Complaints about distortion an progressives...................................

[chip anderson]

Just a pearl that I am sure all of you are aware of. This same "adaptation" is present in SV patient's with high cylinders. For this reason an experienced refractionist will undercorrect the patient's (if he has not been wearing same) cylinder and gradually increase this each year until full or near full cylinder has been reached. For some reason (other than possibly the lens being closer to the eye and the center moving with the lens) this does not seem to be a problem in high cylinder contact lenses. These people can stand full correction for cylinder in the contacts (but probably not the spectacles) first try.

This probably indicates that one can adapt to incorrect cylinder in large amounts even if it's in the form of distortion if done slowly.

Chip

[Chris Ryser]

Hey, we agree on something! :D

Happylady, I am so glad that we have found grounds to agree upon...................

So now if you cultivate your patients that have purchased progressives at a low add, they will happyly continue to do so and you have created a very good customer base that has nothing to complain about.

Just stay away from a first progressives with a higher add starting at 1.75 and higher. Those cases are an invitation for arguments and trouble.

[Happylady]

I agree that it is better and easier to start a person with progressives with a lower add.

However, if someone is getting their first mulitfocal with an add of +1.75 or more I don't suggest flat tops. I mention them and I tell my patients honestly the pluses and minuses of both types of lenses.

I find that very few people want flattop bifocals. Don't forget, they also have distortion but it is in the middle of the lens and not on the sides. They also don't give any correction for midrange, which is important with stronger adds.

I have a set of longettes made up with two progressives, one has a +1.50 add and one has a +2.00 add and a set with a flattop with a +2.00 add. All have a plano distance.

I explain to the patient that they won't be exactly like actual glasses and I hold them up over his present distance glasses and show him both distance and near. I hold a reading card and move it to the side and tell him to tell me when it gets blurry. I then tell him to turn and look at it directly. I have him look at the distance and then raise his head and I explain why it gets blurry. Most people comparing the lenses perfer the progressives.

If someone walks into your shop wanting to get her first mulifocal and her add is a +1.75 will you always recommend a flattop?

[spartus]

Happylady, I am so glad that we have found grounds to agree upon...................

So now if you cultivate your patients that have purchased progressives at a low add, they will happyly continue to do so and you have created a very good customer base that has nothing to complain about.

Just stay away from a first progressives with a higher add starting at 1.75 and higher. Those cases are an invitation for arguments and trouble.

I'm so glad you took the time to reply to my post above. I spent a lot of time writing it, so I thank you for your thoughtful and considered reply.

Oh...you didn't. Silly me. Well, at least I got out in front of that one.

Anyway, about your last post, I tend to agree about 90% with it. The 10% where I disagree is when the patient is actively asking for a PAL, no matter the add. You can cajole, reason, beg, plead, talk, or hector them into changing their mind, but if the patient is motivated, they'll make it work. To be clear, I'm not saying that 10% of patients with an add greater than +1.75 are begging for progressives, only that I don't fully agree with your above statement.

All other things being equal, with a competent fitting, appropriate material, AR if applicable, and a well-informed patient knowing what to (and not to) expect out of the lens, it comes down to the patient's motivation. The patients that wear the lens for a day and bring it back are never, ever going to be happy with a PAL.

I find that the greatest percentage of nonadapts are the 45-50ish +1.00 little-bit-of-cyl previously uncorrected hyperopes. The add doesn't factor into it much other than higher adds being worse, obviously. These are people who, for the first four-plus decades of life, didn't need any help seeing. They've been using +2.00 readers, and they're just great. Suddenly, they're talked into spending an awful lot of money on this (to them) funhouse mirror of a lens, everything's blurry and--what the hell?!?--they're now suddenly having trouble seeing without glasses at all.

So they try it out for a few days, getting increasingly frustrated, and come in raving and complaining. Those are the nonadapts that you're never going to convince. Myopes are used to correction--they've either always worn glasses or accepted that life's just blurry. Higher-power hyperopes are in much the same boat. So, when situating myself across the dispensing table from a patient with a possible trouble RX like that, I make very clear what they can expect, and that it will take time to get used to the new glasses. More often than not, however, they end up getting either simple readers or an occupational lens.

[cinders831]

I'm so glad you took the time to reply to my post above. I spent a lot of time writing it, so I thank you for your thoughtful and considered reply.

Oh...you didn't. Silly me. Well, at least I got out in front of that one.

Anyway, about your last post, I tend to agree about 90% with it. The 10% where I disagree is when the patient is actively asking for a PAL, no matter the add. You can cajole, reason, beg, plead, talk, or hector them into changing their mind, but if the patient is motivated, they'll make it work. To be clear, I'm not saying that 10% of patients with an add greater than +1.75 are begging for progressives, only that I don't fully agree with your above statement.

All other things being equal, with a competent fitting, appropriate material, AR if applicable, and a well-informed patient knowing what to (and not to) expect out of the lens, it comes down to the patient's motivation. The patients that wear the lens for a day and bring it back are never, ever going to be happy with a PAL.

