Suggest a good PAL for plano presbyopes?

[Chris Ryser]

Selling isn't a bad thing but overselling is a bad thing and in this case a traditional lens is going to perform just as poorly as any FF lens.

Bravo! Harry

But then the concept of a Pal at all for this application is overselling.

Chip

Originally Posted by For-Life
we can move to a communist society where they only provide metal round frames, flat tops, and glass lenses.

............................but the situation presented isn't going to work in a PAL very well and throwing money at it isn't going to solve the problem, neither is calling anyone that suggests anything but the most fat cat capitalistic approach of the most expensive product first.

no wonder the on line companies are making more and more sales..............coastal doing 600 jobs of glasses (up 24% first quarter) a day in Canada and opening 1500 account per day.

[For-Life]

no wonder the on line companies are making more and more sales..............coastal doing 600 jobs of glasses (up 24% first quarter) a day in Canada and opening 1500 account per day.

Chris, aren't they all selling big name lenses with AR? I never see them push glass flat tops in round metal frames.

[chip anderson]

Actually For-Life I was suggesting that we an medicine switch to a more altruistic society where we do what, and only what is best for the patient's needs.

Old disappearing concept I know, but then I'm old.

chip

[Johns]

we can move to a communist society where they only provide metal round frames, flat tops, and glass lenses.

There you go, pushing your (political) agenda again!;)

[For-Life]

Actually For-Life I was suggesting that we an medicine switch to a more altruistic society where we do what, and only what is best for the patient's needs.

Old disappearing concept I know, but then I'm old.

chip

Are you saying that Communism is best for society?

Okay, I kid

[obxeyeguy]

Are you saying that Communism is best for society?

Okay, I kid

And now back to our regularly scheduled thread, not about politics as some always seem to turn it.:finger:

[chip anderson]

For-Life:
Me, communist? I didn't vote for Obama.

Chip

[Johns]

And now back to our regularly scheduled thread, not about politics as some always seem to turn it.:finger:

"we can move to a communist society where they only provide metal round frames, flat tops, and glass lenses. "




Yeah, isn't great!;):cheers:
I'm trying to figure out how For Life is going to turn Heather's thread about Doggles into an argument for communism. Free Doggles for all!:hammer:

[For-Life]

:hammer:it wasn't an argument. It was a joke. That is why I said I was kidding.

[OpticianVlad]

This is a tricky question because my RX is low as well. Actually I have plano in my right eye. I became a first-time progressive user 2 months ago. I have the new Definity design and I don't have as much periphery was I would like.

For a patient that works in a cubile, I would recommend an NVF lens. My favorite is the Shamir Office, I stopped using Prio because it only comes in CR-39. Plus Varilux is working on a computer lens now, I'm thinking it's going to be the same Prio design in a higher price tag available in more materials.

My next PAL to try out with be some type of Shamir Autograph. Purely experimental to see if I can get better periphery.

I talked someone out of a 360 lens today because she didn't have any complaints about the previous PAL design. She had Davis Vision and it would have costed her another $200 to go out of plan just to have a "Digital" lens. I told her, "it's a great lens, but if you don't have any issues with what you're wearing now, I can't honestly tell you that your vision is going to be much better". "or at the very least $200 dollars better :)" Her Rx was -0.50 ou +2.00 add ou.


I believe it's better to build trust than to build sales.
Sales will build the business if you worry about building trust with your patients.

[Johns]

:hammer:it wasn't an argument. It was a joke. That is why I said I was kidding.

Hey comrade, we're just pulling your chain!:D

[sharpstick777]

I gotta say when FF lenses are recommended to even the most basic Rx like a plano with add, I start to wonder about the recommenders fitting skills. Selling isn't a bad thing but overselling is a bad thing and in this case a traditional lens is going to perform just as poorly as any FF lens.

I never consider putting patients in lens that will help them see better as overselling. DVA is very important, and in Progressive wearers compliance is an issue when they don't see as well in the distance with their glasses.

Since many digitally processed lenses are less than many grinders it doesn't make sense to not put a patient in the best lens regardless of price, since the price difference is so small.

Sharpstick

[braheem24]

Plano presbyopes love any cheap pal with an intermediate top half and near bottom.

wheather this answers your question is a different story :D

[gemstone]

One might give some small concideration to how strong the add is.
If it's over +2.00 he will need either a progressive or trifocal. Under +2.00 a bifocal of any type should work.

Chip

No contacts?

