So Many Progressives!

[Patsy]

I am one of 3 dispensing opticians at a large Optometric practice and this is my first post! This site is wonderful.

We primarily use the following progressive lenses; Comfort, Piccolo and Definity which normally work for the majority of patients. We do use several others on occasion, but right now we are having a rash of patients who claim they are having trouble seeing, especially at near. The women's frames we have (approx. 600) will, for the most part, accomodate 16 seg ht. with very few having enough room for 18 or more and several having room for only 15.

I would like suggestions for other good progressives that we might try in order to keep our remake ratio down. I am aware of how many there are, but is there a consensus on a few really good ones for working women who only want one pair of glasses and mostly work as teachers or office personnel? Certainly this is a broad question, but I would appreciate any help. Our adjusting skills are good and panto solves some but not all of the problems.

[chip anderson]

The Reason we have so many is that they are all so much better than the others.

[ayoco]

Hi Alan, at ProFitOptix.com;
I received our lenses on last Thursday. I prepared myself for the stress of edging coated lenses in the usual way by cleaning each lens surface first. I typically cannot use the extra pads to help assist with slippage because my Santinelli edger has a lens surface tracer and the LMU always gets caught on the edge of the tape. I decided to give the pads you sent a try and they worked flawlessly on all four lenses.

We are really impressed with our new lenses. Mine were a 1.67 with Steel a/r, overkill for my +1.75OU distance but the lenses are incredible. They are wafer thin but what I can’t get over is how clear everything appears in them. My first impression when I put them on was that the room was brighter and I’ve realized through the weekend just how sharp and clear my vision is. Great for me as I am monocular (amblyopia) and will take any additional vision I can get. When my wife tried hers on (CR39 with Steel AR) she immediately said the room looked brighter (I had made no mention of a similar experience to her) and exclaimed a couple of times this past weekend how clear things appear. I can’t wait to try them out on someone with greater refractive error and see if results are similar.


Thank you Alan for the lenses. I really do love ‘em and looking forward to trying some of your other products as well.
Tony Gibbons
TheLensGuru.com

[Uncle Fester]

I am one of 3 dispensing opticians at a large Optometric practice and this is my first post! This site is wonderful.

We primarily use the following progressive lenses; Comfort, Piccolo and Definity which normally work for the majority of patients. We do use several others on occasion, but right now we are having a rash of patients who claim they are having trouble seeing, especially at near. The women's frames we have (approx. 600) will, for the most part, accomodate 16 seg ht. with very few having enough room for 18 or more and several having room for only 15.

I would like suggestions for other good progressives that we might try in order to keep our remake ratio down. I am aware of how many there are, but is there a consensus on a few really good ones for working women who only want one pair of glasses and mostly work as teachers or office personnel? Certainly this is a broad question, but I would appreciate any help. Our adjusting skills are good and panto solves some but not all of the problems.

Welcome to Optiboard Patsy!:cheers:

To me the answer lies in what looks like your attempts to satisfy the ladies (and your collections) desire for fashion over function. Sadly there is too often a problem when you have someone used to a larger B dimension and switch them to a narrower frame.

I too have had good success with all the lenses you mention but, and here's the key, whenever you have someone picking out a smaller frame and especially if you are changing the the lens design you need to prepare almost to the point of over explaining what to expect with the new lenses. I suggest over explaining so they lower their expectations and are more accepting of the new lens. I also explain that anytime the add power is increasing they should expect the progressive corridor to narrow or as I'll say feel more defined. Again this may not happen but you are preparing them for it if it does.

Hope this helps.

PS- Sometimes I too seem to go through a stretch where it seems everything's coming back then just as quickly it goes back to my usual 95% success rate.

[Happylady]

Are these patients telling you the reading areas are too small? Are you fitting pupil center? Are you sure your pds are correct? Pupilllometers can easily get out of wack and even a millimeter or two off can mess up reading.

At 16 high patients just aren't going to have a huge reading area. I have the Definity Short at 18 and I still find the reading area small. I know it's the frame, if it was deeper it would be better.

I use the Ellipse often for narrow frames with good results, but at 15 or 16 no progressive is going to be as good as a frame that allows 20 or more.

