So I had a meeting with an Essilor rep this week about their PAL products. The one take-away that stuck in my mind, because it seems to be repeated by other lens manufacturers is "removing the obstacles to PAL lenses FOR EMERGING PRESBYOPES". By that, I mean someone with a +1.00 add.
For example, Essilor has developed a PAL called "Liberty 3.0" (not to be confused with the older "Liberty" for grandpa flat-top design...although it's going to definitely be confused) that only goes to a +1.50 and is a cheap entry-level model.
Shamir has it's own "training wheels" design (called "My First PAL") and I assume there are others. (Zeiss has their "Light" series, e.g.)
Some of these lenses are el-cheapo, because they want to "remove the cost barrier".
And without a doubt, VSP (and to a lesser-extent EyeMed) are increasingly selling groups this "standard progressive" feature. (Which pays us jack-squat, BTW. Let's talk about that, too). The giant vision-care plans have created a market for these lesser-expensive PALs, and the now-almost completely free-form companies are stripping bells and whistles (oftentimes useless bells and whistles, at that) off their super-customized designs and calling it a new lens. I think not; they're just a lot of the same designs with the default options set to zero or almost.
So what do we do? Do we sacrifice on emerging presbyopes? I say...well...yes. Hear me out and see if this is a valid take.
By way of digression, you know how all these "near boost for your awesome 5G phone" lenses are proliferating? Eyezen, Shamir Relax. Zeiss Digital. All these lenses are just the same old progressive technology with baby adds being marketed to goofballs to go with their blue-light coatings so they can look at Tik-tok for hours in high definition. Why not, if you're a lens company, market expensive stuff to a wide-as-possible audience?
What I'm saying is that the concepts behind PALs are subtly changing. Whereas it used to be "Hey grandma, time for a bifocal... yes, it's 'your time'" then to "NO-LINE bifocals, so no one will know you're getting old" emerged. The experience was like taking a bitter spoonful of cod liver oil.
Fast-forward to todays "tech is our god" society. Why do you think blue light filters are so compelling to the average numbskull? Yes, there's the Luddite "cOmPUterS huRT YOuR eYEs" contingent, but there is a lesser-recognized "I like gaming. I like Twitter" contingent that think that blue light filters are F-I-R-E because it's part of the online scene. Those are the same people that will shell out an extra $200 for a blue light filter plus "near boost" lens package.
Digression #2: "There are only two things you sell. Good feelings, and solutions to problems." ---famous anonymous smart business guy.
"Selling a delicious Starbucks latte (good feelings) is a heck of a lot easier than selling a new muffler (solution to problem). Try to sell good feelings" ---drk
So, having said all that,
1. I'm re-inventing/re-marketing lenses in my office. We are going to de-emphasize the now toxic word "progressive lens" because everyone now has a bad story they've heard. YOU KNOW THIS IS TRUE! We are just prescribing lenses with "focusing help for reading and making your eyes feel way more comfortable". (Same way we'd describe these anti-fatigue lenses to 30-somethings, if we were that craven to do such a thing, which we aren't. Same way Essilor-Shamir-Zeiss, etc market these boutique lenses...read their marketing to see how they do it. And heck, if you want to really go wild, combine the concept of AR coating to the mix in a package..."these lenses relax your eyes for reading and make everything crystal clear".)
2.We also are going to prescribe immediately, and we're going to prescribe NOT even +1.00, but +0.75. Why?
a. because it's impossible to screw up a +0.75 add, either by a stripped-down design or a sloppy optician.
b. because they're mostly free, anymore, because of the VCPs sneaking this into the mix, and because there are fantastic, inexpensive designs that the lab's computer entry person can select and flip a digital switch.
c. there are almost no adapation effects with an add that low, I've found.
You are a hero! Jump on this stuff at the first hint of trouble and be pro-active. You gotta sell the good feelings. "Comfortable, clear vision" (yay!) vs. "first pair of bifocals" (really?).
Why would you ever DO THIS? Why give away the milk when they can buy the cow? Because you don't want what we have now...the in-denial, cheap, no not me!, 49-year-old who now finally is complaining that they can't see and you now are faced prescribing a +1.75 add COLD. And then they moan up a storm for the rest of your life. Train them. Train them early. Take away the stigma. Take away the obstacles.
Now, of course, when their add jumps to even +1.25, you have to have "the talk" perhaps. I won't use basic designs on any non-emergent presbyope. If someone's +2.00, you need all the technology you can get on them. So, they will have to upgrade at that point. (I'm working on the sales pitch, but it will go something like "you now need a more advanced lens. Pay up.")
But that first pair in training wheels (that you are subsidizing in reduced reimbursement--or not, because they may have just said "no-I-want-single-vision-keep-away-from-me-with-your-voodoo-I'll-just-remove-my-glasses/get-readers/squint"--and you won't get paid, anyway!) will be very instrumental in getting them mentally adapted and visually adapted to the heavier PAL lift of moderate to advanced presbyopia!
