Does someone with an Add of +1.0 to +1.25 really need progressives (or bifocals or reading glasses)??
What Add do you really think they really becomes necessary?
(I still find I can still comfortably read fine with my one pair of single-visions, so I'm doubting whether to try changing from S.V. to progressives for my next set ... at my eye exam last month the optometrist said "it's up to you")
With us there's only one rule...... if the patient is happy putting on and off their specs or changing from one to another, that's OK.
We do point out however that one pair of progressives will make life easier.
I can't recall having made a pair with 0.75 add!
In theory and ususally practice, one does not need help at intermeadiate distance until a +1.75 or +2.00 (very late '40's) and a bifocal should suffice.
But we also have cosmetics, marketing and "jump" here. The marketing part is get them used to a progressive before they actually need it, that way they will be "adapted" when the add gets to +2.00. The marketing is: "No one will ever know you are wearing bifocals." And jump, is the wearer seeing the line or noticeing the fact that things seem to "jump" as focal length change abrubtly.
Now as to when does one need either? Usually age 40, but most patient's don't want to hear this so most practioner's wait 'til the patient is complaining that "My arms are too short." Same with trifocals, the doctor's are used to hearing so much reaction to bifocals, they don't seem to know (or want to risk another round of protest when trifocals (around age 50-56) are indicated. They ususally let the optician decide when (we used to have the courage to do this automaticly when the add was +2.00 or more.) Now we mostly either leave the patient in bifocals or keep them in progressives and avoid that little scene ourselves.
Chip
Chip
Last edited by chip anderson; 09-04-2005 at 07:30 AM.
Same for reading?Originally Posted by chip anderson
Are many PALs made with 1.0 or 1.25 add?? Or are most pals about add 2.0 or higher?
Daisey: Most pals are made from +1.00 to +3.50. A few higher or as low as +0.75. Below +.075 people can just hold the paper a little further away.
For the same reason people seldom need any help at intermediate distance until the add requirement is +1.75 or higher. Some exceptions for everything of course. If they don't need help at intermediate, they don't "need" a progressive. Now want on the part of the patient or sales person (higher price/commission, of course with a rationalizer of "Getting them accustomed to a pal "and it's inherent distortions") is another part of the equation.
"Need" is sometimes a question of preception.
Chip :)
Is PAL distortion or "waviness" worse for higher Add's and/or higher minus prescriptions??
(Is that perhaps why it's easier to adapt younger? )
(Also I'd imagine more 1.0 Adds might be non-adapts because we can still read with our single-visions, i.e., the benefit of the PAL magnification is far outweighed by the peripheral distortion and inability to see distances through the lower lens.)
Daisy, are your single vision glasses reading glasses or distance glasses?
I went into a progressive at a +1.25 add. I could have gotten a +1.00 add, but figured the +1.25 would be useful a little longer. I had no problems with adaption. I was very comfortable in them right away, and completely used to them within a couple of days.
Personally I think it is easier to get used to a progressive when the add is lower as there is less distortion in the outer areas of the lens. It is also easier to get used to them if you never wore a bifocal, though I have switched many people from bifocals to progressives.
I could have waited as I can see up close without glasses, but I didn't want to have to take my glasses off and on all the time. I still enjoy being able to read with no glasses, though.
Daisy -
The "distortion" / waviness does increase with stronger prescriptions. In my experience of dispensing, I have found that if a person is farsighted, they adapt more quickly (with any bifocal) where nearsighted people can still take off their glasses to read and thus I have found it can slow down the adaptation to any multifocal.
I know for myself, I LOVED getting my +1.00 add because I couldn't tell if the heads of the screw were phillips or flatheads ... LOL
Karen
I've only ever had one set of single-vision distance glasses. I'm hitting mid 40's. I'm returning to university for one year next week, after 2 decades away, and i cannot afford to take a week or two to adapt my vision. Alas my existing glasses got scratched, so I'm wearing my really old big ones that look really out LOL
My add is +1 and the optometrist & optician both say it's my choiice whether to continue S.V. or try PALs. I'm -6.0 sphere -1.50 cylinder, but I can still read with my one-and-only glasses in any light (and distinguish a philips screw from a flathead, lol).
