Varilux Physio comments & feedback please

[Bezza]

I recently attended the launch for Varilux Physio here in the UK and during 2 days of being thoroughly looked after by Essilor, enjoying, fine food, entertainment, drunkeness and horse racing at cheltenham festival somehwere in there they mangaed to fit in a presentation regarding this new lens technology.:cheers:
I have to say that it does look pretty special, mapping wavefronts through both surfaces and surfacing both surfaces to reduce coma and other high order abberations etc....all very clever stuff. All the Essilor staff at the event were saying that this was just the tip of the iceberg and that they have only just begun to understand the capabilities of this new technology, which they have 5 seperate patents for.
Anyways I was just wondering what sort of reception this lens has received elsewhere as im sure that other countries have already been using it before us. Are you getting good responses from PXs using the lens and is it really as good as they say it is?
Anything else I ought to know before I start dispensing them to all our Panamic wearers?

[rinselberg]

Information is my game, not optics (per se); but I have a suggestion: Use the OptiBoard Search option. Search by Key Word physio and be sure to select Search Entire Posts and not Search Titles Only. Select "Search All Open Forums" and "Show Results as Posts". Execute your search with the Search Now button. I retrieved 193 posts in reverse chronological order. It's a good way to zero in on which OptiBoarders have actually dispensed any of these lenses, and what some of them had to say.

The answers are out there ...



nsofar as one can define existentialism, it is a movement from the abstract and the general to the particular and the concrete ... http://mythosandlogos.com/

[Chris Ryser]

I recently attended the launch for Varilux Physio here in the UK and during 2 days of being thoroughly looked after by Essilor, enjoying, fine food, entertainment, drunkeness and horse racing at cheltenham festival somehwere in there they mangaed to fit in a presentation regarding this new lens technology

If a company can still do product launch parties of that kind.........in the UK and how many other countries.................they for sure will price the product accordingly and count on major sales figures.

The customer will always have to pay back advertising cost and original R&D in the price of the product.

[Bezza]

If a company can still do product launch parties of that kind.........in the UK and how many other countries.................they for sure will price the product accordingly and count on major sales figures.

The customer will always have to pay back advertising cost and original R&D in the price of the product.

apparently its gonna be priced the same as the panamic

[Happylady]

I have a pair of regular Physios in poly with AR. I have also worn Panamics with no problems. My distance correction is -2.00-.50 and -2.50 sphere with a +2.00 add.

The Physios are wonderful. The distance is excellent and so is the intermediate. The reading is good, I can see the width of a page of a book. Compared to my Sola Ones which I also like a lot the distance area is wider.

My husband has the Physio 360, his distance is about a +.75 -.50 and his add is +2.50. He also likes the lens a lot though he thinks his previous pair of Sola Ones have a wider reading area. I don't notice any difference with mine. Perhaps it has to do with the difference in the rx.

So far I have had no non adapts with the Physio. Several patients told me they could see very clearly. One patient told me she noticed no difference in the width of the distance area but her add did increase several steps.

I have one patient that I fit with the Physio 360 that hasn't been happy with progressives in the past but didn't want to try a lined bifocal yet. I checked her glasses in yesterday so I don't know what she thinks of them yet.

[fjpod]

I have always had difficulty wearing any progressive over my monovision Acuvue contact lenses. For the most part, I see fine both distance and near with the CLs alone. Now that I'm 51, there are occasions where I could use a little help with fine print and night driving. (Although the real reason I got them is that my opticians on staff think should wear spectacles to boost sales.)

So, I thought I would try physios, OD -.25sph, OS -1.00, 2.00 add OU. The distance and intermediate areas are truly wider and much more distortion free (IMHO). The near zone is clear and seemingly wide enough...lateral head positioning for reading seems less critical. The one weakness I think I have found is there seems to be more distortion in the inferior peripheral areas of the lens. I guess you gotta put it somewhere.

[AWTECH]

The regular is produced just like the Panamic.

The 360 uses a point file produced surface.

I do not understand the logic in calling these both a Physio but it is not my company.

[Tim Thurn]

For your husband try a little more tilt on his frame, from my own experence and that of colleagues this makes all the difference, the same goes for all apsheric PALs

[dbracer]

If a company can still do product launch parties of that kind.........in the UK and how many other countries.................they for sure will price the product accordingly and count on major sales figures.

The customer will always have to pay back advertising cost and original R&D in the price of the product.

What's wrong with that?

Confused dbracer

[doclabs]

Physio 360 (among many others) is an improvement to normal front side progressives. However, they do not surface the front side. It is a cast normal front side progressive that they say is digitally designed (marketing). The distance/intermed/near are all done on the front side (confronted essilor on this and they admitted this -pre-moulded progressive). The backside of the progressive is aspheric/atoric and that is where the freeform component comes it. This asphericity allows for less abberation in the periphery.

Dont take my word for it. To find out if you have a front side progressive and an aspheric inside curve (physio 360 while physio is just a normal conventional prog) simply use a sag gauge on the front of the progressive in different areas and u will see that all of the progression is on the front of the lens. If you clock the back (on the two meridians) you will see that there is only the slightest amount of asphericity. An improvement or conventional progressives but by no means the holy grail. Fully internal progressive are the real deal.

