is everyone fitting comforts as low as 18 w/success?

[beth]

Is everyone fitting caomforts as low as 18 and with really great success.

With managed vision care what progressive do you use?

[Jim G]

Comfort can be fit at 18 with success (some kick the add .25D). Having said that, would it work better at 22? You bet! Comfort reaches 85% of the reading add at 12 mm's; 100% at 18 but, it's a pretty narrow reading area at 18. The "short corridor" design PAL's such as Compact, Pentax mini & now SOLAmax allow for a reasonable reading area at 18 mm's but don't expect much in the way of an intermediate corridor. Folks in the +2.25 add range probably aren't gonna like them a lot, particularly if they've been in a "regular" PAL prior. A PAL design is a constant battle of where to push the power (and conversely the distortions) for the benefit of the user.

[Texas Ranger]

beth, I suppose in some cases you could go to 18 on any pal, but why? we have pts routinely want the cute little narrow styles,so we put them on them, ask them to look down, if they are looking under the frame (which is usual), we ask that they allow us to fit them with a bit deeper shape,but this lets them know that 1)we respect their choice, and 2)they know that if they choose that style, they'll not likely have their best visual comfort. then let them choose. if they decide on the shallow shape, and later on complain, well, we did recommend that a deeper shape would be better, etc. if, on the other hand, you reinforce their selection, assuring them that it will work fine, just to please them, you won't have a leg to stand on. IMHO. Al.

[stephanie]

I personally do not fit anything 18mm. We had a meeting a few months ago and the rep there was saying it was ok to fit vip/xl that low also. Another problem I have is when I go to cut them (we have a Santinelli) is they hit the chuck and will not cut out anyway. This is especially true with the very small,narrow frames. I have also experienced the bifocal being cut in half. Now in my opinion you have such a small space to read in a PAL anyway, why would I want to make it any smaller?! I know of some people who do it, but I myself do not and will refuse to pass anything I believe unacceptable. That can be someone else's problem.
Have a good day!
Steph

[Cindy Hamlin]

You can get blocks for half eyes for the santonelli which will eliminate your cut-out problem.

[stephanie]

Hi! We have the half chucks for our Santinelli,but if the frames are very narrow with a very small seg they still will not cut. They hit the chuck and slide right off. It is very annoying.
Talk to you later!
Steph

[LD]

Steph, If you use a blocking system that chucks up on center of your progressives, try decentering them by hand and changing your edgers' blocking status to geometric center or the equivalent. This should leave your block in the center of the lens and you should be able to cut out even the narrowest of progressives.

[Mermaid]

What about Pananmics at 18??? Just gotta watch the Poly, huh?

[Bob Rihl]

Originally posted by Mermaid:
What about Pananmics at 18??? Just gotta watch the Poly, huh?

Mermaid:
I've had very good luck fitting Panamics at 18 High and even did one at 16 High on a "tech" to see what would happen, and she's happy. But I still say that you've gotta bump the add by +0.25 if you go 21 or below and +0.50 if you go 18 or below. Unless you want about 2 mm of full add power. That "achieving 85% of add power at 12 mm" stuff may be true, but in a progressive, any progressive, you NEVER have anybody complain about too much plus at the very bottom....they like it for threading a needle, etc....but they sure complain about too little plus. And yes, by all means, stay away from Polycarb. I think now they're calling it "Air Wear" or something to avoid the stigma, and vaguely referring to a "resin coating" in the sales literature, but it's still poycarb. Polycarb is a very soft material with a rough surface. You can put all kinds of stuff on the surface to smooth it over, but it's still rough underneath. Hence, the poor "Abbe Value." Stay with 1.6, if your customers can afford it, and await the "new, revolutionary" CR-39 Panamic that comes out this month, I think. I got almost all of my "Air Wear" Panamics back from customers who had previously worn the Comfort in CR-39. So I put them all in Zeiss Top CR-39s or Hoya Wide CR-39s and they all were happy. I even put a few in Panamic 1.6s, and they were happy, too. BOB in JAW-juh

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[Bob Rihl]

Originally posted by beth:
Is everyone fitting caomforts as low as 18 and with really great success.

With managed vision care what progressive do you use?

WHOA...CORRECTION!
I misread this message. Did you say COMFORTS??? NO. You can't fit comforts 18 High, even if you do bump the add. Didn't think ANYBODY was still using them now that the Panamic has come out. The Comfort has suddenly become a second class citizen. And managed care? Just say "NO" to managed care. BOB in JAW-juh

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[Jeff Trail]

I tend to agree with AL, Can you fit it 18? Sure, you can fit any of them around 18.. does it work.. some cases it "can" some it can't, depends on small unimportant things..like oh say PD'S and frame shape. :)
I think we tend to forget that just because it can be done then "hey lets do it".. but can you get the most benefit from any of the designs at those lowest fittings NOPE, if you read the fine print in most of the ads it says DOWN TO 18 .. but are you taking advantage of the true qualities of the designs? nope.. All these pushing people into a frame with a narrow B is making it rough and it is one of the things I see as a major factor in alot of the "non adapts" that come back through my lab.. the patient came in wearing a 52 eye with a B of say 40 and the put them into a frame with a B of 34 or so and then its always the same complaint.. I feel like I run out of frame before I need to :rolleyes:
If you put Shaq into a Mazda Miata you figure he is going to be comfortable ..hmm NOPE.. but he probably could work it.. you put a PAL in a frame with a 17 hght. with a B of 30 mm .. sure you could but is it going to be giving the patient the optimum benefit of the design..NOPE...if you lose more then a quater of the reading circle in cut out and you cna't keep that fitting cross 10 mm from the top of the frame then you shouldn't do it.. specially if you "bump" adds..
Just one guys opinion... with tens of thousands of frame designs out there seems to me someone can always find the right size and shape for every design (lens) and still make the patient happy :)
Can't blame the shoe salesman for that size 6 not fitting your big ole' size 9 foot!! :) and can't blame the lens designers for a PAL that don't work when you decide to fudge stuff all over the place :)

Jeff "full of opinions and probably something else" Trail


[This message has been edited by Jeff Trail (edited 07-01-2000).]

[Matthew]

AO Compact at 16 high all day. TRO Discovery 17 high all day. Let the patient be the judge if they like it or not because for most, it works!