When should Reverse Slab Off be ordered on a lens?

Reverse slab off is a technique employed in lens prescription to manage vertical imbalance issues that can arise, particularly when one eye requires a significantly stronger plus prescription compared to the other eye. This situation often occurs when there’s a considerable difference in the curvature or power of the lenses prescribed.

When you have a minus lens on one side and a plus lens on the other, the resulting effect can lead to unwanted eye strain or discomfort due to the different focal points. The reverse slab off essentially adds a controlled prism to the more powerful plus lens, which compensates for the vertical displacement that arises due to the disparity in lens powers.

Ordering reverse slab off is most applicable in cases where you have the most plus and the least minus. This helps to ensure that when the patient is looking through their lenses, their vision aligns correctly without causing strain since the higher plus lens needs this prism to balance the difference caused by the decreased power in the other lens.

Understanding this context helps identify why this particular scenario is recommended for a reverse slab off, which aims to improve the patient’s visual comfort. The other choices do not create a situation where reverse slab off would be beneficial, as they either indicate too little difference in power or just an equal distribution of plus and minus powers, which