Simpler PALs

**Dolphran** · 03-18-2013, 11:09 AM

I'm trying to discern the advantages of various state-of-the-art PALs for a "simpler" prescription. The script in question is +0.75 Sph with +1.50 Add (same both eyes, and no astig.). The client is 52 year old mild hyperope whose presbyopia has now advanced to the point where he is considering "full-time" glasses. He currently does not wear glasses at all for distance but has begun to notice a potential need there especially when tired at end of day. He works at a computer all day (at a slightly farther than average distance of 36") and is happy using +1.25 otc readers at his desk. He is interested in a set of glasses for "everything else". He is willing to pay the premium for high end lenses. He is an engineer who researches his buying decisions thoroughly. He has suggested that he may want Varilux S or Shamir Autograph III - in Trivex with Transitions and Crizal. He has even suggested that he may wish the seg height to be set slightly low so as to give him maximum peripheral clarity at distance.

He is shying away from traditional bifocals because he feels that having the intermediate range available could useful when these are the only glasses he has on him - and importantly, his wife is pushing for PALs because she feels that bifocals will make him look older.

My question concerns the advantage of these high-end lenses for this kind of prescription. With a mild +, no cyl., and both eyes the same, the advantages of free-form (as I understand it) may not apply. However, as a non-eyeglass-wearer for most of his life, I think he will need a wide channel to be happy. What lenses do you think are most suitable here?

**Happylady** · 03-18-2013, 11:51 AM

I think he is actually the kind of patient that would benefit from the best lenses! He's been doing research, he's an engineer(they are very picky) and he doesn't really need a correction for distance.

People with small or no distance corrections often are pickier about their distance vision- they are used to seeing great and will notice any reduction in clairity on the sides of the lenses until their brain adjusts.

Sell him the best, don't drop the height but try to use a metal frame with notepads. Also, don't oversell the lenses. Let him know that there will be an adjustment period and the best thing to do is for him to wear them as much as possible during this period.

**Uncle Fester** · 03-18-2013, 02:30 PM

Welcome to Optiboard!

I agree with the Auto 3 and everything Happylady says!

My rx has some astig but is still quite minor and I really don't like to wear them for distance. My new Auto 2's 15mm fixed are working as good as any I've worn (maybe a dozen different types) but I'm not as picky as most engineers. (I think it's genetic.)

**becc971** · 03-18-2013, 02:53 PM

at the word "engineer" immediately sell him/her the "best" lens available to you and STILL undersell it

**Robert Martellaro** · 03-18-2013, 04:25 PM

Originally Posted by Dolphran

He is shying away from traditional bifocals because he feels that having the intermediate range available could useful when these are the only glasses he has on him - and importantly, his wife is pushing for PALs because she feels that bifocals will make him look older.

Would "he" be "you" by any chance?

My question concerns the advantage of these high-end lenses for this kind of prescription. With a mild +, no cyl., and both eyes the same, the advantages of free-form (as I understand it) may not apply.

Right, I'll stick my neck out. Generally no advantage unless there are unusual fitting parameters. Even then it's marginal. Semi-finshed should be fine. Put the money you saved towards sunglasses, Rx readers, or if you're feeling charitable, the Lions Club.

However, as a non-eyeglass-wearer for most of his life, I think he will need a wide channel to be happy.

The channel/corridor won't be used here. Think generous distance and near zones. Fit close, spot on postioning by the book (don't cut the height unless you sit well above the desktop monitor), bump the panto tilt if there's room, use lightweight materials, and you're good to go, although he might still prefer the OTCs for reading at home.