My husband is my patient ... help!

[Opti_cat]

Hi gang … been lurking awhile but this is my first post. My husband and I just moved from Athens, GA (Go Dawgs!) to Memphis. I have found a wonderful new doc to work with and after years of nagging and our house being littered with cheap readers in varying powers my husband ageed to get a check up. Well to his surprise, he is a mild hyperope (less than +1.00 in both eyes). He also has a slight astigmatism in the right eye. His add is +2.25.

Since his distance Rx is so mild I suggested a progressive like the PCWide. He wants something he can wear all the time because he fears that if the glasses are not on his face he’ll lose or forget them and then be stuck without when he needs them. He’s in the telecom field and does a lot of work on the computer and lots of reading. I know he’s not going to be happy if his intermediate field is too small.

In my old office we use mostly Zeiss and my go to progressive was a GT2 3D. At my new place we use mostly Shamir and Seiko. I spoke with the Shamir rep who recommended the InTouch. I have not fitted this lens yet. Most of our patients are in the Autograph II. I have done one Seiko Supercede 2. From what I have read I am leaning towards putting him in the Surmount WS. Seems to have a nice wide intermediate with plenty of distance and reading area as well.

Think of your worst unhappy patient and then having to live with them and you’ll have an idea what I’m up against. I appreciate any insight.

[Jubilee]

I have not tried the InTouch yet. Might see if I can get a voucher for one.

I have pairs of the Auto II and the Surmount. Both are fabulous lenses. I have a hard time deciding which I like more. Surmount is a flatter/thinner profile, and seems softer on the eyes. However I miss that sharpness of the Auto II in my near. Last night when I was working on my jewelry, I found myself grabbing the Auto II's for that sharpness of field.

The fit will matter more than the design. The other aspect is AR. You might find yourself choosing one over the other in order to pair it with your favorite AR.

[Gleedaniel13]

Think of your worst unhappy patient and then having to live with them and you’ll have an idea what I’m up against. I appreciate any insight.

That would be really worst if your patient is your husband. But one good thing is that you can give your all since your patient is your love ones.

[Opti_cat]

I've done some additional reading and found another lens that looks interesting namely the Essilor Definity 3. I'm still considering the Surmount and the InTouch. I know, three VERY different lenses. I still lean a bit toward the surmount WS simply because he's a mild hyperope will a moderate to high add.


Please chime in here

[Robert Martellaro]

He’s in the telecom field and does a lot of work on the computer and lots of reading. I know he’s not going to be happy if his intermediate field is too small.

The only logical solution is to make a task pair, that is, computer eyeglasses. If he loses them, no big deal, because he's married to Opti_cat, and life is good.

[DazeyReign]

Our office fits Shamir lenses almost exclusivley and have most patients in Autograph II. We have just recently started fitting InTouch and Autograph III and the response to the InTouch in mild to moderate hyperopes has been glowing. They just love all that plus and getting it a little bit faster really seems to please them.

[globaljp]

Plus one on the intouch. We are getting lots of wows with it. It's actually solved several non adapts and non lovers of the other digitals they bought from us in the past.

[CCGREEN]

He may become difficult because this is all new to him and he wants the vision he had when he was 17. And he has you in the business so therefore he may feel he can whine a little more then normal. Doing anything for family or friends most the time turns out to be a aweful experience.
Second thing is do not let him compare any field of vision with a progressive or a FT to a SV reader. There is no comparison. It would be like comparing carrots and bananas. Only thing they have in common is shape.
I have found making a progressive pair for intermediate and near with most any progressive works well. If you have a low add its even better. And if that dont cut the mustard then let him keep using readers. When he gets tired of the off and on then he will accecpt the limitations of any multifocal.

[Happylady]

Don't discount the importance of a good distance area if he plans to wear these a lot. The fact that his uncorrected distance is very good makes this even more important. He's used to not wearing anything in the distance and looking through a progressive lens in the distance is probably going to bug him at first.

I suggest a balanced lens that does not sacrifice distance to get more near. And tell him he needs to suck it up and wear them most of the time for a month.

[Uncle Fester]

Try the new Shamir "Workspace". Maybe with a comp from the local rep!

