Physio 360 vs. Nikon Seemax

[angryrectangle]

Hello all!

We have a bit of a difficult patient who recently ordered a pair of Physio360 progressives from us. I believe she was wearing an old pair of Varilux Comfort or something similar (but I'm not 100% sure) previously. She decided within seconds of putting on the new glasses that these lenses were no good, and that the corridor was too narrow. I went through the usual steps (adjusting, asking her to take them home and try them out, etc.) but I think she has it in her head that they're not going to work for her. She's wanting to possibly upgrade to the Nikon Seemax after hearing that it was a "better lens" but I'm a bit nervous since I think the problem is not with the lens, but with her.

Anyways - I told her I'd do a little research for her as to how these lenses really stack up. We tend to sell more Varilux products here, and I've only sold the Seemax a handful of times so I'm not terribly well-informed as to how it compares to something like the Physio360. How do these lenses really compare? Is the Seemax really that much better? Can anyone point me in the direction of some technical information regarding these lenses? I want to give her an honest answer, but I don't want to get her hopes up too much!

Thanks!

[Robert Martellaro]

Hello all!

We have a bit of a difficult patient who recently ordered a pair of Physio360 progressives from us. I believe she was wearing an old pair of Varilux Comfort or something similar (but I'm not 100% sure) previously. She decided within seconds of putting on the new glasses that these lenses were no good, and that the corridor was too narrow. I went through the usual steps (adjusting, asking her to take them home and try them out, etc.) but I think she has it in her head that they're not going to work for her. She's wanting to possibly upgrade to the Nikon Seemax after hearing that it was a "better lens" but I'm a bit nervous since I think the problem is not with the lens, but with her.

Anyways - I told her I'd do a little research for her as to how these lenses really stack up. We tend to sell more Varilux products here, and I've only sold the Seemax a handful of times so I'm not terribly well-informed as to how it compares to something like the Physio360. How do these lenses really compare? Is the Seemax really that much better? Can anyone point me in the direction of some technical information regarding these lenses? I want to give her an honest answer, but I don't want to get her hopes up too much!

Thanks!

Dear agitated and edgy,

This sounds more like a reaction to a Rx change than a PAL design change, although it could be both, in addition to other changes that may effect PAL performance i.e. vertex distance, pantoscopic tilt, etc.

Post a complete history so that the folks here can provide assistance.

Hope this helps,

Robert Martellaro

[angryrectangle]

I'm not really agitated - I just know this patient, and I know that she is incredibly difficult.

Her Rx hasn't changed in the last 8 years we have on file, except for a slight increase to her add power 4 years ago. Of course I checked the Rx of the old pair, and it is the same as the new specs.

-2.25
-1.75-0.50x087
Add +2.25

[becc971]

I would try a Physio W3 over the 360, if she was in a comfort than the comfort W2. I've never used Nikon product, so i'm not sure on that end.

[Robert Martellaro]

I'm not really agitated - I just know this patient, and I know that she is incredibly difficult.

Sorry, I was just having a little fun with your pseudonym, and that I recently heard John Prine sing "Dear Abby".

Myopes can be finicky- let's try to sort this out.

Her Rx hasn't changed in the last 8 years we have on file, except for a slight increase to her add power 4 years ago.

That helps.

Of course I checked the Rx of the old pair, and it is the same as the new specs.

Do you have the old PAL design noted?

-2.25
-1.75-0.50x087
Add +2.25

Some folks with this type of Rx will read without wearing their eyeglasses. Those who read with the eyeglasses on will need a PAL/corridor design that has a more aggressive power profile, those who read with their eyeglasses removed may prefer a slower, less aggressive power profile.

Confirm that the fitting point is center pupil. Confirm that the lenses are as close to the eyes as possible.

Try to pin down the complaint- how is she describing what she sees and feels.

Is she an avid reader (tablet, books, general close work/hobbies)?

Does she look at a desktop monitor? If so, with the eyeglasses on or off? How frequently?

What else is pertinent?

Robert M.

[angryrectangle]

Sorry, I was just having a little fun with your pseudonym, and that I recently heard John Prine sing "Dear Abby".

Myopes can be finicky- let's try to sort this out.

That helps.

Do you have the old PAL design noted?

Some folks with this type of Rx will read without wearing their eyeglasses. Those who read with the eyeglasses on will need a PAL/corridor design that has a more aggressive power profile, those who read with their eyeglasses removed may prefer a slower, less aggressive power profile.

