Best lens options for different categories of patients

[stedel]

Hyperops: Seiko Surmount, Zeiss Individual 2, Definity (only the Surmount and Individual offer fully free-form optomized corridors in the US, Zeiss will hold an edge in higher Hyperopes because its more adaptive and allows slightly higher BC in high plus powers, as it goes to dual add)
Myopes: Most lenses are optimized for low myopes, so its fairly easy. For high Myopes the Auto III, Seiko Superecede, Zeiss Individual, Shaw Lens, Stealth PRO HD, and Ice-Tech.
Hi adds: Harder designs: for wider corridors: Surmount WS, iD/Lifestyle, Supercede, not as hard but the Definity is decent. For better distance: Zeiss Individual, Shaw Lens, Stealth HD, Shamir Spectrum, the Auto series will provide good distance and low distortion in high adds, but the corridor does narrow more than other, must pair with Office type lens.
Low adds: Softer designs: Shamir InTouch, Zeiss Choice, Seiko Succeed, Autograph Series
Heavy computer users (wide intermediate) <---- nearly all our patients want wider intermediate: Seiko Surmount is often 4-8X wider in the intermediate than most progressives.
Short corridor. Any lens that has multiple corridor or variable fitting options, (like 14,16,18, 20) All newer Free-form Zeiss, Seiko and Shamir adapt well to shorter corridors, MUST be 100% Free-form, HYBRID Lenses do NOT do well in shorter corridors. lenses with only 2 fitting heights do not do as well.
An excellent computer lens: Shamir Office /Desktop, Seiko PC Wide, Zeiss has new options but I have not tried them.
A lens that's good for people who can't adapt to anything else: The Seiko Surmount with its reverse geometry design often works with spacial distortions, as does the Autograph series due to its very low distortion and soft design. Prism? iD Lifestyle, Definity, Surmount Large Reading: Stealth Plus or Stealth Pro RD Aniseikonia and Anisometropia: The Shaw Lens (ps, server is not allowing me to edit this well)

We sell Essilor lenses as well, and we're going to keep selling them for various reasons. Here's my guess as to what Essilor lens goes into each of those categories:

Hyperops: ??? (Comfort 360 maybe?)
Myopes: Physio 360 (is this the same as Physio DXr btw? I haven't seen that lens as an option before)
Hi adds: ???
Low adds: Ovation ADS (Ovation DS in the US I think)
Heavy computer users (wide intermediate): ???
Short corridor: Ellipse 360
Computer lens: Computer DS
Non-adapts: Ovation (conventional)

As you can see, there are some big blanks in my guesses. Can anyone help?

[Mr.Powers]

My "Shotguns" are Autograf II and Seiko Supercede. Autograf Works for allmost all. Seiko is for the High Hyperope

[Caroline]

How come no one talks about Nikon lenses? I've recently started using them and really like the Presio Power and so do my patients. Comments?

[Mr.Powers]

Never used Nikon tell me about them what is so great about them ?

[Britt8701]

Hope you soak in all that info it will give you a leg up. As well as speed up the learning curve.

Few bits of advice:
Never stop learning this field is EVER-Evolving.
A young Optician with a sponge for information is better than a 30-year vet with a closed mind.
Also never doubt yourself your confidence will ensure patient compliance which is over half the battle.

[Caroline]

I'm a first-time progressive wearer and when I got them, I kept looking around for the distortion. I couldn't see any. Then I got a pair of Hoya Summit CD iQ and if I turned my head a little bit each way, it blurred out. Just my $0.02, but my patients are really happy and so am I. I've fit plenty of Varilux products in the past, never wore them before, and patients were happy with those, too.

[Britt8701]

Shamir has a new Autograph III(variable) out with a truly distortion free design, you will have to spend more time deciding with of the variable designs will fit your patients lifestyle. However it leads the way for 2014. There is no one answer for lens selection however the Autograph III(variable) will give you the widest array of options to customize. I usually wouldn't fit in the Shamir family however I must say that I've been blown away with the response from the lens. However I'm not a PAL wearer, I cant give you a first hand perspective.

[jpways]

Shamir has a new Autograph III(variable) out with a truly distortion free design, you will have to spend more time deciding with of the variable designs will fit your patients lifestyle. However it leads the way for 2014. There is no one answer for lens selection however the Autograph III(variable) will give you the widest array of options to customize. I usually wouldn't fit in the Shamir family however I must say that I've been blown away with the response from the lens. However I'm not a PAL wearer, I cant give you a first hand perspective.

We use the Auto III too but to call it distortion free is a misstatement of the facts. I doubt there will ever be a truly distortion free progressive lens (I doubt that it's even possible to develop under our current knowledge of lens design). The Auto III has less distortion then the Auto II and is up there with with the top lenses in minimizing distortion, but to call it distortion free is wrong

[Mr.Powers]

The Auto III has less distortion then the Auto II and is up there with with the top lenses in minimizing distortion, but to call it distortion free is wrong

what is the top lenses, iyo ?

[jpways]

Hoya's ID Mystyle (but the difference between the Autograph III and the Mystyle is not that great)

[Mr.Powers]

realy, first time i hear someone who like hoya top products. but great to hear.

