Above the 180

**PBS** · 04-06-2002, 08:16 PM

We all know there are many many different progressives. All in all they more or less work the same with differences in corridor length and near width. Blah, Blah, Blah..... Patients seem complain about 3 major points regarding progressive lens design. That being, reading width, corridor length and periferal blur. I know not one progressive fits all. I've worn Panamic, Multigressive, and Gradal Top and have been wearing the Hoya Wide for about a year now and my biggest complaint is the blur above the 180. I have 3.5 diopters of astigmatism OU. I find for people with higher amounts of astigmatism the aspheric atoric brands seem to work best. With that being said, the other day I had 2 people pick up on the periferal blur on the Wide. Both were farsighted with low amounts of astigmatism. The fit of the lenses was fine. They were just sensative to the blur. What I want to know is this.... what progressives are you fitting to combat blur above the 180 :hammer: It's this simple, what lens to you think has the least periferal blur above the 180?
I do understand Hoya is coming out with a new lens they say has no blur above the 180. I'll believe it when I see it (or don't see it):p

**PBS** · 04-08-2002, 06:28 AM

I can't believe nobody is responding to this one. Does this mean there is not a viable answer?

**Joann Raytar** · 04-08-2002, 10:56 AM

I just figured I would let somebody more technical answer before I said ... it depends. ;)

Speaking from personal experience I would say it depends on frame shape, powers, frame and patient PD's and what the customer does for the bulk of their day. For example, I recently found out that while Panamic has very little distortion on the temporal edges it has a degree of distortion on the nasal edges. I actually found Essilor Natural and Sola Adaptar to have the most balanced vision for what I do during my day although they have more temporal distortion. If my own PD were wider, I think the nasal distortion on the Panamic would make me buggy.

I have found if I don't think about the distortion or look for it everything is fine and I really don't notice it much. Perhaps, patient comfort involves being as positive as possible about the lens and not putting the non-adapt bug in people's minds. Sometimes, it is difficult to help customers be patient while they get used to their lenses.

**Steve Machol** · 04-08-2002, 11:04 AM

Jo said:
....and Sola Adaptar....

Sola Adaptar! :D

In my opinion one of the better progressives for minimal distortion above the 180 line is the Sola VIP. There are probably others as well, but I no longer have access to all the contour plots I used to see when employed at Sola.

**Texas Ranger** · 04-08-2002, 11:09 AM

PBS, sometimes we need to understand the limits of lens design...that said, I am convinced that NO lens design can restore "normal" vision to folks with refractive error and/or presbyopia. some lens designs solve more problems than they create...All of the lenses you mentioned are outstanding...I prefer the Panamic, and fit about 90+% of our pts. with them...their new 1.67 aspheric panamic should solve more of your peripheral problems with high cyls. OK, do folks experience no peripheral problems with ST-28 bifocals? Does the area size of the lens become a factor? Is it better to have a tiny peripheral blur than image jump of a ST 28? If you're wearing a ST-28 with a +2.25 add, can you see your desktop laterally to the right and left while looking straight ahead? In those lenses, can you see the PC monitar at 40", six inches above the desktop? I can with my Panamics, and I hardly ever notice peripheral blur, unless I'm specifically try to observe it! So, when we suggest and dispense pals, we educate the pt to turn their head a bit to avoid the slight peripheral blur, that some of the success in them "learning" how to use the lens, is their responsibility....

**LO1007** · 04-08-2002, 04:04 PM

You are correct that Hoya does have a new progressive called Summit ECP. I also want to say that I work for a Hoya lab and got a pair last week. My first reaction was very good.........I do not notice any blur above the 180, the vision is very good and very relaxing to the eyes. The design is based on a lot of new technology that Hoya developed. I have an account that has sold a couple and the reaction from the patients was very very good. One was a problem patient with all other pals called to tell them how much she liked her new progressives.

