Premium Progressive of choice

[Oha]

I know that there's a lot of great progressive lenses to choose these days. I'm just wondering what everyones favorite is most of the time, and why.

[Joann Raytar]

I voted for other because I have a couple of favorite progressives that I use depending on the patient's lifestyle, Rx, and frame choice.

My top favorites are Varilux Comfort, SolaMax, Pentax AF/AF Mini and Seiko Proceed/Proceed Short.

[hcjilson]

is the Varilux Comfort. I have also had great sucess with the Hoya GP Wide in trivex. I wear both more or less interchangably.

hj

[Lee Prewitt]

Here in in our office, we have been using Shamir for over a year with great success. Shamir has a very deep range of product within the family of lenses.

[Robert Wagner]

I also wear both the Varilux Comfort and the Hoya GP Wide Trivex with out any problems switching from one to the other, However with patients, and the frame selection, I tend to use whatever it takes for that particular patients needs.

Robert
;)

[Laurie]

Hi,

I think Shamir deserves a spot on the list...

...not only for great lens technologies, but also for the really nice people within the company.

So, my vote goes for the Shamir line:

Genesis progressive lens for conventional fitting heights.

Piccolo progressive lens for short corridor shallow "B" frames

Office progressive for working distances of 10 - 12 feet in...

: )

Laurie

[Texas Ranger]

About 80% of our clients wear Varilux Panamics, quite happily; of those, 95% are in Crizal AR, and about 20% now are in the new transitions NG...about 20% of these have polaraized Vx with Crizal.

[Specs]

Hoya GP Wide is my vote. Can't believe its not included in a list of "premium lenses". I guess others feel the same either about the Hoya Wide or the many other premium progressives that are available as the 2nd most votes so far is for "Other".:finger:

[Eddie G's]

Comfort used to be my Premium lens until I started replacing the comfort user's with the Zeiss Gradal Tops and have had no complaints (actually they didn't notice a difference).

Most of my progressive's are the AO PRO's and AO Compact's.
They're cheaper and they work!

Eddie G's

[Pete Hanlin]

Hmmm, this requires a lot of objective, unbiased thinking... Well, after giving lengthy consideration (all of 2 seconds), I'd say "Panamic." One, because I work for the company that produces it and believe in our products, but two (and more importantly) because I've used this lens in the dispensary and found that- when properly fit- it is superior to anything else I've tried on patients.

About the only PALs I don't really like are the "short-corridor" offerings. In my opinion, they are a poor compromise on overall vision. Marketing smack aside (and I'm sure Essilor will have its own marketing smack when we launch a short corridor), short-corridor lenses are simply not ideal PALs. In my opinion as a dispenser, a Varilux Comfort fit 2mm high with a little extra pantoscopic tilt is better than any short corridor on the market today (fitting any PAL in a frame requiring a height of less than 16mm is just irresponsible in my opinion). Just my opinion, but it is an educated one based on the power profiles I've seen for these short corridor lenses...

PS- Let me back up a bit. Most companies' general use PALs fit 2mm high and given extra panto (4 degrees) will work better than their "short-corridor" offering.

[aaron]

This is a question that I have been searching for the answer to for quite a while. Which is the best?

Having fit quite a few of almost all progressives, and not needing any myself due to lack of proper age, it is hard to say. Almost any of the new progressives are great if PROPERLY FIT!

I believe that there is no one size fits all PAL. I really like Sola's approach of having several lenses for differant lifestyles/uses. Varilux is a trusted brand. I have done great with Shamir, Kodak Precise, and the new AO easy has done very well in my trials.

Needless to say I fit into the "other" catagory. But I would also take into consideration a company that offers me more than just a progressive. The cash incentives for Kodak and Shamir as well as the VSP e-buy cash back for Sola are all ways to add to the bottom line. And I am not sure but I believe that Varilux will add you to a list of people on their web site if you are a loyal partner. My two cents.

ad

[keithbenjamin]

Pete,

Could you please explain exactly why you feel the short corridors are so bad and why fitting them is irresponsible?

Thanks,

Keith

[Pete Hanlin]

Sorry for the delayed response, I just noticed your question concerning short corridor PALs... My objections to "short corridors" are several...

First, several of the "short corridor" offerings out there have progressions that are not particularly short.

