Technical Help Requested

[efsamuel]

I am not a consumer, but a frustrated optician. I have dispensed quite a few of the new Physio lenses (not the 360 and that may be the answer) and have for the most part had no problems. In fact one pt brought her husband back to get him a pair she was so impressed with the distance. My problem seems to be with plus pt's. I have some examples here.

Case #1. 21 Seg, 1.67 lens, average panto and face form, Prev lens Panamic Poly, semi rimless into semi rimless
+3.00 +.50 155
+4.00 +.25 080
Add +3.00

Case #2 17 Seg, 1.67 lens, average panto and face form, prev lens Panamic Poly, semi rimless into full metal frame.
+4.50 sp
+4.75 sp
Add +2.50

Case #3 18 Seg, poly, average panto, slightly more face form than normal, prev OTC, full readers into drilled rimless.
+1.50 sp
+.75 +.50 015
Add +2.00


OK, all pt's had great distance, much better than anything before. However for the reading to be clear it seemed to be much more dependant upon looking right at the item and there was almost no give in the reading channel.



Pt 1 and 2 were happy with the reading in the Pans and the reason for the switch was the blurred peripheral vision in the distance. They both can not stand the reading in the new lens. Unfortunately I can not get a distance Physio and a reading Panamic.



Pt 3 was readers only before and was counseled that she would have a shorter reading width but her exact quote was "If I am looking at the word 'the' the t and e are blurry."



Any help would be much appreciated.

[Jubilee]

I have noticed some trends with this as well. Not as extreme.. but certainly it does seem as if plus powers don't care for the reading area. Speaking with my local lab rep, their feedback has been that plus patients seem happier with the Definity or panamic than physio.

Cassandra

[eromitlab]

I've heard the same things with Definity... wearers with moderate or moderately high plus scripts usually had problems with reading or just using the lenses in general. I'm curious to see what the engineer-types that see this thread might attribute the problem to...

[beertv]

I have seen the same thing as the two of you. I have had very good luck with the Sola One and the Gradal Top. In small frames for plus powers I have had great results with the Solamax, for computer users they just love this lens and will not be happy in anything else. .

Don

[Happylady]

Just my personal experience with the lens, my husband is slightly farsighted, about a +.75-.50 with a +2.50 add. I put him into the Physio 360 in poly. He likes it a lot, but he thinks his previous glasses which were a Sola One had a wider reading area. He is happy with the lens, though.

I am nearsighted, about a -2.50 with a +2.00 add. My glasses are regular Physios in poly. These are as good as any progressive I have ever had. My other glasses are Kodak Concise and Sola One. The distance area is much better in the Physios then either of them. I like my Sola Ones and have had no problems with them, but when I compare them side by side with the Physios the distance is wider in the Physios.

The reading is okay in the Physios, it is about as wide as a page in a paperbook book, but it doesn't strike me as extremely wide. I usually just take them off if I read for any length of time though.

[Pete Hanlin]

After reading the posts in this thread, I went back to look at the details of the clinical studies of Varilux Physio vs. Varilux Comfort & Varilux Panamic- which are broken down by ametropia and presbyopic advancement, as well as by individual characteristics of the design.

My intent being to see if the findings of the double-blind studies show the same results as your experiences in the dispensary. The clinical findings reveal that the near vision satisfaction of hyperopes and advanced presbyopes was markedly higher for Varilux Physio over Varilux Comfort, and basically equivalent for Varilux Physio over Varilux Panamic (higher, but not significantly so). The overall satisfaction with the design reported by hyperopes was significantly higher for Varilux Physio compared to Varilux Panamic and Varilux Comfort.

Since I have not personally dispensed Varilux Physio to anyone with this level of hyperopia, I have no personal experience upon which to draw. The individuals I have personally dispensed have all seemed very happy with all aspects of the design- but none were hyperopes.

Greater width at near was not one of the design claims or objectives (vertical stability at near was improved based upon needs uncovered during R&D). Based on the clinicals- I wouldn't have expected the problems you've experienced.

efsamuel- it is my understanding that your consultant will be calling on your office in the near future, if you would like, we can work together with one of your patients to try some options. I appreciate the feedback from the field on the product. OVerall, the performance reports have been very positive, but it is from the challenges that I learn the most- so thanks!

Best regards,
Pete

[spartus]

While you're here, Pete, a general Physio question: What's with the "h" laser marking next to the "e"? The first one I got back from the lab, I looked at the marking, and the thing says "heP". Two out of three ain't bad, but I'm still curious.