[chip anderson]

For contacts the lower the distance power the greater chance of failure.
Failure in this case meaning the patient doesn't like them and ends up wearing glasses.
I know some people concider failure and success having to do with whether or not the bill was paid, but not here.

Chip

[sharpstick777]

Bravo! Harry
But then the concept of a Pal at all for this application is overselling.
Chip

OK, Chip and Harry ... here are few of my recent patients.

2 of them are national level speakers who travel around the country and speak at large meetings of 500-2000 people almost every week. 1 specializes in consulting for corporations, the other does medical CE seminars for nurses and MD's. Neither has significant distance RX but their criteria are: 1) no lines 2) they must see an audience clearly at up to 100 feet over a wide width of view 2) they don't want to in the middle of presentation have to change glasses to see thier laptop on a table, or their notes at a lecturn, or the person with a question at the back of the room 3) they often can't control the room they are in, the table or lecturn they use as they stand to speak. 5) Money is no object, they want the best. One has +2.25 add the other +2.50.

Another is a factory manager who drives large trucks and needs good VA reading, distance and intermediate, needs to look at spread sheets and needs to examine testing equipment at 40" and read reports at 18". He HATES having 2 pairs of eyewear (previous solution) as he is all over the factory floor, using different computers at different work stations. Plus +2.00 add, VSP insured.

Another is a mother with 6 kids and a husband away in the military. She is always on the go, with her hands full and also hates changing eyewear and looking in her purse to find her readers are NOT there. Did she leave them at home? in the car? Damn, another kid is crying and she can't read the medicine bottle. +1.75 add, and she very concerned about glasses making her look older.

I hardly think that meeting a patients needs as they stated them with the best product possible counts as over selling especially since all three of these patients stated they HATED having multiple pairs of glasses and their goal for coming in was to find something besides readers.

What would you put these people in?

Sharpstick

[drk]

Sharpie, you're missing the point...

If the patient is emmetropic, there's nothing to customize/individualize.

(Ok, maybe position-of-wear, if you're concerned about that...)

[HarryChiling]

OK, Chip and Harry ... here are few of my recent patients.

I hardly think that meeting a patients needs as they stated them with the best product possible counts as over selling especially since all three of these patients stated they HATED having multiple pairs of glasses and their goal for coming in was to find something besides readers.

What would you put these people in?

Sharpstick

You take care of yours and I'll take care of mine. Your attitude matches the product you sell high brow with nose turned up, I don't respect it or like it. If you chose to fit your patients in the newest in technology and highest in price to make up for your lack of knowledge that is a problem with your dispensing not mine. The FF product currently available is generations better than the first incarnations and half the cost in some cases, but it still does not warrant it's use in every scenario. If they're so flawless why not fit all your patients in progressives young and old, why even use the natural accommodative ability of the eye, FF is here to save us all.

The blind providing vision what a sight to see. Show me proof of the best product, show me the patients needs when your first example says the patient doesn't WANT to switch pairs.

I am assuming that the patient came in wearing PALs what was wrong with them? Did you bother to ask for their current eyewear to see where they were lacking? Were the current glasses made properly? It doesn't matter either way you wouldn't have posted the scenarios if they didn't turn out in your favor either way and they are still anecdotal. Back up bull with bull. It's your prerogative to do it, just don't drag my name into it.

What freakin arrogance, best product, patients needs, money is no object, the want the best. They want what works, and the fact that they are willing to pay $10,000 or $10 has no significance on which lens will be the best choice for them. Even our American National Standards Institutes factor cost vs benefit, the recent changes to the ANSI were due to the insignificant number of people who would notice the 7 degree axis shift for a 0.25 cyl or the increased amount of error allowed in a PAL due to the molded nature of PALs compared to the savings in spoilage the lab would reduce. You keep selling those 0.01D accurate lenses that are produced with Rx's that could have been refracted down to a 0.12D with a duochorme test, the refractions that could be anywhere from +/-0.50D different even on the same day produced by labs and manufacturers that lobby for looser standards while claiming to sell more accurate lenses to an industry that is known to be full of ignorant boobs that won't admit what they don't know. Maybe one more post about how FF lenses could be used to cure diaper rash and you get another pouzzle piece and a chance to win a free tote bag.

What would you put these people in?

How about an office far away from your's, one with a professional in it.

[Barry Santini]

Harry,

Four points:

In very short order I believe, most FF lenses will be less expensive than traditional lenses, re manufacturing costs. You're also counting out the material choice that FF provides. Not a trivial advantage, IMHO.