Confirm that the fitting point is center pupil. Confirm that the lenses are as close to the eyes as possible.

Try to pin down the complaint- how is she describing what she sees and feels.

Is she an avid reader (tablet, books, general close work/hobbies)?

Does she look at a desktop monitor? If so, with the eyeglasses on or off? How frequently?

What else is pertinent?

Robert M.

Ahhh yes, I forgot about my username! :)

Yes - of course I checked the measurements and adjusted the frames. I can't make out the progressive markings from the old specs as they are fairly scratched up/the coating is starting to go. She also didn't want me to hold them too long since they "could break" and it's her "only pair". I'm telling you, difficult. *Pulls hair out of head*

She told me that they were "good Essilor lenses" that she bought ~9 years ago and that the brand is now discontinued, which led me to think they could be Varilux Panamic. But as I mentioned, I'm not too sure.

Her only complaint is that when she put them on - within seconds - she declared the corridor was too narrow. I tried different adjustments and asked her if the reading and distance were fine, but her only complaint seems to be that the corridor is narrower than the old pair, and that the distortion is too much. No complaints about access to reading/intermediate/distance. She seems concerned she'll have to move her head around too much.

She is specifically interested in the Nikon Seemax, which is why I'm trying to determine if it's noticeably better in terms of corridor width than the Physio360. I don't want to upgrade her and then have the same complaint :/

[becc971]

Ahhh yes, I forgot about my username! :)

Yes - of course I checked the measurements and adjusted the frames. I can't make out the progressive markings from the old specs as they are fairly scratched up/the coating is starting to go. She also didn't want me to hold them too long since they "could break" and it's her "only pair". I'm telling you, difficult. *Pulls hair out of head*

She told me that they were "good Essilor lenses" that she bought ~9 years ago and that the brand is now discontinued, which led me to think they could be Varilux Panamic. But as I mentioned, I'm not too sure.

Her only complaint is that when she put them on - within seconds - she declared the corridor was too narrow. I tried different adjustments and asked her if the reading and distance were fine, but her only complaint seems to be that the corridor is narrower than the old pair, and that the distortion is too much. No complaints about access to reading/intermediate/distance. She seems concerned she'll have to move her head around too much.

She is specifically interested in the Nikon Seemax, which is why I'm trying to determine if it's noticeably better in terms of corridor width than the Physio360. I don't want to upgrade her and then have the same complaint :/

Sounds like a drawer patient to me!!

I have great luck switching old school essilor people to a comfort or the accolade. Usually they don't like new free forms, for no reason other than being difficult that I can see.

[Robert Martellaro]

angry rectangle,

That sounds like the the Panamic, a low (for its era) surface astigmatism, wider corridor (binocular vision-wise), very soft design. However, as a myope with a +2.25 add, I liked the Physio over the Panamic due to better off-axis distance vision.

Why is your client uncomfortable? It could be personal preference, a frame that is narrow forcing the software to shorten the corridor, or the lens was something else, maybe a Comfort, which would imply a different problem, that is, that the Physio has too short of a corridor for this application.

That said, the Physio is a very good general purpose lens and should be worn about 10 days before taking the next step- sorting out the above, followed by a change in PAL design.

Hope this helps,

Robert Martellaro

[angryrectangle]

angry rectangle,

That sounds like the the Panamic, a low (for its era) surface astigmatism, wider corridor (binocular vision-wise), very soft design. However, as a myope with a +2.25 add, I liked the Physio over the Panamic due to better off-axis distance vision.

Why is your client uncomfortable? It could be personal preference, a frame that is narrow forcing the software to shorten the corridor, or the lens was something else, maybe a Comfort, which would imply a different problem, that is, that the Physio has too short of a corridor for this application.

That said, the Physio is a very good general purpose lens and should be worn about 10 days before taking the next step- sorting out the above, followed by a change in PAL design.

Hope this helps,

Robert Martellaro

Yes, thanks for your input :)

I would still like to have something to tell her about the Nikon Seemax, as I think she has those lenses stuck in her mind.

As for the frames - they were very similar in measurements and style to her old pair, and even offered a little more lens depth than the old ones!

I had to practically force her to take them home and try them out, as she seemed confident that she would not adjust to them. This is my concern - that she's got it stuck in her head that this pair won't work, thus she won't even try to get used to them.

[Robert Martellaro]

Her Rx hasn't changed in the last 8 years we have on file, except for a slight increase to her add power 4 years ago. Of course I checked the Rx of the old pair, and it is the same as the new specs.

