PAL'S FOR 22-38 year olds

[Jason.Teran]

I have two offices, both in corporate financial buildings, where I see a ton of patients that do extensive amount of Int/NV work. I am talking well over the typical 8 hour work day. I have experience patients notifying me of 7am-10pms five times a week. Case in point, my doctor and I are agreed that no matter what the age, (most of the patients walking out of the exam room range from 22-38 years of age) need PAL'S. We are fitting progressives as low as a +0.75.

I have heard of both the Shamir Relax and Essilor Anti-Fatigue, but through personal experience, have not seen much of a difference in prescribing/dispensing this lens. (The Relax and Anti-Fatigue are SV lenses with a +0.62 on the bottom) My Rx is a -2.50 OU, and trying the Relax and Anti-Fatigue for a period of 6 weeks did not notice any difference in my vision.

I later went on to try PAL'S (with a +0.75 Add) , and immediately saw a world of a difference. My eyes feel less fatigued and my computer/lab work comes at a focusing ease.

The point I am trying to make is for the young professional that spends most of his/her day on the computer screen, more than the average person :
A) Is a PAL ideal for him/her? (even though he/she does not refract with an ADD power)
B) Are there any studies that show PAL wearers experience a more comfortable field of vision while working in their office both INT/NV work?
C) Is there common in the practice you work with, or know of someone who sees this on a regular basis?

All insight is greatly appreciated.

[chip anderson]

As long as you are ripping them off by putting them in a product they don't need yet, why not use the most profitable one available and get all you can.

Bifocals for 22 -28 year olds indeed. Suspect your doctor prescribes a lot of -.50 +.50's too.

Chip

[Robert_S]

Could wearing and getting used to a PAL at a young age and for a period of time reduce a patient's ability to accommodate naturally?

[chip anderson]

Robert:

It sure could. The reason "the patient sees improvement" is that he is looking through a magnifying glass. With this logic we could attach a microscope to the patients and they would see improvement when looking at small things. I'd also be willing to bet that the doctor involved also prescribes exercises for dyslexia.

Chip

[rbaker]

I have two offices, both in corporate financial buildings, where I see a ton of patients that do extensive amount of Int/NV work. I am talking well over the typical 8 hour work day. I have experience patients notifying me of 7am-10pms five times a week. Case in point, my doctor and I are agreed that no matter what the age, (most of the patients walking out of the exam room range from 22-38 years of age) need PAL'S. We are fitting progressives as low as a +0.75.
All insight is greatly appreciated.

Have we sunk to this depth of greed and depravity in order to turn a buck.

Now, dont get me wrong, I support your freedom to do whatever is in your power to legally make a dollar, but in my humble opinion, this is getting pretty close to misfeasance.

[RIMLESS]

Have we sunk to this depth of greed and depravity in order to turn a buck.

Now, dont get me wrong, I support your freedom to do whatever is in your power to legally make a dollar, but in my humble opinion, this is getting pretty close to misfeasance.

I second that. But unfortunately that's what it's become.

[RIMLESS]

Still not as bad as Lens........ selling edge polish to a person with +.50's in a full metal frame.

[uncut]

Food/question for thought.........WHY does our industry ignore, the first diopter of presbyopia, and......... the fact that resolving capability starts to decrease at age 8?

[Jason.Teran]

The PAL'S are not being fitted for every single patient, nor are we recommending them for everyday use. The doctor is prescribing them (mostly for myopic patients) as a computer use/nv work only pair of glasses.

Let's take for instance, a 32 year old myopic patient.
RX -4.25 sph

If he/she were to wear the glasses from 8am-10pm, that patient would feel a visual fatigue. To focus on spreadsheets, multiple computer screens, and smart-phone's, he/she would be using majority of their AOA. He/she would first have to first use all of their AOA to neautralize the -4.25, then produce more plus power to focus on near objects. Focusing in and out, from distance and near, will definitely affect this patient's visual system.

Prime example is lifting a 10lb dumbell. Do it 10 ten times, and it'll be light as a feather. But do it 1000 times or even 2000 times a day, and no matter how fit or muscular you may be, you arm will be fatigued and tired.

Let me state, that neither do I agree or disagree with my OD or the points you make Chip. But if we were just trying to make a few more bucks, we would definitely not try to fit a patient with something they do not need just to try to make a few bucks. If you don't think a +0.75 or +1.00 makes a difference, why would companies like Essilor and Shamir make a lens with a +0.62 in the Relax and Anti-Fatigue? Although they have tons of money in their disposable, it would be foolish to waste all the time and marketing in presenting a lens like this if in fact the +0.62 didn't work for some patients.

