I work for an Optometrist who prescribes the Shamir relax for quite a few twenty and thirty somethings. I have noticed the non-adapt rate to be fairly high, with patients preferring their previous single vision lenses. Has anyone had a high success rate with any of the anti-fatigue lenses? Maybe Eyezen?
Eyezen's been fine for everyone I've fit in it. Maybe dumb statement, but obviously you make sure you're getting OC height on any given anti-fatigue lens. Pre-presbyopic patients tend to not even notice it, honestly, and early presbyopic are like "oh neat, I can read again and don't need BIFOCALS, I'm not THAT old!" Obviously I don't correct that second bit
The only complaints I occasionally have, honestly, is that they have the slight yellowish blue filter, and a couple of patients really did not care for that (and needed to be reverted to standard SV). Most, again, don't even notice however
Thanks for your input, Juno. Yes, OC height is always taken, yet still a reasonable amount of unsatisfied patients. I will consider trying Eyezen, maybe it's a Shamir Relax 'thing'.
I've never had anyone really come back and have a complaint about them. I think a huge factor is making sure they are told that they have to use them slightly differently than regular single vision lenses like being aware of the zones. You almost need to do the same training with them as you would do for PALs.
Edit: We use Eyezen only
Last edited by Michael22; 02-14-2024 at 05:23 PM.
Do all of these 20 somethings need anti-fatigue lenses? Do the have a legitimate accomodative deficiency? Do they have major complaints of headache and eyestrain? If not, your doctor is prescribing a more expensive lens for no benefit and less use to the patient. Best case scenario is laid out by JUNO "Pre-presbyopic patients tend to not even notice it, honestly" Why would you fit a "upgraded" lens to someone who isn't going to notice it? Time to have a talk with the doc.Originally Posted by Daniel.D
I agree that twenty somethings with "normal" accommodative function do not need a lens to assist them with near vision. Is there a conversation to be had regarding the twenty something, in college, doing an excessive amount of studying, benefitting? The ciliary muscles aiding the crystalline lens in expansion and contraction, may experience a little relief, from say a +0.50 boost? Is there a case to be made that if they are symptomatic, the anti-fatigue lens may aide in symptom relief?
Who are you fitting with anti-fatigue lenses? I get that it's for 20 somethings, but are these patients actually complaining about near vision? Are these people who are spending a significant amount of time with near tasks? I think it also helps to have a conversation educating them just how you would for a first time PAL wearer. The better you educate the patient during the sale/fitting, the lower the likelihood of non-adapts. And you have to re-educate them if they struggle with the lens. But not every lens works for every patient. You have to ask some lifestyle questions so you can make the best recommendations for the patient. Non-adapts waste time and money, so approaching it the right way from the start eliminates that. I had a lot of non-adapts to PALs, etc, when I first started because I wasn't asking the patient lifestyle questions.
There is also a different between eye fatigue from an accommodative deficiency, and eye fatigue from just staring at screens all day and not taking breaks. We blink less frequently when looking at screens and that will make the eye feel dry and strained. I tell patients that blue light coatings and lenses like Eyezen may help somewhat but if you're not taking breaks to look away from the screen and blink, your eyes may still feel tired and strained. And better lighting also goes a long way.
Krystle
Marketing vs medicine.
*shrug*
Yes, the conversation goes like this. During excessive study times, set a timer for 20 or 30 minutes and look out the window or across the room for 30 seconds. Problem solved.
Apologies ahead of time for excessive opinions. tl;dr: anti-fatigues meh, but computer glasses heck yeah, for everyone!
Though marketed as single vision lenses, the anti-fatigues are certainly not. I agree with what has been said, they should be counseled on what to expect similar to first-time progressive wearers. The add power necessarily produces peripheral blur and distortion just as a progressive, and habitual SV wearers will often not tolerate this loss. Unless they are counseled to expect it, and are interested in the benefits despite the compromise.
The following is not specifically about anti-fatigue lens designs, but about accommodation in general. As far as need, yes they need it. Anyone spending sustained periods of time on screens needs it. Does a +1.00 hyperope need correction despite the fact that they get by just fine with natural accommodation and report no problems? Yes. Does someone who has had a 0.50D myopic shift need and additional -0.50 correction despite having no complaints and being unconcerned that they miss a few letters on the 20/20 line? Yes.
At computer distance even twentysomethings are accommodating about a diopter, and on their phones about 2D. Can they do so without noticing problems? Of course. But can it be better? Of course. Hiking with a backpack all day is doable, but absolutely more draining than without. Putting the pack down for 20 seconds every 20 minutes is better than not, but it does not eliminate the effort. The best solution is eliminate the effort. I don't go so far as to fit young emmetropes with full +1.00 computer glasses, but I certainly recommend +0.50. Is that valuable to a young person on screen all day? Well that's their decision, not mine. If I don't recommend it I rob them of even having the choice.
How do I know these corrections are effective? I demonstrate it with +0.50 flippers. I sit them in front of a screen at their typical working distance and hold the flipper in front of them. 50% of people immediately report improvement, the other half say "meh". Then I ask them to pay attention to how their eyes feel when I take the flipper away, and another 40% go "eww" and don't like that. Great! I can get rid of that. The last 10% shrug and don't care, but now they know.
Anti-fatigue designs in general I don't find very useful. Sure it helps, but looking downward into the add area is mostly only effective on phones, and unless they're feeding their tiktok addiction or falling down a youtube hole they're not staring at that screen for hours on end. But laptops and desktop monitors, those definitely get many hours of unwavering stares, and that unnatural situation can absolutely be improved with eyewear dedicated to that task.
I agree that patient selection and managing expectations is key.
Here's a 7 year old discussion:
https://www.optiboard.com/forums/sho...(sneaky)-idea?
NOW YOU'VE DONE IT.
W.r.t the OP: IMHO Eyezen lenses are as good as any other free form anti-fatigue by a competent lens lab, just take note of the specific addition powers available and the 4 drop (different to say, the 6 drop and additions of Zeiss lenses). This is because for almost all anti-fatigue lenses I've seen, the progression towards the addition power starts only at the PRP, not the fitting cross. Therefore the drop is significant.
On the topic of anti-fatigue lenses in general...
TLDR: I agree with DanLiv on this matter.
After a few years trying out anti-fatigue lenses by the big 3, and also their generic counterparts, the feedback from (symptomatic) patients who used handphones/tablets/laptops was almost entirely positive (mehhh for those more towards desktop use, as expected). Required addition power was determined + dispensed after trial lens demonstration and also near retinoscopy to check the accommodation response. I also do check the near binocularity, I do not dispense these lenses to patients significantly exophoric at near.
I did not use them as a training lens for presbyopes to adapt towards progressive lens use, some solid lens reps even as far back as 2015 were advising against that. So my sampling of patients was I daresay almost entirely from the non- or pre-presbyopic demographic. Not counting those cases where I repurposed an anti-fatigue lens as an indoor progressive or office lens, of course.
However, as recently the use of desktop monitors at nearly eye level is on the rise, I find that patients seem to appreciate a low add progressive instead. Comparable peripheral blur, but a reduced angle of downgaze gives them a partial addition bump gazing through the corridor (whereas anti-fatigue lenses need too much downgaze to be useful in such a desktop monitor situation).
Given the low addition powers involved, even a short corridor generic progressive works well enough. Sometimes I even (successfully) use stock progressives, especially for those hardcore contact lens users who don't mind a pair of indoor glasses but want clear distance vision at the upper half of the lens for presentations etc.
Last edited by AndyOptom; 02-20-2024 at 04:58 AM.
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