[Golfnorth]

Hoya's ID Mystyle (but the difference between the Autograph III and the Mystyle is not that great)

I second the Hoya ID Mystyle! Haven't tried the Autograph III

Regards,
Golfnorth

[madcapzany]

I'm a first-time progressive wearer and when I got them, I kept looking around for the distortion. I couldn't see any. Then I got a pair of Hoya Summit CD iQ and if I turned my head a little bit each way, it blurred out. Just my $0.02, but my patients are really happy and so am I. I've fit plenty of Varilux products in the past, never wore them before, and patients were happy with those, too.

Hi there! Would you say which lenses you found to have the least distortion?
Every rep claims theirs is the best, and the demos always look great, no matter what!
Which one worked for you before you tried the Hoya lenses?

[lightbender27]

For Computer: Try a Access or a Perfecta Professional
General: This is older but we used Kodak Unique and everyone loved them, Perfecta's are a great newer option.

[m0002a]

Hyperops: Seiko Surmount, Zeiss Individual 2, Definity (only the Surmount and Individual offer fully free-form optomized corridors in the US, Zeiss will hold an edge in higher Hyperopes because its more adaptive and allows slightly higher BC in high plus powers, as it goes to dual add)

Does anyone have an opinion on whether Hoya Mystyle is also good for Hyperops, especially in the higher powers (+5.00 or so with 2.50 add) ?

[sharpstick777]

Essilor is not at the high point of the their technology curve, the "S" has an enormous non-adapt rate (see other posts) and most of their other lenses are Hourglass shapes which don't offer clear edge to edge in any one zone. Hourglass shapes even if Free-form are general purpose lenses, that will not usually score the best in a specific category but will do OK in most of them (Except intermediate, the Comfort has terrible intermediate).

Their widest lens is the Physio DRx but that has a LONG adaptation time (also covered in other posts).

I have no interest in you stopping selling Essilor, but you are extremely limiting yourself by choosing only one brand. Its like being on the golf course with only a 5,6, or 7 iron. Even if I have the best in the world of those 3 clubs, even a cheap putter would do better on the greens, and cheap drive off the Tee. Most manufacturers don't create designs that are widely different from each other, yet God created patients who are.

We sell Essilor lenses as well, and we're going to keep selling them for various reasons. Here's my guess as to what Essilor lens goes into each of those categories:

Hyperops: ??? (Comfort 360 maybe?)
Myopes: Physio 360 (is this the same as Physio DXr btw? I haven't seen that lens as an option before)
Hi adds: ???
Low adds: Ovation ADS (Ovation DS in the US I think)
Heavy computer users (wide intermediate): ???
Short corridor: Ellipse 360
Computer lens: Computer DS
Non-adapts: Ovation (conventional)

As you can see, there are some big blanks in my guesses. Can anyone help?

[sharpstick777]

Hi there! Would you say which lenses you found to have the least distortion?

Given the same add power, the lens with the narrowest reading and the longest corridor will provide the lowest peak distortion. Its a function of opposing choices even in Free-form.

[sharpstick777]

How come no one talks about Nikon lenses? I've recently started using them and really like the Presio Power and so do my patients. Comments?

Nikon is half Essilor product that is rebranded (They do have some slight differentiation) but its hard to figure out where.

[sharpstick777]

I'm just going through a Seiko pricebook right now and determining selling prices and such for the various lenses we're going to sell, and I came across the Seiko Supernal. Does anyone know what type of person that lens is targeted toward? The marketing material that came with the pricebook suggests that it crosses over with or replaces the Surmount, but I don't trust PR.

The Supernal is very much like the Shamir InTouch but a slightly harder design in most RXs. Its 2 part intermediate, the top is great for Cel phones and Tablets the lower is for PCs, both these lenses drop distance below the 180, are good for first time wearers, but require a min of 16 mm seg or you crush the PC zone. Fit both on Center. I give a slight nod to the InTouch for low power myopes, and to the Supernal for hyperopes. Both are designed for active Presbyopes, and work well in larger frames. (think Hipster lenses)

[NCspecs]

Sharpstick, ever since I've made your aquaintence my non-adapts have become virtually non-existent. Your gracious attention to my questions have made me a much better Optican.

Fitting different brands and styles of lenses (not just PALS) comfortably is what separates a sales person from an excellent Optician. I'm also incredibly lucky to work for ODs that bring patients to my dispensing table and say, "Okay, Pt is a low hyperope, likes to craft and facebook, what do YOU recommend?" hand me a chart, and let me do what I need to do.

To all the newbies and "good, better, and best package" sellers- do your research and remember there is no magic bullet for all patients. Know your math, know your patients, and you'll get great results when you really apply your knowledge successfully. :)

[stedel]

Thanks sharpstick:). Your replies have been very helpful to me, especially with new products that we hadn't sold before.

I've been asking everyone I can what *their* particular progressive looks like to them (mostly people in Essilor products, and a few Seikos now that we're selling them), and a few of the things you've said have tied together the comments people have made:

1) People have been saying Physio 360 lenses are very sharp in the distance compared to other lenses they've tried. If that lens is a "T" design as you've said in other posts (not on this thread, I think), and if a narrow reading and longish corridor makes lenses sharper, that would make sense to me.