-2.25
-1.75-0.50x087
Add +2.25

She told me that they were "good Essilor lenses" that she bought ~9 years ago and that the brand is now discontinued,

She didn't fill the Rx with the add power change four years ago if the lenses are nine years old, right? This needs clarification before we move to the next step because an add power change could cause the symptoms you described below, especially when the old eyeglasses were worn for nine years without any updates!

Her only complaint is that when she put them on - within seconds - she declared the corridor was too narrow. I tried different adjustments and asked her if the reading and distance were fine, but her only complaint seems to be that the corridor is narrower than the old pair, and that the distortion is too much. No complaints about access to reading/intermediate/distance. She seems concerned she'll have to move her head around too much.

Robert Martellaro

[Hayde]

Some folks with this type of Rx will read without wearing their eyeglasses. Those who read with the eyeglasses on will need a PAL/corridor design that has a more aggressive power profile, those who read with their eyeglasses removed may prefer a slower, less aggressive power profile.

Robert, just to demonstrate that no good deed goes unpunished, may I quiz you on this comment?

When you say 'aggressive' power profile, we're talking about rate of add power distribution down the channel? Or am I misunderstanding?

Assuming so, then would you agree your observation implies lenses like Shamir In-Touch and the Autograph 3 may be problematic recommendations to myopes who habitually read without their glasses precisely because these lenses try to distribute the power higher for myopic optics?

[Robert Martellaro]

Robert, just to demonstrate that no good deed goes unpunished, may I quiz you on this comment?

When you say 'aggressive' power profile, we're talking about rate of add power distribution down the channel? Or am I misunderstanding?

Yes. The power ramps up quicker, sometimes starting sooner or higher in the corridor, with or without a shorter corridor, but usually shorter than the average PAL corridor length.

Assuming so, then would you agree your observation implies lenses like Shamir In-Touch and the Autograph 3 may be problematic recommendations to myopes who habitually read without their glasses precisely because these lenses try to distribute the power higher for myopic optics?

Right, the idea being that if the eyeglasses are being used primarily for distance, we might want to bias the PAL design towards a more generous distance zone, measured along both the horizontal and vertical meridians.

This helps to provide for the best possible distance vision, especially during mesopic and scotopic conditions (watch for younger presbyopes with larger than average pupils). Combined with a slightly longer corridor, the lens will also feel more relaxed and less dynamic. I discuss this with my clients, looking for behavior that might support or contradict this course of action.

http://www.2020mag.com/ce/TTViewTest...essonId=106735

[ak47]

The Seemax is a great lens, however, it will not give a corridor significantly different than physio 360, physio enhanced or w3+ at most fitting heights. If a wider corridor is the chief concern, Seiko Surmount is the go-to lens.

Also, a great question by Robert above, was the higher add power from 4 years ago ever filled or is this the first pair actually being worn with the higher add?

[jc17777]

Just curious if you are thinking about the SeeMax High Power or the SeeMax Master AP. The SeeMax Master AP would benefit her the most in regards to minimal distortions and corridor length

[edKENdance]

Just curious if you are thinking about the SeeMax High Power or the SeeMax Master AP. The SeeMax Master AP would benefit her the most in regards to minimal distortions and corridor length

I'm curious as to how you've arrived at this conclusion. Can you be more specific as to why?

[jc17777]

I'm curious as to how you've arrived at this conclusion. Can you be more specific as to why?

The SeeMax Master AP is Nikon's best lens which further decreases distorions over the Seemax High Power. The High Power is a step down.

[edKENdance]

The SeeMax Master AP is Nikon's best lens which further decreases distorions over the Seemax High Power. The High Power is a step down.

The High Power is the only lens that Nikon offers with a completely customized inset. From a tech standpoint I'd say that complete customization of the corridor based on both far and near measurements is a step above what's offered with the SeeMax Master which relies solely on an algorithm to determine what Nikon thinks the client's near PD should be as opposed to what it actually is. There aren't very many lenses on the market that allow for this degree of customization. Nikon is horrible with (and they're not alone) disseminating information about how their progressives are designed to work. Would either of those lenses work equally as well for someone with a -6.00 as they would for someone with a +6.00? There's not enough information out there to give you an answer.

[jc17777]

I havent delt with Nikon as much yet as I would like too. I did not know that the HighPower near Inset could be adjusted and that the Master could not. Thanks for the info