Troubleshooting Hoya Lifestyle ID

[Reeseleonard]

Hey guys,
I would appreciate some advice here.
I had a patient last week who found us in the yellow pages. She was just calling around to different optical shops to get info on different progressives, and she came into our office because she liked the way I explained the lenses over the phone, which I took as a huge compliment.
She was somewhat cost-conscious, but still wanting a good lens. I fit her with the Hoya ID Lifestyle in Trivex. The seg was 19, the frame fit well and was properly pre-adjusted, trivex lenses, premium ar, etc. I am not sure which lens she was wearing previously, but she complained that she did not have enough reading room, so I figured since we were going with a premium lens that was not a short corridor like what she was previously wearing, she was going to love them.
Wrong.
In our optical, it is just myself and my optical manager selling and adjusting. I have done this for 10 years, and she has been doing it for almost 30. We both really try to check everything thoroughly and if a pair of glasses is not within tolerance or even questionable, we send it right back to the lab. My point is, we are both very picky.
When the patient came to pick up the glasses last week, I was out sick Thursday and Friday, so the other optician was the one to inspect and dispense them. The patient returned the following day, and complained that she could not see through them still. The optician again checked the rx, verified measurements were taken correctly, and sent her back to where she had her exam/refraction down the street.She thought that perhaps her refraction was incorrect.
Wrong.
The doctor or tech that rechecked her told her that their refraction was indeed correct, and that we made the glasses incorrectly and they are off axis and the bifocals are cut off.
The patient is coming back this afternoon to see me for a full refund and returning her glasses.
I explained to the patient on the phone that I would like to check the glasses myself. Perhaps when she took the glasses we made to her doctor's office, they did not mark up the lenses when they read them? Has anyone else had trouble reading some of the digital/freeform lenses if they are not marked up? There is no way the bifocals would be cut off if the seg was a 19, right? I don't even think they have an optical at the place she went, so maybe they aren't familiar with the newer progressives and compensated rxs. I also asked the patient if she would like me to switch brands and perhaps try an AutographII or Varilux, but she no longer trusts us.
I guess I just take it personally when someone can't see out of their glasses and it is something that I fit. Please advise... and sorry for the long-winded post lol.

[Robert_S]

It's a difficult situation and one we've all been in. It's very poor form for the other company to criticise your work. Even if they are right, they should have called you personally and then told the patient that after discussion you were going to check some other factors. That's where the problem really comes from, because resolving spectacle issues is a lot easier than regaining someone's trust.

We can't diagnose the problem without more information, and even then it would be very difficult, but please don't call the 'reading zone' the 'bifocal' as that is a misnomer.

In any case, you fitted the patient with an excellent lens; one of the best in the world. Things don't always work out the way we want them to but optics is an incredibly complex business.

[Robert Martellaro]

I am not sure which lens she was wearing previously, but she complained that she did not have enough reading room, so I figured since we were going with a premium lens that was not a short corridor like what she was previously wearing, she was going to love them.

Welcome to Optiboard, Reeseleonard.

Try to gather more information when asking for troubleshooting help, i.e., Rx new and old, lens design new and old, etc..

Best guess due to thin history...

Is she a moderate to high myope? Switching from a short corridor to a relatively long corridor might be disappointing for some wearers, especially when adds are over +1.75.

OTOH, if the old PAL was a short design, the frame might have been too narrow, and that's what she meant by "not enough reading room".

...optics is an incredibly complex business.

Very much so, especially with the more complex Rxs and/or lens designs; the prescriber, fitter, and fabricator all have to be at their best to achieve good results.

[ChrisinNH]

We've had 2 patients I can recall in the last year that were having troubles with the reading areas of their progressives (Varilux Comfort 2) and everything measured correctly...good fit, good frame...all appeared well as far as I could determine but both patients were having problems adapting. One patient with both lenses and the other with one lens in particular. Long story short...I said, well...let me have new lenses made...maybe there is something with the lens that I can not detect that is causing a problem. Had two new lenses made for one patient and the other, I had the single lens made. Both patients loved their new Lens(es)...same lens, same heights, pd, etc...nothing changed except the lenses. Placebo effect? Some optical defect that I couldn't measure? At any rate...all is well with them. On a side note, we dispense the HOYA ID LIfestyle and Amplitude HD on a regular basis and generally, patients are very pleased.

[jefe]

I've begun to shy away from the iD Lifestyle for plus rxs -- using instead the Spectrum, Mod PAL and Definity.

[sharpstick777]

Welcome to Optiboard Reeseleonard

You are stuck with 2 choices, one that costs a lot of time (trouble shooting), the other that costs a lot of money (refund).

To trouble shoot the issue, you need the old pair she use to wear, the new RX, and her confidence.

Don't worry about what the other office said. If you verify the new pair was made and fit correctly, you can go on the next issue.

The first thing is to check distance and reading visual acuity in both the new pairs and old. I cannot tell you how many patients told me they were not seeing well through the new pair, yet VA was actually higher. It can happen because of "feel", that is another issue we will tackle soon.

You need to separate if the issue is the RX, or the lens. The fastest way is to use +-.25/.50 flippers in both distance and reading. If she sees better with the flippers, using an eye chart, then its an RX issue. Here is what can happen with FF lenses though. In the exam chair OD's have been trained when a patient was between 2 Rx's (OD "what is better, 1 or 2" " I don't know! Ok, 1, no, 2! I can't tell"). FF lenses can reduce power, OD's can reduce power, and when combined push VA down in a few cases, in a few lenses.

If there is a suspected RX issue, you will have to write a detailed explanation to the OD of what you found, and why, using professional terminology and testing, on your letterhead. You will probably have to provide your Free-form read out along with it. Very diplomatically.