On the dispensing front, the overall reaction to the Physio has been extremely positive. I just placed my first 360 order, and for the time I spent with that patient (an hour just talking about lenses! Science teachers are nearly as bad as engineers!), it had better be good. ;)

[Judy Canty]

Well, I am wearing my new Physio's in Airwear with Crizal Alize. My rx hasn't changed in several years (+1.25 ou/+2.50 add ou), so I wasn't really expecting much. However, driving home that first evening (I leave work at about 8pm), I did notice a difference in my very long distance vision. Now it could have been the Crizal Alize or it could have been the Physio design, but my view down Braddock Rd. was noticably sharper. Go figure. My husband, God love him, is my whinyest patient and even he is pleased. Go forth and sell these things.

[Pete Hanlin]

While you're here, Pete, a general Physio question: What's with the "h" laser marking next to the "e"? The first one I got back from the lab, I looked at the marking, and the thing says "heP". Two out of three ain't bad, but I'm still curious.
I believe one of the early descriptors of the lens was "high-resolution," so I would imagine that to be the origin of the "h" (if I remember the marking correctly, there are also three lines- I think I could explain them as well, but that's another one of those interesting stories that come out of the development process ;^). Of course, the "e" is ubiquitous on Varilux designs to designate Essilor. If I'm not mistaken, the "P" indicates you have a polycarbonate lens (the Greek pi symbol is used to denote lenses made from Thin&Lite 1.67).

[spartus]

I believe one of the early descriptors of the lens was "high-resolution," so I would imagine that to be the origin of the "h" (if I remember the marking correctly, there are also three lines- I think I could explain them as well, but that's another one of those interesting stories that come out of the development process ;^). Of course, the "e" is ubiquitous on Varilux designs to designate Essilor. If I'm not mistaken, the "P" indicates you have a polycarbonate lens (the Greek pi symbol is used to denote lenses made from Thin&Lite 1.67).

There are the three lines, but they proved too difficult to duplicate in simple HTML, and I'm not gonna bother to make an image to show you something you've already seen. And the "P" I know, of course.

So tell further stories of the "h", if you've got them. None of the Essilor propaganda sheets say much about "high-resolution", so I'd love to hear why it stuck around on the lens. More stuff about the three lines--I like this sort of trivia.

[efsamuel]

OK I have remade Pt #1 into the 360, this may work we have to see as she is having surgery so everything is wonky right now.



I had a golfer recently who was OK with the Panamic but wanted a really clear distance. I told him about the Physio and that the reading may not be as good as the Panamic but the distance should be an improvement. He loves the new Physio for golfing, did notice a bit more thought was required to adapt into his reading but said that it was "OK" after he got used to it. His Rx is



+2.25 +1.25 x175

+3.50 +1.75 x175

Add +2.50



The bad thing about this is the number of Pt's coming back to be re fit is giving the Physio a bad name her in the office (I am the only Optician) so when the Pt tells the tech they just ordered then new Lens they blurt out "not the Physio". Not wearing a PAL just yet (soon though) I still think they are great for the PT who wants more clear peripheral vision without being too much of an expense. A nice compromise if you will.





"My intent being to see if the findings of the double-blind studies show the same results as your experiences in the dispensary. The clinical findings reveal that the near vision satisfaction of hyperopes and advanced presbyopes was markedly higher for Varilux Physio over Varilux Comfort, and basically equivalent for Varilux Physio over Varilux Panamic (higher, but not significantly so). The overall satisfaction with the design reported by hyperopes was significantly higher for Varilux Physio compared to Varilux Panamic and Varilux Comfort."



I wonder how long after wearing the lenses were the surveys taken? I have always had rave reviews in the office it is a few days to a week later when Pts are home comparing to their older (minor Rx changes) pair that they notice the difference in the reading. Also, since I am in an MD's office we trend to the older Pt who does spend a significant more amount of time reading books magazines etc where a constant need to refocus is not as much an issue as a wide reading area.

[Pete Hanlin]

I wonder how long after wearing the lenses were the surveys taken? I have always had rave reviews in the office it is a few days to a week later when Pts are home comparing to their older (minor Rx changes) pair that they notice the difference in the reading. Also, since I am in an MD's office we trend to the older Pt who does spend a significant more amount of time reading books magazines etc where a constant need to refocus is not as much an issue as a wide reading area.
Clinical studies of Varilux designs are generally longer term (i.e. month or longer with each design being tested).

Since reading this thread, I've checked in with a number of our consultants to see if anyone is raising the issue of narrow reading for hyperopes- no other chronic problems with this that I've heard so far, but this will be something I'll be sure and look out for going forward. We can work through Amy, who indicated she visited you today. I'll be seeing her next week at our district meetings and will supply some avenues to explore. Sometimes its difficult to troubleshoot from a distance, but I'm sure we'll get to the bottom of this eventually.

[efsamuel]

Pete, I am not kidding I had just hit the send button on the post when she walked through the door! It was a bit freaky. Yes we discussed several things and it look like it will be taken care of. Thanks for the info.