the rx is
RE -6.00/+1.50 x180
LE -5.75
A report needs to be written comparing high index lenses with normal index lens using the above rx...
i know the advantages and disadvantages of high index lenses but with the LE rx especially, would the patient need high index lenses and why?
is only -4.50 -1.50 X 090. Would they benefit from a thinner lens? I believe so. What index of refraction are you thinking of putting them in?? And why would you question the OS without questioning the OD??
Good luck to you!!
Days where my gratitude exceed my expectations are very good days!
Well first off no one needs high index. I know it is reassuring to think that we offer more expensive materials and lenses because we're out to help our patients, but the reality is different.
I just got a Jhane Barnes 3-piece done in trivex, and it is a bit thick at the edges. I can see, though, and the whole thing is still light weight and looks great. Did I need 1.74? Will I suffer for my choice? Of course not.
To me, the only question is "would a normal person notice the difference in either vision, weight, thickness (or a combination of the three)?"
And which is most important to your customer?
I can promise your customer doesn't care about the math; he or she wants good optics, light weight, and good looks--it's up to you to figure out which of those three is most important for him/her.
Further, you have to consider what the customer will pay for. It doesn't matter if he "needs" (our lying way of saying "wants") thinner lenses; if it ain't in his budget it doesn't matter.
I assume you consider the patient a capable human being, therefore you should forget about "need" or what might "be best" from some objective standpoint and listen to the patient. Find out what they want, then sell them whatever fits that bill and will make you the most money.
Personally, I'd put the px in 1.6 at least - thinner, lighter (all the normal reasons), but you also need to consider frame choice - size, shape, material, frame PD, Px Pd...
It also depends on the budget and lifestyle of the patient in question. If you are talking polycarb (uggh), or something similar, don't forget to compare relative clarity (Abbe values) as well as impact resistance.
steff
The thinnest lens (in any 'normal' sized frame/PD configuration) for this Rx will be a Resolution poly.
Charge a premium for an aspheric lens and promise the thinnest lens available. My aspheric upcharge is about 30% of the high-index upcharge.
Since many of you will ask - Yes. I am saying that a poly resolution will be thinner than a 1.67 at this Rx.
This is an opportunity to tout your knowledge. This Rx is an automatic high-index recommendation at many establishments. But I sell the "Marc Power Package" and I tell the patient that I just got them the thinnest lens at any price.
and before anyone starts talking about Abbe. The Abbe of 1.67 is barely better than poly.
And while we are on the subject of high index, my personal sidebar please? I work in a practice that I have finally taken most of the patients out of the ole' Varilux Comfort Cr39 , to the exotic world of high index, edge polishes, fashion tints and for goodness sake ......can I hear it for AR? So I am on the right track tho it be a hard road with the patients squacking harder than at other practices in the area about needing to stay within the limits of the ins. coverage. Oh no....I am good....but I will tell you these folks are hardcore, I believe it is a cultural thing which is the same as my Doc.
The question at hand is this......my Lab advises that the 1.74 doesn't sell them in most cases in terms of that much thickness reduction in the high minus rx's which I usually have the most of , I mean really high minus....like -7.00 on up...as far as price vs. diff from 1.67 to 1.64.
Who out there would like to discuss this?
Thanks
I'm not sure I understand this, whats your question exactly?Originally Posted by specs4you
thanks,
In a high-minus Rx, I usually recommend a 1.67, ground with a 1.2 center and with AR.
Personally, I agree with your lab: I don't think the price differential between 1.74 and 1.67 is justified by a huge difference in lens thickness. However, the few patients I've put into 1.74 who have Rxs over -7.00 have loved the lenses and praised the thinness.
Several opticians I've worked with have gone to poly 1.0 thickness as the thinnest lens in high minus. I've avoided it because of my concerns about the amount of flexion and distortion that I've seen in poly lenses with that thin a center. But I know there are many who love it.
Andrew
"One must remember that at the end of the road, there is a path" --- Fortune Cookie
Maybe I'm an idiot, but with a high minus I start with frame size and shape versus axis location. I sell high-index based on want, not "need."
I may be more of a salesperson than an optician, but I sure don't tell anyone they "need" high index.
Anyone who thinks someone "needs" high-index has read too many marketing flyers from lens manufacturers. If -4.50 constitutes a "high" minus, we might as well outlaw CR-39.