2) Our Ovat/ADS tends to be the lens that we get the least non-adapts from. I think this is for two reasons: i) we've been selling it for a while so the licenses know the ins and outs of fitting the lens, and ii) it's a standard hourglass shape lens, so it's an acceptable balanced lens for most people, even though it doesn't stand out well in any given area, unlike newer, more expensive lenses.

[sharpstick777]

Sharpstick, ever since I've made your aquaintence my non-adapts have become virtually non-existent. Your gracious attention to my questions have made me a much better Optican.

:)

Thanks so much for the kind words! Its very encouraging.

[Nobody77]

My Takeway:
After a few hours of reading threads about lenses and coatings and the like, here are a few things that I think I've gathered:

1. "Digital" doesn't mean much of anything.
2. Essilor is evil.
3. "Freeform" can mean almost anything, and what it means depends on what company you're talking to.
4. What freeform probably *should* mean is "the add power is ground into the lens, not molded onto the front". Close? Yes? No? Maybe? Both? Neither? Quantum superposition of all those options?
5. Essilor is attempting to take over the world one banana stand at a time.
6. Digital/Freeform lenses are often very narrow in the intermediate (moreso than conventional lenses?), despite the sales reps claims.
7. If you make one part of a progressive corridor wider, you have to make other parts narrower. The area of the corridor remains the same.
8. Essilor lenses suck.
9. Nikon Canada (or Nikon as a whole?) uses Essilor lenses, even though their rep tells us they are better. Is this true of anyone else? Who knows... certainly not the sales reps selling the product.

My Problem:
I'd say 80+% of our customers are heavy computer users (I'm told Canadians are among the worst internet addicts? I wouldn't know, with all my long hours online I don't have the time to find someone and ask), and many want a single lens with with wider intermediate that they can still drive in and read with. We sell a separate pair of computer lenses to everyone who will buy them, but some people just don't want to switch between two pairs. I'd ask sales reps what I should be selling, but they're all useless idiots.

My Question:
Right now we sell like 30 different lenses and I just don't see the point. It seems like each optician has their favourite lenses and pushes that lens on everybody. So I'd like a list of a lens or two that will be best for each of the following categories:

• Hyperops
• Myops
• Hi adds
• Low adds
• Heavy computer users (wide intermediate) <---- nearly all our patients want wider intermediate
• Short corridor
• An excellent computer lens
• A lens that's good for people who can't adapt to anything else.

I'm gone for the weekend, so I'll check back in on Monday or Tuesday. Thanks in advance for any advice!

1. Digital is only a way to tell you the lens "could" be pixel exact calculated (not produced)
2. Against the opinion of Robert :) Yes. But to be fair, they are not that evil, they are just not so innovative and coat old designs with new marketing names to provide you with "new" (but not really) products.
3. Only a manufacturing platform, everyone is using it, but its not THE thing, the calculation of the Lens is the important thing. (As in all Taxi drivers drive a car, but it's their driving skill that makes you enjoy the ride or not).
4. FreeForm... Think of it as a more exact tool... You may paint a great painting using a big wall brush, but if I give you a fine brush for painting small models, I give you a more fine/exact way to give your painting way more detail. So to put this into a lens, you can cover the lens surface and its required diopters way more exact than with the conventional technology used XX years ago.
5. Well Yes :)
6. No, depends on the Lens and prescription. Problem you get often is, the person who used conventional lenses for X years comes back and you convince them to buy a new "Digital" (call it what ever you like) lens. Some may come back with the complaint that the reading portion is more narrow than with the old lens. Usually this has more to do with the Addition change than the design change. Going from Add 1 to Add 2 or 2.5 will significantly reduce usable reading width.
7. Well talking about the very same design, yes. If you would increase the reading width of design X, its distance would suffer a loss. You could yet create a new lens, which may give you a better performance in an area and keep the good areas of the design X, but yeah overall you often have to trade X for Y.
8. While I like Hoya more, many customers were happy with Essilor lenses. Then again, many of us will be happy driving "any car" but if we could choose, you may start noticing that people tend to pick a certain brand.
9. Sadly I can't give you a 100% answer on this, but surely it was mentioned here by someone else :)


To your question, the best recommendation I can give you is this...

"Every client is different and what may suit one, may not suit the other. Listen and engage in talks about what they need the new glasses for, what they expect and their habits. Their prescription and previous experience is also very important"

There is general rules, which may help you decide on your way in picking the best lens your client will get the most benefits from and it does not always have to be the most expensive one either. Older designs will perform worse with new frames as they are were "designed" for "back then" frames with higher pantoscopic tilt etc. Heavy computer users may benefit from an occupational lens, which will provide around 4 times as wide intermediate part than a PAL and twice the reading width (give or take depending on the lenses you compare).

There is just so many things that could influence the Lens choice itself :)

[Bey Patrick]

Can ANYONE!!! Send me some surfacing charts...

I am training a new employee and I really need to provide them with some steady info.
I REALLY NEED YOUR HELP