -3.50. In which direction has travel occurred? Travel was in the minus
direction. The direction traveled is the cylinder form of the prescription. What is the distance
from -2.00 to -3.50? This travel is 1.50 units. This is the amount of cylinder. The correct
answer is -2.00 -1.50 X 180. If the desired cylinder form is positive cylinder, make the most
minus or least plus of the listed powers the sphere power. Follow the same steps for the rest of
the problem that were used for negative cylinder form (ask the same two questions: direction and
distance traveled); the only difference is that travel will occur in the positive direction.

Summary
While it can be intimidating, if it’s broken down piece by piece, you will find that you can be
confident in your optical math abilities.
“Optical Math Made Easy”

To receive one hour of continuing education credit, you must be an AOA Associate member and
must answer seven of the 10 questions successfully. This exam is comprised of multiple-choice
questions designed to quiz your level of understanding of the material covered in the continuing
education article, “Optical Math Made Easy”.

To receive continuing education credit, complete the information below and mail with your $10
processing fee, $10 per hour of CE before December 31st of this year to the:
AOA Paraoptometric Resource Center, 243 N. Lindbergh Blvd, St. Louis, MO 63141-7881

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Select the option that best answers the question.

1. Transposition involves changing the

a. patient’s PD
b. the cylinder form of the prescription
c. the magnitude of the cylinder power
d. none of the above

2. Transpose the following prescription to minus cylinder form -1.75 +2.00 x 160
a. +0.25 – 2.00 x 70
b. -0.25 -2.00 x 70
c. +0.25 -2.00 x 160
d. -0.25 -2.00 x 160

3. Convert the following multifocal prescription to a single vision, near only prescription
OD +1.00 -1.50 x 050 OS +1.50 -1.00 X 100 ADD +2.00 OU

a. OD +2.00 -1.50 x 050 OS +2.00 -1.00 x 100

b. OD +300 -1.50 x 050 OS +3.50 -1.00 x 100
c. OD +3.00 +1.50 x 050 OS +3.50 +1.00 X 100
d. OD +3.00 -1.50 X 140 OS +3.50 -1.00 X 10
4. To convert a multifocal prescription to a single vision intermediate only prescription you
need to
a. add the sphere power and the cylinder together
b. rotate the axis by 90 degrees
c. algebraically add the sphere power to the add
d. algebraically add one half the add power to the spherical power of the distance
prescription

5. What is the total amount of power found in the 180 meridian in the following prescription?
+3.00 -2.00 x 90
a. +1.00
b. -1.00
c. -2.00
d. +2.00

6. The Optical Cross can be used to determine

a. the refractive condition the prescription is correcting
b. the opposite cylinder form of a given prescription
c. all of the above
d. none of the above

7. What is the spherical equivalent of -2.00 -1.00 x 120

a. -1.00
b. +1.00
c. +2.50
d. -2.50

8. What is the spherical equivalent of +4.00 -0.50 x 100

a. +0.50
b. -0.50
c. +3.75
d. -3.75

9. A magnifier that is 8X has approximately what dioptric power?

a. 8 D
b. 32 D
c. 40 D
d. 24 D

10. At what distance from the viewed object should a 16D magnifier be held for clearest
vision?
a. 3 inches
b. 3 ½ inches
c. 2 ½ inches
d. 2 inches

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