How can this be? Corridor length is described using various definitions. Logically, one would assume corridor length is the distance it takes to go from the beginning of the progression to 100% of the marked add. However, in Japan (and several other countries), the corridor length is simply defined as the distance between the fitting cross and the top of the near verification circle. So, if you want to shorten your corridor, all you really have to do is move the fitting cross down into the progression or move the near verification circle up. Having looked at the progression plots, it is my opinion that this is exactly what has occurred in at least one of the "short corridor" offerings.

In fact, most "short corridor" PALs begin their progression significantly above the fitting cross. This means the patient is receiving some of the addition at the fitting cross- s/he is "overplussed" (and that, as we know, is not a recipe for a happy patient). Fortunately for the short corridor, most frames have enough pantoscopic tilt to mask the elevated height at which the progression begins.

Another objection I have is the nature of the progression in most "short corridor" PALs. Most of them have very linear progressions. In other words, the rate of progression is constant from the top to the bottom. Why is this not an ideal situation? Ideally, you want a progression to advance rapidly at the top of the progression- to about 85% of the ADD. This is because 85% of the ADD is required to read the top of a held page (the top of a page is usually held a bit farther away than the bottom). With a linear progression, the patient must tilt the head farther back to access the top of the page. Also, the linear progression does not allow for a vertically long range of near vision. In an effort to be short, the progression boogies its way up to 100% of the ADD somewhere in the middle of the verification circle (that's right, most short corridors don't end at the top of the circle either- see point one to understand why).

Finally, most short corridors are not ideal from a balance and softness standpoint. This is practically self-evident. After all, it stands to reason that the manufacturer made their original design as compact as possible. "Scrunching" the design to make it a "short corridor" sacrifices something- it simply has to... the sacrifice is usually a harder design with greater aberration at the sides. Fortunately, most short corridors aren't all that "scrunched" anyway, since it is far easier for a manufacturer to mess around with the placement of the markings than the nature of the design.

In my opinion, you should be able to use a general purpose PAL for any frame you fit. If you absolutely have to have a height of 17 or 16mm, then raise the fitting height of your general purpose PAL of choice by 2mm and increase the pantoscopic tilt by 2-4 degrees. This should work just fine, and will provide better vision than most every "short corridor" offering. DO NOT "bump" the ADD- this just screws up the design and leaves the patient with narrower near vision.

What if you require a fitting height of lower than 16mm? Then use a blended. There is no PAL out there (in my opinion) that is going to provide decent intermediate vision with a fitting height that low anyway, so just go to a lens that will provide very good near vision and distance vision at a short height.

Now, all this said, Varilux will be coming out with a short corridor PAL sometime in 2004. I know the R&D folks in France have been working on it for a couple years now and were determined to provide a design that is actually optimal for short fits (with the understanding that a short fit on a PAL is not really optimal to begin with). I'm eager to see the plots for this new lens, and if they aren't better than the ones I've seen for the short stuff that is already on the market, I'm going to stick with recommending Comfort at short heights.

Anyway, that's my opinion... Can a patient use a short corridor PAL and get decent vision? Sure, but then again, some people can wear anything. Short corridor PALs are an oxymoron- you can't give a power the progresses if you don't give the lens room to progress.

[Laurie]

Hi Pete,

A couple of things:

1. To determine the length of the corridor, we should consider how long it takes to get to the FULL reading power.

85% is not acceptable...If a lab sent me a flat top with 85% of the add, I would reject it....why should progressives be any different? Granted, we may tip the top of a paper slightly while reading, but certainly not enough to increase the working distance to where we would no longer require our full add power to read the top of the page.

To stay within high quality standards, I would say that we must agree to keep at least 5mm (vertical) of FULL NEAR POWER.

That being said, if you wish to know the length of a corridor, simply take the manufacturers minimum fitting height, and subtract 5 mm. If we agree on this as a standard criterion, we can better compare lens designs.

2. Not all short corridor progressives have a linear corridor. The reason why I like Shamir's Piccolo short corridor lens, is because the design successfully keeps a multi-variable-soft design with a short corridor. This is partly due to their "eye point technology" software that simulates human eye movement and adds it to the design equation. I have fit a few (very) low with great success.

Our clients NEED premium progressives in conventional fitting heights.

Our clients also WANT fun, fashion-forward (read: small "B") frames...certainly they are better off with a lens truly designed to be a short corridor, rather than fudging a conventional PAL seg height.