He'll still probably not want to wear them all the time but fields are great around the office. As with any new experience prepare him for an adjustment period. Mine was minimal but I knew what to expect.

Let us know how it turns out and---Welcome to Optiboard!!!

[braheem24]

DO NOT try to WOW an in denial presbyope in 1 step.

IF you're allowed to modify the Rx, start with his current OTC readers if he's the typical in denial presbyope he's probably wearing a +2.50 to use for his distance and intermediate.


Make him a PAL, ANY PAL.

Use the full distance rx +1.00 and fit the add no more then +0.25 over his OTC. In this case if his OTC is a +2.50, his add would be a +1.75 making the reading +2.75 total effective power weich is +0.25 over current OTC.

With the above combination, He will have distance better then his current OTC, Reading better then current and intermediate that is usable enough because of the lower add as well as the option of using the wider near portion for intermediate work since it's the same power as his OTC that he has been using for intermediate work.

In 2 weeks when he starts complaining about his near acuities, Give him the full add in a better lens to really wow him.

...And always remember it could have been worse, Your wife could have been your patient.

[Opti_cat]

Try the new Shamir "Workspace". Maybe with a comp from the local rep!

He'll still probably not want to wear them all the time but fields are great around the office. As with any new experience prepare him for an adjustment period. Mine was minimal but I knew what to expect.

Let us know how it turns out and---Welcome to Optiboard!!!

We carry a lot of nice designer frames and he had a hard time choosing so I talked him into a Shamir "Woekspace" lense and a pair with the Shamir InTouch. I may make yet another pair for comparison to the InTouch. If I do, I'm going to use either the Seiko Surmount or Essilor Definity 3. Keep your fingers crossed

[Happylady]

Let us know how he does!

[Robert Martellaro]

We carry a lot of nice designer frames and he had a hard time choosing so I talked him into a Shamir "Woekspace" lense and a pair with the Shamir InTouch. I may make yet another pair for comparison to the InTouch. If I do, I'm going to use either the Seiko Surmount or Essilor Definity 3. Keep your fingers crossed

Shamir's 'Workspace' is for those who are ambulatory, and/or need to see mid-distance, that is, top of desk to the door across the room, interoffice, station to station, without changing eyeglasses. Those using desktop monitors for extended periods of time will see much more clearly, without posturing, with generous monitor distance zone width when you select the correct lens design.

Edit:

It appears that the 'Workplace' is just a tweaked 'Office', which means that it is not for those who are ambulatory, but for general desktop tasks where some distance vision is needed (posturing required). The new 'Computer' looks a lot better for those who spend more time in front of a desktop monitor, although their claim that it provides clear vision out to 1.5m (with posturing) means that the progressive optics and degression extends above the primary gaze, with a narrowing of the zone width in the area that is used for a desktop monitor.

I suspect that the reason they don't design the computer lens properly is that opticians will start fitting it for general use. Because these 'task lenses' are priced more competitively, Shamir (and all of the other PAL manufactuerers) would experience decreasing revenues from their general purpose PAL sales.

[Uncle Fester]

Robert's observations are duly noted but your hubby's rx is very similar to mine and I can accommodate distance just fine and wear them all day at work.

[Robert Martellaro]

Robert's observations are duly noted but your hubby's rx is very similar to mine and I can accommodate distance just fine and wear them all day at work.

I wear my computer eyeglasses most of the work part of my day also. Correct me if I'm wrong (I did trial Shamir's Office many years ago), but the Workspace has a distance zone above the primary gaze (about +.50 over the distance Rx), narrowing the vertical and especially the horizontal zone widths when used with a desktop monitor. This lens is not to be used while driving motor vehicles, about the only time that this subject will wear a distance correction, especially at night.

The OP stated heavy use for computer, and I would make sure that the lens design is the best possible for such use, typically with a work distance of about 25", clear vision on the vertical gaze from the primary (straight ahead) to about 10 degrees below, and a horizontal field sufficient for clear vision across as many monitors as necessary.

Depending on many unknown factors, the subject may need a pair of general purpose multifocals.