**PBS** · 04-08-2002, 04:40 PM

These are some decent answers. Isn't it funny how some of the older designs work well. ie: VIP and the Adapter. The new Hoya lens that is coming out is not the Summit ECP, it's actually something newer than that. (According to my rep.) If you think about progressive design, the soft designs have more distortion. The only way, it seems to me, to reduce the blur above the 180 is to make a hard design. Thus the older designs. Hmmmm... I guess sometimes newer isn't always better. There is no wrong or right here. How about some more answers to the perplexing question? I don't need detailed explanations about recommending progressives and how to deal with patients, just names. Thanks

**LO1007** · 04-08-2002, 06:39 PM

Sorry PBS but the new lens is the Summit ECP, it has been out in Europe as the Summit PRO since last year, but bringing it to the US required a name change. The initial launch was at Vision Expo East. There has been a lens out called Hoya Summit, that is a completely different design from the new Summit ECP. The Summit is only available in the Hoya 1.60 material, the new ECP is avail in CR, 1.60, Phoenix and a new 1.70 material.

**Jackie L** · 04-08-2002, 09:58 PM

We have had great results with the Hoya Summit 13 as a short corridor lens, especially for drilling. I did learn about the new ECP at Vision Expo East. Sure would be a bummer to go back to yesterday's harder technology. Just my opinion.

**sticklert** · 04-08-2002, 10:36 PM

Jackie are you implying that the ECP is a Hard Design? If not this is just a good explanation of the ECP technology.

I work for a Hoya Lab, and my understanding of this new technology is that it is a combination of both "Soft" and "Hard" design technology. The improved horizontal, asymmetrical design ensures that peripheral astigmatism is reduced in all areas, which enhances the visual field. Furthermore, when you go into a higher add power, over +2.25, the design does become more of a hard design making it more functional because when the higher the add power, the more the peripheral area is affected by astigmatic distortion, compromising the visual performance and the field of vision over the entire surface. In addition, with no less than 120 “Inset Variations”, the ECP Progressive Lens has personalized the design properties for enhanced visual comfort.

:D :D

**bwheeler** · 05-15-2002, 02:05 PM

I find that it will depend on the patient expectation. In many cases, we as opticians can assist in forming that expectation to meet a favorable outcome.

If the patient is a previous wearer, ask how they have liked their present progressive. If the answer is positive and no complaint, then wisdom would indicate matching that lens/fit as close as possible. If they have never worn them, I always mention that while they provide a smooth and continuous power corridor for the distance to near points of vision, this takes place through the central vision area and the areas to the side of the lens provide a softer image area. When the patient sees this through demonstration, they are then prepared for it at wearing time.

If they are unhappy with a present progressive lens that they have worn for a while, try to find the specific complaint. If it is peripheral "blur" it might be better to council them that they will not be able to escape it completely but with evaluation of the type of lens they are wearing and a description of the instance when they feel the most limited by the "blur" a better lens may be an improvement. Understanding of the various lens designs and their worn characteristics will prove valuable in making a successful recommendation.

**LENNY** · 05-15-2002, 09:02 PM

Does VIP and XL have the same desighn above 180 line?

**Steve Machol** · 05-16-2002, 12:02 AM

LENNY said:
Does VIP and XL have the same desighn above 180 line?

No, they can't because they are very different designs.

**Homer** · 05-16-2002, 06:23 PM

and dream of days of hard designs ?

Anyway, VIP is my fall-back lens for peripheral blur problems, expecially for myopes. To me Adaptar is a soft design. I would say that 90% of my complaints of distance peripheral blur, are from Myopes. You can fit a hyperope in nearly anything. I also fit Myopes high and hyperopes low.

About 10 years ago I had a myopic farmer whom I fit with the Adaptar and we even remade it once without real success. Finally I took him back to his old "New Super No Line" design and it worked like a charm. As he was learing, he turned and said, don't you every try and fit me with that new stuff again. This was a farmer with a post-grad college degree and a high-school teacher as well.

I have been burned more that once on "the latest technology in lenses".