And for the record, rarely do we refract RX's with -/+ 0.50.

[chip anderson]

Jason: If there were some truth in what you say, and one does not have to use accomodation equal to the distance refractive error. Why not just sell them some $25.00 PC Peekers to wear at thier computer station and not burden them with all the peripheral distortion of a PAL?

Chip

Jason: Sorry I forgot to answer your question about why major manufacturers make and promote anything: To make money! Has nothing to do with a niche need.

[Chris Ryser]

Jason: If there were some truth in what you say, and one does not have to use accomodation equal to the distance refractive error. Why not just sell them some $25.00 PC Peekers to wear at thier computer station and not burden them with all the peripheral distortion of a PAL?

Chip

Jason: Sorry I forgot to answer your question about why major manufacturers make and promote anything: To make money! Has nothing to do with a niche need.

Chip...............I just love your comments on this thread. They sell the young people PALS on top of it, the most expensive version probably because they are more antifatigue tha the cheaper ones.

I was at the inaoguration of Varulix lenses in 1958, I think it was, which at the time where promoted by the inventors Essel, specially for women who did not want to admit that they had reached the age where the wrinkles start to show, and the eyes are acting up when looking close up.

It seems to now have progressed to sell to these people who don't need glasses at at all. I sit at the computer for 7 hours at the moment this morning at 11.00 am and the day is not over yet, however I am using my preferred SV + 3.00, the screen set at 150% and everything is crystal clear, including the keyboard at reading distance with these glasses.

[Robert Martellaro]

I have two offices, both in corporate financial buildings, where I see a ton of patients that do extensive amount of Int/NV work. I am talking well over the typical 8 hour work day. I have experience patients notifying me of 7am-10pms five times a week. Case in point, my doctor and I are agreed that no matter what the age, (most of the patients walking out of the exam room range from 22-38 years of age) need PAL'S. We are fitting progressives as low as a +0.75.

I have heard of both the Shamir Relax and Essilor Anti-Fatigue, but through personal experience, have not seen much of a difference in prescribing/dispensing this lens. (The Relax and Anti-Fatigue are SV lenses with a +0.62 on the bottom) My Rx is a -2.50 OU, and trying the Relax and Anti-Fatigue for a period of 6 weeks did not notice any difference in my vision.

I later went on to try PAL'S (with a +0.75 Add) , and immediately saw a world of a difference. My eyes feel less fatigued and my computer/lab work comes at a focusing ease.

The point I am trying to make is for the young professional that spends most of his/her day on the computer screen, more than the average person :
A) Is a PAL ideal for him/her? (even though he/she does not refract with an ADD power)
B) Are there any studies that show PAL wearers experience a more comfortable field of vision while working in their office both INT/NV work?
C) Is there common in the practice you work with, or know of someone who sees this on a regular basis?

All insight is greatly appreciated.

For healthy eyes, the CW, and from my experience, the answer for A) unlikely, B) I couldn't find anything recent but I'll keep looking, and C) no.

The PAL'S are not being fitted for every single patient, nor are we recommending them for everyday use. The doctor is prescribing them (mostly for myopic patients) as a computer use/nv work only pair of glasses.

Let's take for instance, a 32 year old myopic patient.
RX -4.25 sph

Why myopes? They accommodate less than any other group.

If he/she were to wear the glasses from 8am-10pm, that patient would feel a visual fatigue. To focus on spreadsheets, multiple computer screens, and smart-phone's, he/she would be using majority of their AOA. He/she would first have to first use all of their AOA to neautralize the -4.25, then produce more plus power to focus on near objects. Focusing in and out, from distance and near, will definitely affect this patient's visual system.

Our body has muscles that routinely contract full-time without stress or fatigue. I'm sitting on one as I type this.

Regardless, when the need arises (binocular disorders, symptomatic emerging presbyopes), I would recommend separate eyeglasses, usually SVNO. The anti-fatigue lenses are not effective for desktop monitors.

[snotbagel]

I've been using custom corridr length lenses very successfully for early presbyopes. Consider the height at which the near vision is used.. a 14-16mm corridor lens works well with low add power for this group. Shamir and Seiko (perfas) both let you choose a shorter corridor than the frame calls for, and because of their design incur very little distortion..