If the flippers don't help, you probably have a lens issue. Since your patient has lost confidence, you will either have to refund or switch lenses.

The key to preventing this is your dispensing dialogue. New lenses, even great lenses, can send the brain for a loop. Your patient lost confidence in you, and its frankly your fault for not using good predictive dispensing before they walked out the door.

Free-form lenses (in most cases) move the add power from the steepest portion, to the flattest portion of the lens. To the patients view everything is going to move and seem different, esp when the walk and move their head. In some cases the add power will be less, and the patient has to adapt to that. The patients muscles will have to get used to finding different powers, and different distortions in new locations. The brain has been compromising and adapting for a long time, it will need to relearn how it sees. This is all best explained before the patient tries their new glasses on.

Even great lenses won't replace great dispensing.

[Mr.Powers]

short corridor like what she was previously wearing........ Never ever use long corridor, they ar dead in my wolrd. Stick to short corridor. and there are no problems.

[Jaka]

I also prefer short corridor. Especially if patient is use to it. I also prefer to use 2 mm more than minimum height required.

What is the differnece between the old and the new Rx? And what did she complain about exacly ?

[impress2010]

I have been using Hoya progressives for the past two years. But I mostly stick to the iD MyStyle. It's been my most favorite and successful lens. What I have learned however is that in some cases, clients do have to give the lenses a fair shot. One day is just not long enough especially when you are changing lens designs. A few times that has happened to me when they pick the glasses up, they instantly say they cannot see clearly or as clear as their old ones. When I instruct them to just wear them for a few days, without switching back to their old glasses. Then after a few days, put on the their old ones and they will see a huge difference. On my followup phone call, they have gotten used to them and they love them. Not sure why this is the case, but that is what my Sales Rep told me to tell clients if they are having a hard time initially. Hope this helps for future. I abolsoutely love this lens. I have been able to switch clients from whatever lens design to the iD MyStyle no problem.

[Robert_S]

Hello impress, welcome to optiboard.

what you mentioned is mostly the case because the varifocal market is saturated by hard designs, and Hoya's lenses are generally soft. It can be very difficult to switch from one type to another, but persistent wear usually solves any issues, like you said.

[Kallen]

Sorry to hear about this...first of all, that specific lens I personally had a few non-adapt issues and was better off with a shamir autograph II, however, also, with the new freeform digital, what refraction system are you using? It is still within a quarter diopter? Also, what are you using for a lensometer? Traditional, automatic, etc. Check them yourself, try a different lens style but in all cases like this, if someone is happy in their current progressive even if it isn't the latest technology, it's our habit to want to give them better but remember what's "better" by industry standards might not be "BETTER" by the patient. Let us know how it turns out. FYI, Visionix has the WaveLensPro that is an automatic lens analyzer customized for free-form/digital lenses....will map the lens for you and show you the diagram, rx, parameters, etc. Great piece of technology for the lab if you're doing a lot of these lenses.

[sharpstick777]

I also prefer short corridor.

There is a danger in short corridors with higher adds. Even in Free-form distortion increases geometrically each mm the corridor is reduced. As well, each usable zone shrinks in height. A 2.50 add in a 14 mm seg will be one unhappy patient.

Corridor length should be determined by add power first, but as Jaka said, a few people want that reading power to come up quicker. It does improve the reading but at the cost of the computer zone.

[KStraker]

The Id Lifestyle is an excellent lens. We use a bunch of them. Put her back in the CD version and be done with it. Call Hoya and do a remake as a non adapt. To the others who only use short corridor lenses: IME, the loss of midrange seems to be a problem if the add power +2.00 or more.

[Nobody77]

You didn't provide much information tbh... What is the prescription? What was the corridor lenght? I am not sure if it's the same in the US but there is a new version of LifeStyle in Europe, or rather two options for LS... Harmony and Clarity. Which distance did she complain about? I find it hard to believe she was unsatisfied with all distances. How did the addition change from old prescription? It would even help if you could somehow find out what her old lenses were. Sometimes when ppl with low ADD were happy with their conventional old lenses, they sometimes have trouble to get used to the new lenses, especially if her old lens was a quite hard design as classic LS is rather soft.

It also takes an avg. of two weeks for the brain to adapt to a new image + another 4 weeks to get start getting used to a new design. If the lens was fit well and she came back the next day, she didn't give it enough time.

Can you provide any additional information?

[Lesle]

I've been working in the optical field for 5 months and not familiar with Hoya lifestyle 2 lenses. I wanted to know what is the power range for this type of lens?

[Lab Insight]

I've been working in the optical field for 5 months and not familiar with Hoya lifestyle 2 lenses. I wanted to know what is the power range for this type of lens?

Call your Hoya lab and they will send it to you. The Rx parameters range based on material.

[Uncle Fester]

1.5 CR39 -8 to +6 cyl to -4 add +.75 to +3.5

poly -6 to +6 out to -4 cyl add +1 to +3

1.6 -11 to +8 cyl to -4 add +.75 to 3.5

1.67 -13 to +8 cyl to -4 add +.75 to 3.5

trivex -8 to +6 cyl to -4 add +.75 to 3.5

Is AR required? Rarely deal with them.

PS-Lesle-- Welcome to Optiboard!!!

[cowboytelemark]

I've been working in the optical field for 5 months and not familiar with Hoya lifestyle 2 lenses. I wanted to know what is the power range for this type of lens?

The Lifestyle 2 comes in two different configurations. The Clarity is distance weighted and works well for a lot of myopes, the Harmony is more equally weighted and works well for hyperopes or those with a lot of intermediate/near demands.

[Lesle]

Thank you so much for the info. I am glad to be member of Optiboard Yes, I put AR and transition as a side option.

[Lesle]

Yes, it's all true base on my research. But knowing that clarity works well in myopes and harmony for hyperopes are good to know :)