Can you get a few more frames that are deeper but still stylish?

[Patsy]

I think you are absolutely right. We do try to concentrate on lens style, etc., but the pressure in our community to be "stylish" sometimes overrides our knowledge of what is best for vision. Thank you for reminding me of the primary function of a dispensing optician!

[Happylady]

I think you are absolutely right. We do try to concentrate on lens style, etc., but the pressure in our community to be "stylish" sometimes overrides our knowledge of what is best for vision. Thank you for reminding me of the primary function of a dispensing optician!

I deal with it too, the styles today just aren't progressive friendly. And when they are deeper, then they are often too wide for women's heads.

When the frame reps come in ask them to show you any stylish progressive friendly frames.

Talk to your patients about it, tell them while you can put progressives in narrower frames that they might not have as much reading area as deeper frames do. Still, I do progressives all the time at 16 to 18 with very few redos so I wonder if it could be something else.

Make sure they are fit correctly, it is very important in the smaller frames. I use a penlight to mark the pupil center. I also make sure my PDs are correct.

Good luck.:)

[Lee H]

Welome to Optiboard Patsy!

I love the Piccolo for a short corridor lens choice, especially for reading. The higher the add (>/= 2.00) and the more office work that is performed the more important it its to:

a) simply insist on a different (larger B) frame selection for better near and intermediate vision.

or

b) Suggest a second pair of task specific lenses such as the Shamir Office for those that spend several hours a day reading and/or in front of a computer

and

c) As Fester states satisfaction is directly related to expectation.....

Sometimes different is interpreted by the patient as "not as good"
With any rx change or lens style change as you know I'm sure, a little prepping can go a long way.


Again I must agree with Uncle Fester....I have noticed occassionally a slight run on issues (such as narrow reading)....as long as the proper frame adjustments, measurements, and psychology work is done up front :)these issues usually disappear quickly.....until the next full moon.

Good luck!

[AdmiralKnight]

We primarily use the following progressive lenses; Comfort, Piccolo and Definity

Welcome to the forum Patsy!

My question to you would be, if the majority of your frames are only letting you get a 16 height, which lenses are you using? The comfort is an older lens, and even though it's still widely used, if you're struggling to get an 18 out of your frame, it's just not gonna cut the mustard.

Generally speaking, I try to live by the addage "If it aint broke, dont fix it." and try to keep people in the same type of progressive that they've been using, unless of course they've had problems.

It most likely boils down to frame selection though. You need to get some deeper frames in there. The short corridor lenses out there work as well as they can with what they have... but if the patient is used to a 23 seg, they're just not going to be happy with a 16.

[chip anderson]

Lest Ye Forget, People can see in many ways better with straight tops. And they work with seg. hts. as low as 10 or less.

[Lee H]

[Happylady]

Lest Ye Forget, People can see in many ways better with straight tops. And they work with seg. hts. as low as 10 or less.

Flat tops have their place and in some ways they are better then progressives. But in some ways progressives are better.

I have a pair of flat tops to wear over my contacts and I like progressives MUCH better. The reading area on flat tops are very noticeable looking through the lenses. I hate the line, not just the way it looks from the outside looking in, but the way it looks from the inside looking out.

Right now I have progressives on and when I look up from the computer and look around everything looks pretty good. With the flattops I am VERY aware of the reading area when I look around.

I think there is a place for both. I also think it's important to realize that our own experiences with lenses are not always the experiences that other people have.

I know some people dislike progressives and like flattops but that doesn't mean that people who don't feel that way are just fooling themselves and just wearing progressives for vanity reasons. The reverse is also true.

[Metronome]

Delete.

[NgCognito]

I think everyone has their favorites. I personally like the Varilux family. Physio 360 for 17 mm and Ellipse 360 for 13 mm. So far, I get very few if any complaints on the area available to read. I do however explain thoroughly the difference in reading area between the two. I try to also have a few deeper frames around that will allow for deeper seg heights. It's hard to tell people that they can no longer have the tiny frames it they want large reading areas. It's kinda like telling older or out of shape people that spandex is not the material of choice for every outing. ;)

[IndianaOD]

If the frames are semi-rimless you can also ask your lab to increase the B measurement a couple of millimeters. This works great for us.