I was wondering what the lowest seg ht you have "SUCCESSFULLY" fit a progressive lens. I am aware it can vary from brand to brand for design, length of corridor, manufacturers suggested minimums, etc...I just want to know the brand and any tips on how you do it soooooo low. Example; increase ADD +.25.......Mullo
mullo, I have fit panamics at 18 in a few cases, and I think that you have to consider the needs of the pt. personally, I am myopic and can read at 12 inches without my glasses. having the varilux allows me to see at mid range and near without taking the glasses off, so my "need" for a large reading area is quite different from that of say newalice(on another thread) who has a +1.00 w/2.50 add and is an artist at mid range. she likely won't be as pleased with a reduced reading area, and likely would appreciate having a seperate reading lens. she just needs to know that, prior to the frame selection process.
I've fit 17-18 mm in many cases with the Comfort. I am well aware that patient needs are of utmost concern, however my question is how low have you gone, with what lens and any tips for everyone......Mullo
We have fit the SolaMax lenses at 17 several times with no problems.
It may be hard to believe....... but I fit the new Kodak progressive at 16 hi with no problem.
Nikon Presio at 16 mm without any problems.
AF Mini at a height of 14. This was not my customers primary pair of eyeglasses. She does just fine with them.
Jackie O
------------------
Still a Maina for now
I just recently did a 16 hi with the Hoya Summit 13. Patient was quite pleased.
Don't want to admit it but I think I got by with 12 once. Wouldn't recommend anything under 18. Why did I try 12, think I let greed get in the way of my common sense.
Chip
Chip, Do you recall the brand used???Mullo
Mullo: Probably VX Comfort and probably with add power kicked a quarter. Remember that even if the patient gets enough add the corridor will be very narrow.
I don't actually plan on trying to fit somebody at the lowest I can, but it is interesting to see what we professionals can do. There have been some pretty low fits as I had expected, or should I say "successful" fits.....Mullo
In a world of John Lennon style frames these days, Manufacturers are getting smart with smarter lens designs. We use the IMAGE progressives in high index. We can usually get a seg height of 17 - 18mm with no problem. If you run into a problem with a patient not seeing well out of the near range, simply increase your add by +.25.(with doc's okay, of course!) :)
We have successfull fit the AO compact at 18 and 17 regularly, and occasionally at a 16. Works great.
Why do you need a Drs. OK to kick up the add .25? If he prescribes a 2.00 add at near
and you are truly delivering a 2.00 add at near. (The extra .25 is "cut off" regardless
of what the marking says). If you put the finished glasses in the lensometer and it reads a 2.00 add at the lowest point in the progressive, aren't you filling it as prescribed?
When I was running the labs for TVC in Penna, I processed quite a few 14-15mm heights using the AO Force55. Note I say "processed" (they sold 'em, we just made 'em ;) ). Anyway, most of these jobs ended up being perfectly acceptable to the patients...
Coincidentally, I know this term may be out of date, but I favor "soft" designs (like the XL) fit perhaps 1-2 mm high. These new, "harder" designs are great for squeezing into these little frames, but nothing beats having room for an actual intermediate corridor (call me old fashioned, I guess...).
Pete
Shamir Piccolo 17 hi. No problems!- although this is a "short corridor" lens
[QUOTE](The extra .25 is "cut off" regardless
of what the marking
Ummmm....okay, I guess !
New Eye guy....perhaps you didn't understand.
The inferior portion of the lens, due to the low seg heights, would be cut off when edged into the frame. Therefore losing the 2.25 portion of the add power and leaving the prescribed 2.00 add. Any questions?
Ray, makes perfect sense to me....Mullo
[This message has been edited by mullo (edited 03-16-2001).]
Hi Ray, makes sense to me if the final outcome has the correct add power.
Not to change the subject but that's similar to what I've said many times about slaboffs even when the Doc doesn't presribe it, all you'd be doing is giving the patient glasses without vertical imbalance in the reading, it would almost be incorrect not to slab some that really need it.
...okey dokey , Guess so. No questions Thanks, anyway. It's a good rule of thumb to start with a frame having enough depth to acommodate the progressive bifocal.Also, to use the prospective cut-out chart to assure the patient is getting the full power of the bifocal.Now, let's not get so critical about something so simple. :D
Eye Guy,
Not to beat a dead horse, but would you fit a petite, 5 foot 2 inch, fourty year old
lady, in a 59-20 frame, with a "B" measurement of 44, just so you could get a seg height of 24? It's not realistic. I just think that cosmetic considerations are just as important as focusing the eyes, and to some patients, even more important.
Bumping the add by +.25 may not always be the answer. You are talking about a usable area the shape of an hourglass. By bumping the add power you are pushing the prescribed add power higher up in the corridor into the neck of the hourglass, reducing the width of reading area. Let's say the Px is reading something that is on 8.5 X 11 paper most of their work day; they will either end up with more side to side head movement or end up moving their task material farther away.
Bumping the add may work for some folks but not everyone. Before using the technique you need to find out how the Px is using their glasses most of the day.
[This message has been edited by Jo (edited 03-17-2001).]
Jo, I agree with you but this would really only happen if we fit a very low seg ht, with a high minus distance Rx and a high near Rx. (Or a fairly large difference between the dist and near Rx's) We should always look at all of these points before bumping the Add power, to avoid pushing the prescribed Add power higher up in th corridor into the neck of the hour glass.......Mullo
[This message has been edited by mullo (edited 03-17-2001).]
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