I find that the greatest percentage of nonadapts are the 45-50ish +1.00 little-bit-of-cyl previously uncorrected hyperopes. The add doesn't factor into it much other than higher adds being worse, obviously. These are people who, for the first four-plus decades of life, didn't need any help seeing. They've been using +2.00 readers, and they're just great. Suddenly, they're talked into spending an awful lot of money on this (to them) funhouse mirror of a lens, everything's blurry and--what the hell?!?--they're now suddenly having trouble seeing without glasses at all.

So they try it out for a few days, getting increasingly frustrated, and come in raving and complaining. Those are the nonadapts that you're never going to convince. Myopes are used to correction--they've either always worn glasses or accepted that life's just blurry. Higher-power hyperopes are in much the same boat. So, when situating myself across the dispensing table from a patient with a possible trouble RX like that, I make very clear what they can expect, and that it will take time to get used to the new glasses. More often than not, however, they end up getting either simple readers or an occupational lens.

You had me until the quote at the end by Chip, until that point I was reading and thinking yes, he's right he's so right and then that wild out of no where for no good reason nasty take on someones words quote and I went darn, just like everyother man....it was so good and then....

[Dd]

I find that the greatest percentage of nonadapts are the 45-50ish +1.00 little-bit-of-cyl previously uncorrected hyperopes. The add doesn't factor into it much other than higher adds being worse, obviously. These are people who, for the first four-plus decades of life, didn't need any help seeing. They've been using +2.00 readers, and they're just great. Suddenly, they're talked into spending an awful lot of money on this (to them) funhouse mirror of a lens, everything's blurry and--what the hell?!?--they're now suddenly having trouble seeing without glasses at all.

Man.... I soooo fit the above profile.
My glasses will be ready in a few days... guess I'll find out.

[spartus]

You had me until the quote at the end by Chip, until that point I was reading and thinking yes, he's right he's so right and then that wild out of no where for no good reason nasty take on someones words quote and I went darn, just like everyother man....it was so good and then....

What nasty take? Those are precisely his words. If you don't believe me, click the link. I thought they needed a more...public airing.

[cinders831]

Perhaps I misunderstood, are you running for president against Chip soon and need to have his feelings advertised? BTW, agree or disagree with Chip?

[Chris Ryser]

Everything has a limit? Damn, there go my plans for a hot-dog powered spaceship.

I'm so glad you took the time to reply to my post above. I spent a lot of time writing it, so I thank you for your thoughtful and considered reply.

I apologize..........guess I got the reprimand for a reason. I pushed off the answer on a long post, because it would merit a long answer.

Long answers do take time, at least for me, because I am not the best typer and have my fingers all of the board and then correct and correct, guess that is the curse of getting older.

I am also still doing long hours starting at the latest 4am and going on till 4pm, occasionally dropping in at the optiboard during the day. So its not ignoring, rather dealying and then not going back on threads. Begging for absolution. :hammer:

[spartus]

I apologize..........guess I got the reprimand for a reason. I pushed off the answer on a long post, because it would merit a long answer.

Long answers do take time, at least for me, because I am not the best typer and have my fingers all of the board and then correct and correct, guess that is the curse of getting older.

I am also still doing long hours starting at the latest 4am and going on till 4pm, occasionally dropping in at the optiboard during the day. So its not ignoring, rather dealying and then not going back on threads. Begging for absolution. :hammer:

I appreciate the reply. I tend to, uh, get carried away sometimes and I fully realize that replying to something that long can be an imposing task. My aim is to not feel insulted until the person I've posted directly to replies in the topic--but not to me. ;) It could, of course, be honest oversight, and it's easy enough to do, particularly with the forum software's extremely handy "Zap to the latest post" feature, to let something like that just get sort of buried.

[spartus]

Perhaps I misunderstood, are you running for president against Chip soon and need to have his feelings advertised? BTW, agree or disagree with Chip?

I'm too young to run for president--maybe in 2012. As for my agreement with Chip, click the link in the sig to be taken to the conversation in question (Don't want to muddy up a topic in the wrong forum).

[Chris Ryser]

Did not know that AO had one of the first patents for progressive lenses...................


1923 Industrial Eye protection department established
1923 Wise Owl eye safety program established
1924 Progressive Lens Patent #1518405 issued to AO (Estelle Glancy)
1925 "AO aquires De Zeng Instrument Company of America (Ear, Nose and Throat products)"
1925 "Tillyer lens revolutionizes Industry, 15 yrs in making, lens corrects for astigmatism and power"
1926 Tillyer patents ophthalmic lens series where off axis power and astigmatism errors were controlled
1930 High temple Ful-vue spectacles introduced

[Dd]

Does one typically see more distortion on one side than the other? My right side seems fine but the left is pretty annoying. Oncoming traffic on my left is somewhat blurry while the right side appears clear as a bell as far over as I can move my eyes to the right.

[Chris Ryser]

Does one typically see more distortion on one side than the other? My right side seems fine but the left is pretty annoying. Oncoming traffic on my left is somewhat blurry while the right side appears clear as a bell as far over as I can move my eyes to the right.