High index is a choice, not a need. Plastic and glass give the best optics, and that's where the "need" comes in. We sell high index because it looks better and weighs less, not because someone needs it. Admit that to yourselves and you will then be empowered to sell them expensive frames they don't need and a few accessories they don't need as well.
Sorry, but that's how it is. Glass provides the best optics, period, so let's be honest and quit pretending we're concerned about need.
Thanks Andrew Weiss;
I appreciate your feedback. Apparently I wasn't clear to one viewer what my question was, so thanks for understanding that I wanted feedback on 1.67 vs. the new 1.74 and if viewers/opticians tho't that it was worth the $$ difference and actually a visable difference all things being the same.
I realize there are the usual optician frame choice factors such as frame size, pupil placement, cyl/axis etc. My patients while being ultra cheap are concerned with the edge thickness and tend to have very wide temple to temple measurements. So wide in fact that the only frames I have in house are the Nike Flexons with the rounded flexible temples. These of course are pricey and they don't want to pay for them.
I approach my job as an information booth. I ask the patient what is important to them, then begin my material/option presentation. I just have to rely on the VSP lab in Sacramento and the couple of technical pros that I found in there to tell me that 1.67 and 1.74 aren't worth the add'l money. Also apparently there is quite a wait for the 1.74.
I am torn everyday as if I don't ever want to promise anything I can't deliver and since I have no experience actually grinding lenses I must rely on those pros out there that do know for sure.
Thanks all.....
I am not sure Mr. Mitchell if I inflamed you or not. I am simply posing a question between two materials. No mention of want or need. I don't think I have ever told a patient they needed something unless rarely they actually did......like U.V. protection or something for a particular problem that would be solved with that option.
"Need" can be more than just optics. There are plenty of patients that don't like the weight of glass or CR. There's also the increased problem of slipage and discomfort associated with the two materials because of their weight. You can consider lenses and frames basic needs just like food/water/shelter. But wouldn't you like fire and a stick to roast your food on?
As far as Poly thinner than 1.67...I've not met that poly lens, at least not in the above Rx which is well within finish stock range. Many companies offer finish 1.67 asphric with 1.0-1.2 c.t. Am I missing something Resolution is doing differently?
You make a good point. I need to recant a little. I was comparing a resolution at 1.1 mm CT to a 1.67 at 1.5 mm CT. That is not fair to the 1.67, because it is well within stock range which will be a 1.1 to 1.2 CT. I also just noticed that it is a -6.00 along the A dim. At first I was thinking it was -4.50 along the A, which would make the poly closer in thickness to the 1.67. So yes, the stock aspheric 1.67 will be a little thinner than Resolution poly stock for this Rx.
Yes, Resolution is a little different. They offer an aspheric/atoric design which is thinner than even aspheric 1.60 in most situations. You can argue about optics if you want, but that wasn't the subject of the post.
Sorry if I sounded harsh on this one, it's just that I personally feel frame choice is the first step if we're talking lens weight/thickness. In the Rx mentioned, the B measurement is of the most concern, so that's easy.
Also...you do realize the frame itself has weight. And some people have thick, resilient skin while others have thin, parchment-like skin. I sell virtually 100% poly and higher index, but I sell it as cosmetic--I don't claim the patient will feel a big comfort difference because I know it's not true.
Sure, in an actual high Rx they might, but -4.50 doesn't qualify.
Vision--comfort--cosmetics. Those are the three concerns. For every patient, each is more or less valuable. The only reason we think a certain Rx automatically indicates a certain lens material regardless of frame or patient need is because we get all those goodies and joke CE credits from lens manufacturers.
If we are talking about -/+ 2.00 Rx's then I tend to agree with you Mr. M. CR or even glass are viable options for the patient when optics/durability are of prime concern. But in my experience, todays patients want thinner, lighter lenses. Weather perceived or actual, they do notice the difference, especially in -/+ 4.50 range, regardless of frame size.
This is especially true of CL wearers. Part of the reason many chose to over wear their CL's is because they feel their glasses are uncomfortable or cosmetically unappealing, or both. In a 4.50 range almost all will notice a reduction of weight, once again, rather percived or actual. I've seen too many patients that utilized their glasses more because of this. And most all opt out for thinner lenses.
I agree, our job as opticians involves providing the best optics, comfort and cosmetics. But our job also involves the best solution to patients needs. Basically though, we need to provide a product that the patient will use and feel comfortalbe with purchasing, and repurchasing from us. Patient satisfaction is our ultimate goal.
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