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Thread: progressive lens with a lot of intermediate

  1. #1
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    Question progressive lens with a lot of intermediate

    So I have a patient who is complaining and insisting on a redo on his new progressive rx because the intermediate is not big enough. I tried to explain to him the benefits of a computer lens, but he wasnt having any of it.

    My biggest issue is, he is currently in a physio... one of my go to lenses for wider intermediates. Anyone got suggestions for a PAL with a wider intermediate?

    Our next try is going to be a GT2 I think.
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  2. #2
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    Definity also has a nice intermediate range, but physio would be our first choice.

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    Always learning OptiBoard Bronze Supporter
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    Quote Originally Posted by Scrumblydumpus View Post
    So I have a patient who is complaining and insisting on a redo on his new progressive rx because the intermediate is not big enough.
    Does he mean bigger vertically or horizontally? In other words, his he saying that he has to lift his chin to see the object, or his he saying he has to move his head to the right or left to keep the object in focus?

    If the latter, there's probably not much you can do beyond making sure the vertex distance is as short as possible. Some lenses spec out with wider corridors but the difference is minor- some people can see a difference, but most will not, myself included.

    If the latter, then a shorter corridor will help, although the consequences are a more dynamic/busy lens, with the potential for reduced distance acuity on-axis, and a much higher likelihood of off-axis distance blur.

    If the object in question is a desktop monitor at essentially eye level, then there will still be some chin lifting going on, even with the shortest corridor lens, albeit much less so compared to moderately long corridors like the Physio.

    You might also want to look at the change in Rx; any increase in minus or decrease in plus on the distance will have a negative impact on the intermediate vision. If true, don't blame the decreased utility at intermediate on the lens design!

    Hope this helps,
    Robert Martellaro
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    Master OptiBoarder rinselberg's Avatar
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    Want to gamble some money on an idea from someone who isn't an Eye Care Professional?

    Look at the website for the atLast! lens:
    http://www.atlastlens.com/

    If you take the text on the website at face value, the atLast! lens is aimed specifically at this situation: A dissatisfied PAL wearer who needs (or wants) more or better intermediate vision.

    The lens is new, so there has not been much discussion of it yet on this forum.

  5. #5
    OptiWizard
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    Is the Autograph II out of the question? Otherwise, have the patient decrease the monitor height if its eye level or higher.

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    OptiBoard Apprentice Trevor D's Avatar
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    The atLast Enhanced Multifocal

    Seems to be a blended round seg embedded into a progressive lens!

    According to the wesbite, a lab in California named "Bad *** Optical" can supply you with it! :p

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    What was the patient wearing before?

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    Master OptiBoarder rinselberg's Avatar
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    Quote Originally Posted by Trevor D View Post
    Seems to be a blended round seg embedded into a progressive lens!

    According to the wesbite, a lab in California named "Bad *** Optical" can supply you with it! :p
    Bad As* Optical (make that last "*" into an "s")
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    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    Use GT2 or Definity

    Do not use the At Last for this patient. It has a very small vertical intermediate. It does have a wide horizontal zone but it is really only suited to someone who could wear a blended bifocal. It's a lot better blend without all the blur in the blend zone. I would guess the intermediate is around 3 mm or so in height. There is a wide distance zone and near zone but even our Pixel Optics Rep said not to use it for someone who needs a wide intermediate.

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    I have a patient who is a pilot and he loves the Rodenstock Life lens. He's tried Definity and says the Life is better. He says the Definity is good but the Life has a bigger intermediate area. He is a hyperope.

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    Master OptiBoarder OptiBoard Gold Supporter DragonLensmanWV's Avatar
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    Quote Originally Posted by IndianaOD View Post
    Is the Autograph II out of the question? Otherwise, have the patient decrease the monitor height if its eye level or higher.

    I have the Auto II and in my opinion, while I love them, the intermediate is the weakest part. Note that I have a 3.00 add though.
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    We talked to the patient & the doc and decided to lower his add and raise the seg a bit. We are going to keep him in the physio, but if he still has trouble I may mention the raising the monitor idea.

