Progressive for First Time Wearer

[Lee Prewitt]

Thanks, Judy and Lee.
Lee, is not CVS just another term for accommodative fatigue/spasm and/or dry eye? If so, I don't mind the moniker, as long as it's not cloaked in esoterica about "Gaussian" stimuli and some new word they invented for "resting focal point" or whatever, designed to amaze and confuse!

I agree that all of these are components of the issue and are integral to the greater scope. But does not a "Gaussian" pixel contribute as a causative effect to computer viewing? Example, as I type this, I know that I will soon get "tired" eyes but if I put my book at this distance, I also know that I can read for many hours before my eyes "tire". Solid image vs. Pixel Gaussian. I find it very hard to dismiss this aspect. I want your opinin on this aspect so lets leave PRIO and their sales hype out of it. We both know that the research led to a product that they could market. But the product does not necessarily invalidate the research does it?

[drk]

All that Gaussian business is just a target contrast issue. Black ink on matte white probably beats whatever your computer screen is, so crank up the monitor's contrast. Also, there may be some issue with luminosity. Higher luminance is may be good when scattered off a non-glossy page, but unnecessarily high luminance of the computer just contributes to eye fatigue, I'd say. Drop your background illumination and reduce the screen brightness to a lower, more comfortable level.

And be sure to wear a green tinted +0.62D lens with 1/2 pd BI in a Prio frame! (Just couldn't resist...;))

[Lee Prewitt]

drk,

You've just diagnosed CVS and some of the components of it. All without a PRIO tester. Proponents of CVS claim exactly that...lower screen luminous and background/room lighting coupled with an Rx. I myself of course prefer my Shamir Office 75's! :D I too, couldn't resist. Alot of the research that is avaible comes from your colleague Dr. Sheedy up there at OSU.

[drk]

Thanks, Lee. Nice talking to you.

[Lee Prewitt]

Same here drk :)

[Pete Hanlin]

I'm all for PRIO, btw- given the fact that only 0.5% of the PALs sold in the US are computer lenses, its obvious there are a lot of people out there who could benefit from a second pair of intermediate/near eyewear.

Whether you want to call their affliction CVS or simply dry eye and fatigue, I don't think anyone is questioning the fact that trying to focus on anything positioned 20" in front of you all day takes its toll on the visual system.

The term CVS, however, is sort of like a marketing term in my opinion. As such, it understandably makes some physicians feel a bit squeamish about using it. Plus, its sort of like hypoglaucemia back in the 80's- its diagnosed everywhere you turn. In this case, its a diagnosis that probably helps sell a second pair of eyewear to some people- so its an iffy area.

Regarding VT, there are simply too many evidences that VT actually works. For example, the ability to track and focus on objects can be enhanced by VT. Many children enter kindergarten unable to track and maintain focus on an object (like a teacher). I'm convinced some of these children are diagnosed as ADD (a real disorder, but another one that is over-diagnosed IMO).

In one study (sorry, don't remember the source), >100 juvenile delinquents were studied. Over half had trouble tracking... VT was given to half of those with the problem and no training was given to the other half. Only 5% of the treated juveniles ended up back in the system (over 75% of those treated returned).

Basically, what I am convinced of is this- "vision" is comprised of far more than one's acuity.

[Cindy Hamlin]

Okay, here's my thoughts on the PC Progressives (I call it that, ain't it cute?). I work in a cubicle for 8 (and sometimes more) hours a day. My work area is about no more than 4 feet away from my chair and I spend the time mostly looking at paper, taking notes or staring at a PC monitor. When I get up to go to the bathroom, it is not more than 10 feet away. My thought was I could wear them most of the day if not all. Taking them off for lunch. On the weekend and otherwise, I would have the progressives to wear.

I won't wear NVO. I refuse to take glasses off and on all day long. As I frequently have to get up to the fax machine, to the copier, to the mail slot, etc. I figure with the PC Progressives I can still do all that. As it is close proximity and I am familiar with it.

I know from years of dispensing that PC users complain of neck problems from adjusting to use the intermediate and in some cases depending on the height of the person the keyboard is fuzzy and they have to adjust for that (I am also fairly tall for a lady). I am not a person that adapts well. I won't wear a shirt or dress again if I have to fidget with it too much. I will stop going to a restaurant or store-no matter the bargain or the food-if it is a hassle. I want a seemless transition to something that I know will be difficult for me. Isn't it for most of your patients?

See, I don't want much, do I? Wonder why I am still single, huh?:hammer:

[drk]

Cindy, I'm glad you're NOT my patient!:hammer:

Think of this:
If you get a +1.00 add at your next exam, you'll get progressives to wear, if you have distance Rx. That's all you'll need. Forget about the computer!

Well, I can see you didn't listen, and you still want computer glasses. Ok. You have a +1.00 add, and you can get a degression of -0.75 or -1.25 or
-1.75. Obviously, you would get the -0.75. That means you're looking at the computer with +0.25 add. That's really going to help! You'd have to bump your add to +1.25 and use a -0.75 degression to get even the most minimal of computer adds!

By the way, have you ever walked around with +0.75 or +1.00? It's not that bad! BUT YOU WILL NOT WEAR SVNO! You are thinking about a +2.00 add or something!
"The customer is always right"

[Rophod]

I think a main point is that Cindy indicated in her initial post that she was symptomatic and having eye strain. Since she works 8-10 hrs a day at the computer it seemed obvious that this is part of the problem in causing her symptoms and I would not ignore it and correct for it.

Her distance Rx is
-1.75-1.00 180
-1.75-0.75 10

If an Access type lens was prescribed with a power of -.75 w/ cyl at the pupil or midline and it decreased by .75 then she would have a +1.00 add at the computer and desk and when looking above midline would have almost her distance Rx for moving around the office. I think this would work quite well for her at work.

[drk]

Rophod:

1. I did not assume that Cindy's symptoms were computer-related. I may be wrong about that. If so, computer lenses still are not that much better than SVNO, but what the heck?

2. You are advocating fitting the Access lens high so that the patient looks though the corridor on the computer screen?