What you describe is something only a professional , like your optician can determine. Se him and explain the problem, he should be able to help.

[pbsE46]

There's isn't one single lens out there be it progressive, bifocal, or single vision that is not a compromise of the normal visual system. Your comments are true indeed and most progressives are sold for greed IMHO. But this is a retail/for profit business and PAL's are very big part of the picture. I agree, Opticians should warn of the disadvantages of PAL's, and I usually do. It was years and years before the lens manufacturers finally started to admit there was perephial distortion. When they finally did, I felt an inner vicroty. :cheers:

[chip anderson]

PBS:

Any optician that couldn't (can't) see the distortion the distortion in almost any lens by holding up at arms length and moving it just a little isn't an optician. Any any that can't see the massive distortion in a progressive or a blended anything is blind.

Chip

[Chris Ryser]

I agree, Opticians should warn of the disadvantages of PAL's, and I usually do. It was years and years before the lens manufacturers finally started to admit there was perephial distortion. When they finally did, I felt an inner vicroty.

Actually when the SL...ESSEL...ESSILOR...introduced the Varilux lenses in Europe in the late 50a they gave courses to opticians warning them about it and teaching them who was and who was a good or bad prospect to wear progressive lenses. So distortion on progressives is an old hat......with the exception the corporations call it now surface astigmatism.

:D

[hipoptical]

PALs look better than Fts, and bottom line is that's most important. ;) Even with the surfaceunwantedastigmatismdistortionunusedportionperipherypa rtofthelens I still like them better. Some don't, and that's why they still make Fts. Many people like standard motors in cars. I think Renesis Rotary engines are much better. They make both. Hybrid cars are better. Standard internal combustion is still the larger part of the market. To each his own...

[QDO1]

if we want to be picky - we can say that all lense distort - that is what we want them to do! Abberations however are a different cuppa tea

[hipoptical]

I like Lion's Gold Label, two sugars, and a touch of milk...

[SpexAppeal]

Hello~

I noticed this post about progressives and I've already given a review of my brand new Ellipse lens glasses, so I won't go into details. But I must say these are just wonderful. No distortion or anything negative at all! I am amazed. I was almost expecting problems from learning about the shorter frames and lenses. But not at all! I truly am pleased with what I was fitted with. Thank you for any advice you've given me here.

[Chris Ryser]

I went grocery shopping after I picked them up and noticed if I tilted the bottoms closer to my cheeks the distance was a bit clearer. I called and then went back to the optician to ask him about this. He said he doesn't prefer to tilt the lenses a lot but he did it for me. He said it's sometimes an optical illusion. ??

Above quote came from another thread. Looking at your profile you are an optician.

Obviously you again back as another thread opener with another name pulling everybodies legs......................

[chip anderson]

It seems that I will be aiding abeting the other side with this post but,
When I get new glasses in for my personal use, I ususally just stick them on, don't adjust, don't inspect, just go for it. I did this with a new pair of progessives as while back. I noticed that the brick walkway I was walking on was laid out in a "U" shape. I wondered why they did this. Then I turned 90 degrees, the "U" design turned with me. I found that if I elevated the temples (added pantoscopic angle) the "U" disappeared. Of course, I broke down and adjusted them at this point.
And only yesterday, I was putting some progessives in a frame, and probably stimulated by this and similar threads I did some grid/print scanning for aberration and found the lenses to have much less of same than I remembered last time I looked.

Chip

[SpexAppeal]

Hello~

I believe you have mistaken my name for someone else's. In your response you addressed it to Spexvet. My name is SpexAppeal (actually Claire). I can assure you am not an optician. Giggle! I have no profile that I know of.

~Claire

Above quote came from another thread. Looking at your profile you are an optician.

Obviously you again back as another thread opener with another name pulling everybodies legs......................

[Eyecing]

In the office where I work, there is one optician who has no CLUE about patient education. She will do her best to push progressives on every multi-focal patient that walks in the door, whether they want them or not. She never tells them ANYTHING about the negative aspects of progressives, doesn't care how the patient will be using their lenses, and then she doesn't bother even trying to TRAIN a patient on how to use them- just expects them to magically know exactly how they work. Because she's brainless, when the patient returns because they can't figure out how the lenses should be used, this optician hands the patient and their glasses over to me to "take care of."

So, I can definitely see this situation from both sides. Some "professionals" do push progressives on patients. I always take the time to let the patients know what they are getting into. I do my best to talk the patients who work using a computer eight hours a day OUT of the ultra-short B measurement frames which will only fit a progressive lens with very little intermediate viewing area. I also try to educate my co-workers on how progressives work and why they are not right for every patient and why certain styles are not right for certain patients.

Unfortunately, many patients & professionals need more than just the standard "education" on lens styles. It's been my experience that some people are unreceptive to the typical lens-style education and require another method altogether in order to truly absorb the information. For patients, their lesson often lies in actually wearing and trying to adapt to progressives. For my co-worker- well - I've tried several approaches so far. The most recent being that I've flatly refused to do any more of her "clean-up" work. Perhaps that will be effective.