Does saying "distortion/waviness does increase with stronger prescriptions", mean more negative sphere/cylinder, or higher Add, or both?
As your add power increases (over the years) the blur on the sides will increase.
Do you happen to know what is the power of your current glasses ?
Daisy, has your distance part on your new prescription increased also? I ask because if the glasses you are wearing now are a little too weak in the distance then they will be better up close. If your new glasses are stronger(more minus) in the distance then seeing up close out of them will be harder.
I find that most people are pleasantly surprised how much easier it is to read with a +1.00 add. As several of us have said, a weak add is easier to get used to. No one can tell you for sure if you will adjust easily or not. Most people do if they lenses are fit correctly, but there are some that don't.
My sphere & cylinder (-6 & -1.5) for my new prescription are unchanged from last time I got glasses. Except now there is the Add. She tested my existing glasses and they match my prescription (except for the Add).
I have to buy new glasses, as mine got wrecked recently, so making do with my existing glasses is not an option.
The optician said it's up to me if I want to pay the extra to try PALs (they freely exchange for single-vision if you don't adapt), but she says PALs won't benefit anyone like me who can already comfortably read a foot away (which I can). So she probably wouldn't bother yet, although she said I'll probably need them in 2 years or maybe less. She first got PALs at age 37, much younger than I am now (45).
Well, you can put it off for a year or two, but just figure that you will need to at least upgrade your lenses then.
No, I cannot procrastinate buying something because I badly scratched my current glasses on holiday.
So I'm wearing my old-old glasses. Besides looking ridiculous (they are really big), they're also actually 0.25 weaker than my new Rx. Maybe that helps me read easily?
What I meant was that you could get single vision glasses now but that in a year or two you will need to upgrade them into progressives.
Being slightly weak will help a little up close.
The first pair I ever wore were with a .75 add. It was my first bifocal of any type. Even an add that low really made a difference. I think it helps a patient adjust to future Rx changes if they start wearing progressives as early as possible. Worked for me.
Was your 0.75 Add a lined bifocal or a PAL?
Thanks for everyone's input so far!
So I guess it really is MY choice whether to stick with one set of regular glasses, or one set of PALs with an Add 1.0 Me undecided still, but maybe I'll try the PAL, if it's indeed easy to adapt to a low add and also the distortion is minimal for a low Add too. Right?
And I guess that almost any mid-priced, major-brand PAL will be fine for a low add? (eg., Essilor ovation, Varilux comfort, Seiko proceed 2, Sola max, Shamir genesis, etc.
On the other hand, do any of you ever run into the need for a higher addition progressive? Such as over 4.00 or 5.00, or even more? I have thought about this for a while and could make an argument both ways. Any thoughts?
If you want to use progressive lenses..............this is the stage where it is the easiest to adapt and get used to them. There are a lot of factors that will make it harder to get adjusted when the add gets higher.
CEO; Yes you see adds stronger than this , no they should not be done in progressives (don't bother asking why not).
Now as to when an add is needed. AGE 40 usually. It should be used when the patient admits they need a bifocal. Little point in doing them before patient admits they need them, especially if distance Rx is not strong enough to indicate full time wear because the patients just keep them in a desk drawer or on top of thier head and tell you how they "can't get used to these bifocals." Patients like yourself have to wear something, so they adapt right away.
Most patients "admit" they need bifocals at 42 or 44. Since you have to have glasses anyway, other people won't know you are wearing bifocals with a progressive, why are we having this discussion? Do you think not wearing bifocal until you're desparate for them (about age 43) will some how keep you from actually being 40? Or from needing them longer?
Chip
These are all good progressives. What people like is very differerent, though. My first progressive was the Comfort and it was so easy to adapt to(for me anyway). Of that list I have also worn the Sola Max. The Sola Max had a good reading area, but it seemed swimmer to me, it is not as soft a design.
It was a PAL
I once had a patient come in with an rx for a .50 add.
I once had a patient come in with an rx for a .50 add.
You must have crazy, confused people come to your place of business ... ;)
Karen :p
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