And, our clients want and need a decent office lens for working distances of 12-13 feet in, progressive in nature, with edge-to-edge clarity.

My personal philosophy is, "I cannot rest until everyone has at least 4 pair"! And I'm talking lay-people!

We are already up to 3...one more to go.

: )

Laurie

[Pete Hanlin]

1. To determine the length of the corridor, we should consider how long it takes to get to the FULL reading power.
85% is not acceptable...If a lab sent me a flat top with 85% of the add, I would reject it....why should progressives be any different? Granted, we may tip the top of a paper slightly while reading, but certainly not enough to increase the working distance to where we would no longer require our full add power to read the top of the page.
My comments regarding 85% of the ADD power indicated that an ideal progression should get up to 85% of the ADD quickly- not that 85% of the ADD should be considered acceptable for reading. The goal being to get to 85% quickly (at which point one can comfortably read the top of a page- which is usually held about 2 or 3" farther from the eye than the bottom). Then, the remaining 15% of the progression can be acheived over a broad space which gives a large reading area. Comfort reaches 85% in 12.4mm and 100% at about 14mm.

To stay within high quality standards, I would say that we must agree to keep at least 5mm (vertical) of FULL NEAR POWER. That being said, if you wish to know the length of a corridor, simply take the manufacturers minimum fitting height, and subtract 5 mm. If we agree on this as a standard criterion, we can better compare lens designs.
Well, you and I can agree to a standard criterion- the problem is we have to convince Hoya and some other manufactuers to live by the criteria we have established. In the meantime, 85% is not some sort of "gimmick" used to make a corridor seem shorter. Rather, it is merely one measurement beyond the simplistic "corridor length" that is used to define the quality of the progression. Additionally, as I've already indicated, a manufacturer's recommended fitting height (or progression length) sometimes has nothing to do with the realities of the lens design.

2. Not all short corridor progressives have a linear corridor. The reason why I like Shamir's Piccolo short corridor lens, is because the design successfully keeps a multi-variable-soft design with a short corridor. This is partly due to their "eye point technology" software that simulates human eye movement and adds it to the design equation.
I've seen mapping of the Piccolo corridor progression. Its not a bad progression, but its also probably not the most optimal progression Shamir has, either. In other words, it is a compromise. Regarding "Eye Point Technology" (or any other software that attempts to simulate the human visual system), most major PAL manufacturers (e.g., Hoya, Essilor, etc.) use simulation technology as part of the design process. Unfortunately, the human visual system is impossible to fully duplicate in a computer. This is why actual wearer's tests during the design process is the best way of refining a design. It is an expensive process, and it takes a lot of time- but only humans can predict how humans will react to a design feature.

I have fit a few (very) low with great success.
...and I've fit a couple hundred pair of blended lenses with very positive results as well. So, we'll just have to agree to disagree on the concept of fitting heights under 16mm. Unless the patient is an advanced presbyope, the blended is going to give them a larger reading area than any PAL when fit below 16mm- without the line. For advanced presbyopes (>+2.00 ADD), while I'm sure they too want and should have a "fun, fashion forward frame" I'm going to suggest they purchase a "fun, fashion forward" pair of readers if they want to wear distance spectacles with a "B" of less than 30mm.

Anyway, good points- and I'm glad you like your products there at Shamir! You and Candi are a force to be reckoned with!

[apaul]

The lab we use are now doing varilux comfort small
minimum height of 18

Alan

OOOPS! JUST BEEN TOLD BY ESSILOR THAT IT IS ACTUALLY THE SAME AS THE ORIGINAL COMFORT BUT AN ELLIPTICAL SHAPE 60X40
AND A FLATTER BASE CURVE FOUND THE ADVERT IN MY LOCAL LAB BROCHURE MISLEADING :hammer:

ALAN

[mrba]

It sounds like no one with an opinion on short corridors, have done enouph to have an opinion.

In my dispensing expirience I would say I do about 50-80% short corridor lenses. (What, did he say 50-80%???!!!) I also reccomend short C. to my docs all day long through my lab.

Yup, We sell teensy weensy little frames, especially to the ladies that want to be tre-hip. I like to use Rodenstock Life XS (I think they just changed the name). Shamir piccolo is also a winner. Outlook is good if you need the funky variations for the sunshine, ie polar poly brown.