For me, my first FF choice is *less* expensive than my previous choice, when both are factored in with a premium AR.

Do not sell the public's perception of eyewear inconvenience short. It is, IMHO, *the* most important hurdle our industry must overcome for its longterm survival

And, for the record, I soooo totally agree with you about refractions/Rxs. The current paradigm needs to be thrown out, or at the least, severely updated. It's time to ditch what I call the "Blind*Rx".

FWIW

Barry

[HarryChiling]

For me, my first FF choice is *less* expensive than my previous choice, when both are factored in with a premium AR.

I know you sell old technology FF lenses (Element), that doesn't exactly support the point that the lenses are better matter of fact I appreciate the fact that you weight the cost vs benefit factor into your lens choice, it's the business side of our industry.

In very short order I believe, most FF lenses will be less expensive than traditional lenses, re manufacturing costs.

You don't manufacture FF lenses so again let the lab mind their store and yu mind your store. It may come off as a bit rude but the reason why the lab wants opticians to seel a product and the opticians reasons to sell the product don't always have to jive.

Do not sell the public's perception of eyewear inconvenience short. It is, IMHO, *the* most important hurdle our industry must overcome for its longterm survival

The original scenario IMO did not call for a PAL and if one were to be fit then the lack of WOW as you like to call it will be similar between the FF and the traditional, the difference will be the price. If I were the patient and walked out of yoru shop I'd get the feelign that every time I opened my mouth the lenses cost more. If I can use an analogy; if you needed to get to Europe tonight you'd need a ticket for a flight not a bus, train, or limo no matter the quality of the last three modes of transport they won't get you to Europe.

[drk]

Help me understand this:

OD +0.25 DS
OS plano
+2.00 add

What does individualized offer this wearer over traditional?

[Fezz]

Help me understand this:

OD +0.25 DS
OS plano
+2.00 add

What does individualized offer this wearer over traditional?

The BEST of course!

;):cheers::cheers::cheers::D

Are we talking individualized or just free-form? Would a free-form Image be just as good as the free-form Element? Would the Element be just as good as an AUto II? How about a free-form Ovation? Or maybe a free-form Ovation 360!

[HarryChiling]

Help me understand this:

OD +0.25 DS
OS plano
+2.00 add

What does individualized offer this wearer over traditional?

For the distance lets say a viewing angle of 30 degrees in CR-39 and lets put it onto a base that couldn't possibly be the right base curve for this lens (+16.00 diopters)

Oblique Astigmatism
OD = 0.03D
OS = 0.02D

Mean Power Error
OD = -0.05D
OS = -0.07D

Like I said negligable, in the reading though the wrong base:
Oblique Astigmatism
OD = 0.06D
OS = 0.06D

Mean Power Error
OD = -0.19D
OS = -0.21D

I'm not even gonna ask you to believe me plug your scenario into Darryls Spectacle Optics program and see for yourself. Lets say you took a traditional Comfort off the shelf and traditionally surfaced it in a 16.00base lens (if it came that high) guess which lens would be better the traditional or the FF version? Trick question the FF version wouldn't be available with todays technology since the high base if it existed would require a high back base/cross curve that the equipment couldn't polish out properly so the miniscule amount of error it could have possibly corrected would render the technology useless.

[optical24/7]

[QUOTE]For the distance lets say a viewing angle of 30 degrees in CR-39 and lets put it onto a base that couldn't possibly be the right base curve for this lens (+16.00 diopters)


QUOTE]

Actually, a +16 isn't too far off the best form base curve for the above power (plano) with the Wallaston's series on Tschering's Ellipes.

[HarryChiling]

[QUOTE=optical24/7;293189]

For the distance lets say a viewing angle of 30 degrees in CR-39 and lets put it onto a base that couldn't possibly be the right base curve for this lens (+16.00 diopters)


QUOTE]

Actually, a +16 isn't too far off the best form base curve for the above power (plano) with the Wallaston's series on Tschering's Ellipes.

Good point but you'll notice nothing significant between 6 Base and 16 base so if I can use anything between without any significant error whats the point of customizing it? I also used the comfort as an example because it come in both a traditional and FF processed version, what threshold should I consider as being an appropriate level of error to correct for that would be worth it to double the lens price. Isn't it possible that the one size fits all philosophy could be flawed and a second properly fit pair for the scenario do the patient more justice.