[Java99]

I used to work for a doc who often put myopic college students in flat tops. He was not trying to make more profit, just trying to ease the eyestrain of his patients. After graduation, back to SV. I don't know if he was doing the right or wrong thing, but his patients were happy. He was also a great believer in 20/happy vs what the refraction really said.

I am a -6.00 and about to turn 35. If I spend more than an hour or so doing close work/reading, I really appreciate my .62 bump. I don't wear that pair full time though.

[Jubilee]

I am one that went into a PAL at the +0.75. Granted I am -0.50 in the right, and +1.75 in the left for distance along with a bit of cyl. When I was trying to use two pairs, it was a PITA for me. I was either wearing the wrong pair while working with patients half the day, or going w/o. My first PAL (Auto II) was the best solution for me. I loved it. I still say that wearing a PAL has given me the most visual comfort I have had when wearing glasses. I understand part of that is also do to the ansio.

When I worked up in Bellevue, WA it wasn't uncommon at all to be giving PALs to the under 30 crowd due to the working environment. While a pair of PC Peekers may work, for many they don't want to have to deal with putting something ontop of their glasses. Looks do matter.. I will say for low adds, it can also be harder to get the power you need for intermediate if it is primarily computer you are working with.

[chip anderson]

PC peekers are +1.12. If you need help at computer distance, i.e. you have a +2.00 to +2.50 add, this is correct for computer distance despite all the discussion Now with PALS it's a question of what level the +1.12 will be at when you actually look through it. This is a function of how high the monitor is and how the patient holds his head when using it.

Chip

[Robert_S]

If I had a youngish Px with a low add doing large amounts of computer work, I'd most likely recommend occupational lenses.

[sarahkirch]

Have you thought about using an Essilor Computer Lens? We have a Lot of IBM patients that are in their 20-30's and the comp. lens has worked very well for them!

[sharpstick777]

Have you thought about using an Essilor Computer Lens? We have a Lot of IBM patients that are in their 20-30's and the comp. lens has worked very well for them!

welcome to Optiboard sarahkirch!

[sharpstick777]

I was at a practice that was close to a law school, and the students and professors were doing near work for extensive periods and for days on end. Even in this extreme case we did do reading eyewear for younger patients, but it never exceeded 15% of the students we saw. In most cases there was also some convergence deficiency. Our choice was to go with SV readers so that the person didn't adapt to the extra power in the real world. Once someone has that extra power its hard to throttle them back, and SV meant they were taking off their glasses for anything that was normal.

I have two offices, both in corporate financial buildings, where I see a ton of patients that do extensive amount of Int/NV work. I am talking well over the typical 8 hour work day. I have experience patients notifying me of 7am-10pms five times a week. Case in point, my doctor and I are agreed that no matter what the age, (most of the patients walking out of the exam room range from 22-38 years of age) need PAL'S. We are fitting progressives as low as a +0.75.

I have heard of both the Shamir Relax and Essilor Anti-Fatigue, but through personal experience, have not seen much of a difference in prescribing/dispensing this lens. (The Relax and Anti-Fatigue are SV lenses with a +0.62 on the bottom) My Rx is a -2.50 OU, and trying the Relax and Anti-Fatigue for a period of 6 weeks did not notice any difference in my vision.

I later went on to try PAL'S (with a +0.75 Add) , and immediately saw a world of a difference. My eyes feel less fatigued and my computer/lab work comes at a focusing ease.

The point I am trying to make is for the young professional that spends most of his/her day on the computer screen, more than the average person :
A) Is a PAL ideal for him/her? (even though he/she does not refract with an ADD power)
B) Are there any studies that show PAL wearers experience a more comfortable field of vision while working in their office both INT/NV work?
C) Is there common in the practice you work with, or know of someone who sees this on a regular basis?

All insight is greatly appreciated.

[Jubilee]

But what did you do for folks who had some distance correction, but needed help for the near/intermediate as well? I know several folks that even a +1.00 add was too much, but getting .62-.75 was perfect in assisting them in the longer periods of computer/reading needed for certain professions/programs.

While a pal isn't something that ALL 22-38 year olds need, there are many who do benefit from it. Why not use it as part of your tool box?

If they have no need for a distance rx, and need intermediate/near... SV NO
If they are slightly myopic and need assistance.. SV DO
If they are hyperope, or maybe even a latent hyperope, PAL or an Occupational PAL can make it a lot easier/comfortable for the patient