Anyway for the morality people out there that think that the tight squeeze is compromising the optics etc, I have this to say;

First I tell the patient about the intermediate "spot" they are going to get if they are lucky. Hence, if they are a computer user for hours on end this isn't nessecarily going to cut it. Next I tell them to get ready for a quicker jump if they are a previous progressive user, because the difference in desighn might freak them out.

Doing these two disclaimers at the beginning has given me 100% success so far (knock on wood) with NO REDOS!

Another side note is an emerging presbyope isn't going to need all the power all the time if you know what I mean, and they aren't going to know any different since they havn't worn anything else.


looks are everything...

mrba

[Pete Hanlin]

Anyway for the morality people out there that think that the tight squeeze is compromising the optics etc, I have this to say... First I tell the patient about the intermediate "spot" they are going to get if they are lucky. Hence, if they are a computer user for hours on end this isn't nessecarily going to cut it. Next I tell them to get ready for a quicker jump if they are a previous progressive user, because the difference in desighn might freak them out. Doing these two disclaimers at the beginning has given me 100% success so far (knock on wood) with NO REDOS! Another side note is an emerging presbyope isn't going to need all the power all the time if you know what I mean, and they aren't going to know any different since they havn't worn anything else. looks are everything...
I didn't realize short corridors were a matter of "morality." I think the objections to the designs out there have more to do with the optics at hand. I'm glad you have had such success with the short corridors in the small frames. However, for the people you describe (i.e., people who don't need an intermediate or who are emerging presbyopes), a blended would work just as well as the short corridor PALs you are using.

Anyway, I didn't mean to imply that short corridors are "immoral," only that they are- in many cases- not what they are marketed as (i.e., they really aren't that short). Plus, since one of the primary benefits of a PAL is the intermediate region in the lens, it seems odd to dispense a product that you yourself admit cuts out this area.

"Different strokes for different folks," I've heard some say, however. Your patients are obviously happy, and I'm sure you're doing a healthy business- so I suppose everyone is "winning" (well, until they need to see something 24" away- but that won't happen until they're 55, by which time many of them will be in bigger frames anyway).

[mrba]

Hmmm. In many cases patients do say they can find an intermediate spot. It depends of course on power and desighn.

By morality, I am referring to dispensors that tend to decide what a patient needs without even asking them about their lifestyle, OR asking them about their lifestyle and what they desire, but are already pre-biased against new ideas, and hence don't even bring the option to the table.

"Sorry you can't get a progressive in there. You need 18 mm at least" (could this lie be immoral?) HA!


My main points are;

1. There are true short corridor desighns.
2. They work.
3. Some intermediate zone is there, although not always optimal.
4. Patient education is essential for succesful dispensing of any lens. Dispensing a short corridor lens sometimes requires an optician to go the extra mile in this regard.

Allowing a patient to do something they couldn't do before, (wear a tre cool frame) is not only creating a lifelong customer, but making a name for your business as somwhere to go to get something different.

People Like to hear "You can", After everyone else says "no way".

mrba

[Eddie G's]

Well my Sister (Optometrist) and my Mother just tried the Gradal Tops for the first time and they are in Heaven!!!

They were both amazed at the vision!
My Mother (76yrs old) tried progressives in the past with NO success and had been wearing trifocals (nasty) all the time.

So NO more AO Pro's for us or anything else for that matter!
I'll still stick to the AO Compacts for the shallow frames.

That's my latest update,
Eddie G's

:bbg:

[Pete Hanlin]

mrba,

Good points! You are correct- offer real solutions to patients who have been told they have no options in the past, and they will beat a path to your door.

I'm glad the products you use are working for you, and it sounds like you take an intelligent approach to what you dispense. My points were simply:

1. Not all "short" corridors are really short
2. There are other options than "short corridor" PALs
3. All PALs are definitely not created equal

There are plenty of products out there that provide good vision- as to which is the absolute best, well that's something that everyone is never going to agree upon. However, there can be no doubt that there are a select few designs out there today that far outperform PALs of the past (when fit with due care).

[fly]

I HAVE RECENTLY BEEN IMPRESSED WITH THE OVATION IT IS AVAILABLE IN MANY VERSIONS AND SO FAR MANY OF THE PATIENTS HAVE USED THE WORDS " VERY COMFORTABLE". SO I MUST SAY CHALK UP ANOTHER ONE UP FOR OTHER.