[Uncle Fester]

I wear my computer eyeglasses most of the work part of my day also. Correct me if I'm wrong (I did trial Shamir's Office many years ago), but the Workspace has a distance zone above the primary gaze (about +.50 over the distance Rx), narrowing the vertical and especially the horizontal zone widths when used with a desktop monitor. This lens is not to be used while driving motor vehicles, about the only time that this subject will wear a distance correction, especially at night.

The OP stated heavy use for computer, and I would make sure that the lens design is the best possible for such use, typically with a work distance of about 25", clear vision on the vertical gaze from the primary (straight ahead) to about 10 degrees below, and a horizontal field sufficient for clear vision across as many monitors as necessary.

Depending on many unknown factors, the subject may need a pair of general purpose multifocals.

I've worn these comfortably driving but I'm sure I'm still accommodating the extra +0.50. My preference as I think this person will also find is to take them off when not in the office. I know the OP thinks that he's going to see a big difference in the distance but for me anyway that was just not the case. I'd suggest he just needs to get used to putting them into a slip in case for convenient access and remembering to take them with him when he goes out. I've never worn Shamir's Office lens but the lack of distortion and field of view when I look at my desktop monitor or write up orders is remarkably full field and comfortable. Much more so than my Physio Enhanced that has the same but uncompensated rx in them.

I think this lens will work well as a less expensive 1st time put'em on and leave'm on progressive computer glass with those who have minimal distance rx and using +1.50 and up otc's. Not sure how much motivation would be there for a +1.00 or +1.25 as in those days I found I only needed them for the tiniest print but as Robert points out that's what a long talk can tease out of this type of request.

PS- You're still going to have a hard time getting rid of those otc's scattered around the house.

[Robert Martellaro]

I've worn these comfortably driving but I'm sure I'm still accommodating the extra +0.50.

There's no accommodation occurring; you're overplussed by at least +.50 D, probably more. You will be accommodating at the desktop monitor though, which is okay if you have enough reserve accommodation, and it can be sustained without symptoms, and if you're blur tolerant (see below). Absolute and near absolute presbyopes don't have that kind of luxury.

I've never worn Shamir's Office lens but the lack of distortion and field of view when I look at my desktop monitor or write up orders is remarkably full field and comfortable.

Belly up to your desktop monitor at a distance of 24" or so, look straight ahead at small text, without lifting your chin, and place +.50 D over.

Much more so than my Physio Enhanced that has the same but uncompensated rx in them.

Non-sequitur, unless you power it to be used as a task lens. If so, it'll run rings around a proprietary 'computer lens'. A segmented multifocal is best, if the segment line can be tolerated.

I think this lens will work well as a less expensive 1st time put'em on and leave'm on progressive computer glass with those who have minimal distance rx and using +1.50 and up otc's. Not sure how much motivation would be there for a +1.00 or +1.25 as in those days I found I only needed them for the tiniest print but as Robert points out that's what a long talk can tease out of this type of request.

The motivation comes from the increased acuity and reduced asthenopia when there are disparate powers and astigmatism, incorporating a multi-focal length lens for desktop and reading tasks, especially when such tasks are frequent and sustained. If you only read a couple of emails from your grandkids, an OTC reader might be tolerated.

[Opti_cat]

Well the Shamir InTouch is a success! So much so he said not to do a second pair with the Surmount, he wants to repeat the InTouch. On a less enthusiastic note. The workspace lens was not a success, but it seems to have been due to lab error (certainly not a fitting error ;)). Hopefully when they come back from the lab he'll like them for desk work as much as he likes the InTouch for general use.

My take from all this is that the InTouch is (or can be) a great lens for a first time progressive wearer and / or a mild hyperope with a moderate to high add.


Thanks to all who offered your insight

Catherine aka opti_cat ;)

[sharpstick777]

I still lean a bit toward the surmount WS simply because he's a mild hyperope will a moderate to high add.


Please chime in here

This is where I would start. You must fit the Surmount on CENTER and order with NEAR MONO PDs to take full advantage. Latent hyperopes will take the longest to adapt to any progressive so tell him it will take a month to get used to, if he wears them full time.