    I thought Shamir's big thing with the autograph series was to minimize intermediate to make near/distance as good as possible?
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    Quote Originally Posted by Scrumblydumpus View Post
    We are going to keep him in the physio, but if he still has trouble I may mention the raising the monitor idea.
    Generally I find lowering the monitor is helpful with computer users. Having the screen too high is a common problem.

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    Quote Originally Posted by Scrumblydumpus View Post
    We talked to the patient & the doc and decided to lower his add and raise the seg a bit. We are going to keep him in the physio, but if he still has trouble I may mention the raising the monitor idea.

    I thought Shamir's big thing with the autograph series was to minimize intermediate to make near/distance as good as possible?

    Hmm, if that's true I didn't know it.

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    Master OptiBoarder OptiBoard Silver Supporter Jubilee's Avatar
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    You can specify the corridor lenght in a situation like this to have more vertical room in the intermediate.


    A couple of other good computer lenses... For width of intermediate, Solamax. For length, the original Gradal Top. For those with Higher adds, have a longer corridor length will give them a true computer zone.

    For lower adds, the short corridors work by bringing the magnification up higher in the lens.
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    Try the GT2

    Quote Originally Posted by Scrumblydumpus View Post
    We talked to the patient & the doc and decided to lower his add and raise the seg a bit. We are going to keep him in the physio, but if he still has trouble I may mention the raising the monitor idea.

    I thought Shamir's big thing with the autograph series was to minimize intermediate to make near/distance as good as possible?
    I have worn both the Physio and the GT2 as well as Kodak Unique and presently the Autograph 2. The GT2 is wider and the magnification is higher than the Physio or the Unique. The Autograph 2 is better than any of these in all ways, but it's more expensive.

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    I felt the GT2 had a very narrow reading area, at least for me.

    The auto II has worked very well for me.

    The Indo Drive lens is basically a distance and intermediate lens, with minimal reading (kind of the opposite of an office lens which is near/intermediate).

    That might make sense depending on what you are trying to accomplish.

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    Thumbs up

    Quote Originally Posted by john-atlanta View Post
    The Indo Drive lens is basically a distance and intermediate lens, with minimal reading (kind of the opposite of an office lens which is near/intermediate).

    That might make sense depending on what you are trying to accomplish.


    :cheers::cheers::cheers:

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    I have worn Physio, Gt2, Ziess individual, and Autograph II. I find the autograph II has the greatest usable area in every zone. So does it have the largest intermediate zone probably not but effectively it feels the largest.

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    I have patients in the Definity who experience clear mid range across the ENTIRE width of the lens.

    I ask every patient at dispense to turn their heads left and right and read print at 18" and at 36", and let me know when it starts getting blurry.

    In most cases the Definity has been the widest Progressive in the mid.

    Sharpstick

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    Quote Originally Posted by sharpstick777 View Post

    In most cases the Definity has been the widest Progressive in the mid.

    Sharpstick
    I have a pair of Definity Shorts on right now. I have a 17 inch screen and I can see the entire screen with my glasses without moving my head. It is very sharp and clear. I do need to look directly at it, if I turn my head one side starts to blur out.

    My distance is about a -2.00 and my add is a +2.25. The top of the screen is about even with my nose.

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    Quote Originally Posted by Scrumblydumpus View Post
    I tried to explain to him the benefits of a computer lens, but he wasn't having any of it.
    I assume you mean Office and Online designs, or did you mean a single vision computer distance or bifocal computer/reading distances?

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    I have 3 brand new lenses... Definity II, Auto II, and Lifestyle ID.

    The Definity has clear midrange across the ENTIRE width of the lens, however, there is a slight magnification on the outsides of the mid.

    The other lenses have their plusses but the Definity is the only one with complete usabilty.

    Sharpstick

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    Short corridor (14mm fitt height), really soft design, probably a free form would work well.. Will very much depend upon the Px's Rx and working distances though. You may find reducing the add by 0.25 may be beneficial too again depending upon the Rx. The other members seem to love the Autograph II we haven't got that as yet, still stuck with the original Autograph....which we see as a pretty good design

  25. #25
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    Auto II blows away original Autograph, IMHO.

    John

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