Position Of Wear (POW)

[SailorEd]

How many of you take your progressive measurements and enhance them with POW (Vertex, Panto, and Facial form) measurements? I know they are pretty much required for the S series by Essilor but how about progressives like the Seiko Surmount, Physio DRx and Comfort DRx. Do they really make a noticeable difference to the patient? For those of you who do, what are the best measuring tools to use for each? Thanks in advance for your info.

[DanLiv]

Some lenses are designed to accommodate fit values, others are not. The Surmount is, and you're not getting the value of the lens if you don't make the measurements (the lab will just use default values, so by not providing the correct values the lens is being deliberately fabricated incorrectly). The Drx line is not intended to use fit values, so even if you supply them they will be ignored. (Although I have interestingly learned that fit values can be applied to some lenses that ostensibly do not use them; I have successfully received Spectrum with compensated Rxs.) The Varilux S come in 3 flavors: Design, Fit, and 4D. Fit and 4D should always have fit values, Design is a fixed corridor and does not use fit values.

If you are taking fit values, use a lens that incorporates the information. If you are not, don't bother using a lens that uses it because you and your patient are paying a premium for little if any benefit. Not every Rx needs fit values and compensation, and standard (even conventional) designs still work just as well for them as fully compensated designs.

We have Visioffice, which works very well. We do measure everyone with it as a matter of practice and to expose all our patients to the evolving technology of the industry. I end up fitting some of those patients with conventional finished SV so the technical values of the measurement are moot, but I have still educated them about the technology and primed them to expect the technology and look forward to it when their Rx may evolve into digital territory. If you invest in a digital measuring device it is worth using it most of the time as is it quick, accurate, and impressive to patients. There's little point in going backwards and pulling out pupilometers and lens markers when you no longer need to.