With respect to essilor claiming their fix higher order abberations well, its a marketing lie. Why? You need to know what you are correcting for. You need an abberometer which measures a persons eye and the higher order abberations therein (opthonics does this). The you can use that mapping to recreate and fix the higher order abberations. However you must ask yourself... if someone adjust their glasses or moves their eyes... that fix is out the door because that fix is at a fixed point only. Marketing is what these big vendors do best. Their staff simply spout what they are told and like to dazzle and wow people with a whole bunch of complexities that are more weighted towards marketing vs truth. That said it is definately an improvement over normal progressives, however i believe fully internal progressive (sag on front reads spherical and full progression on back) is the way to go. Overcomes the inherent weaknesses of having to look through lens material before you can even get to the active curves of the lens (the progression on the front side of progressives)

Also there are dual patents issued in north america for fully internal progressives. Seiko has one, and so does Zeiss/Sola. This means everytime someone produces any internal progressive (their own included), they have to pay just over $3US each. This is the most probably reason why Essilor has not come out with there own fully internal yet (however i suspect they will because the patents are being fought in court). Keep in mind the Essilors and big vendors are marketing machines that know exactly how to successfully launch products and create buzz.

Cheers,

doclabs

[Tim Thurn]

Physio 360 (among many others)

With respect to essilor claiming their fix higher order abberations well, its a marketing lie. Why? You need to know what you are correcting for. You need an abberometer which measures a persons eye and the higher order abberations therein Cheers,

doclabs

I admit that I am an absolute novice to positng on sights, I am usually content to just read. However, I have now seen a number of such comments and I feel I need to respond. I have no qualms about disclosing that I was an optometrist for 10 years and for the last 18years have worked for Essilor in various roles in Australia, France and now as Director of Professional Services for Asia Pacific. I know very well and worked closely with many of the scientists who work in the physiological and visual optics area of our R & D.

There are several points to address so I will take them one by one:

Aberrometry is not restricted to the eye, it originated from astronomy where it is used to clarify images from space seen through telescopes. When that same principle is applied to progressives, you can create a surface that corrects the wavefront as it passes through the lens reducing the aberrations that are normally generated by the progressive surface itself. Unlike aberrometry of the eye it can be done for many directions of gaze.

It is irrelevant if this surface is moulded or generated, it can be done either way, so long as the moulds are created using a "free-form" or digital direct surfacing machine that can replicate the wavefront corrected surface on the mould. We have used digital surfacing of moulds for more than 10 years and now apply that esperience to lens surfacing as well.

Remember that spectacle lenses are considered thin lenses, the wearer sees only the resultant vergences created by the two surfaces. Where they are positioned or when they are created doesn't matter, the resultant output does. This is why it is critical at the practitoner level that fitting is performed systematically, their role is to finish the process that is started by the manufacturer, correct fitting maximises the final output.

One thing I would like to undrstand is why the accusations? From my experience with the company and my close relationship with our R & D team Essilor is, like many French companies, steeped deeply in technology and innovation, R & D attracts far more of our budget than marketing 'lies'. The fact is that the market quickly decides what is innovation and what isn't. I've had the pleasure to dscuss at length with Bernard Maitenaz, he told me that when he launched Varilux 1 in 1959 there were more than 60 papers saying that the product was BS and would never work. It seems that that some things never change.

Best Regards

Tim

[Darryl Meister]

Welcome to the 'Board, Tim. I agree with your comments, but I wanted to pose some additional points that may further clarify this topic.

Aberrometry is not restricted to the eye, it originated from astronomy where it is used to clarify images from space seen through telescopes.

I've never actually seen the use of the word aberrometer or aberrometry outside of eye care, so it would probably be useful to distinguish between so-called aberrometers and wavefront sensors, in general. Commercial "aberrometers" use a wavefront sensor to measure ocular wavefront aberrations, but you generally wouldn't refer to the wavefront sensor of a telescope--used in conjunction with an adaptive optics system to cancel atmospheric turbulence--as an "aberrometer."

When that same principle is applied to progressives, you can create a surface that corrects the wavefront as it passes through the lens reducing the aberrations that are normally generated by the progressive surface itself. Unlike aberrometry of the eye it can be done for many directions of gaze.

I think there is a bit of a misconception here as to the type of wavefront aberrations we deal with in progressive lens design. Because of the inherent changes in Add power and unwanted astigmatism in a progressive, a progressive lens surface produces certain levels of higher-order aberrations (specifically, aberrations similar to coma and trefoil). This is simply a consequence of the progressive change in power. As long as you have a finite pupil size, and a change in mean power or astigmatism across that pupil, you will introduce coma or trefoil.

Further, you cannot eliminate the higher-order aberrations produced by a progressive lens surface, just as you cannot eliminate the unwanted astigmatism in the periphery. But you can judiciously manage both. And, just as there are two general approaches to the management of unwanted astigmatism, by either spreading it out to "soften" the design or confining it to smaller regions to "harden" the design, there are also two intimately related approaches to the management of higher-order aberrations. A "softer" lens design, for instance, will frequently produce relatively low levels of higher-order aberrations over the entire lens, while a "harder" lens design can produce lower levels of higher-order aberrations in the central distance and near viewing zones at the expense of higher levels around the viewing zone boundaries and in the progressive corridor.

In any event, traditional progressive lenses are not designed to minimize the higher-order wavefront aberrations produced by the wearer's own eye. First of all, there are several technical limitations involved because of the fact that the eye rotates behind the lens and higher-order aberrations do not possess the symmetry of the lower-order aberrations (i.e., traditional sphere and cylinder errors). Secondly, aberrometry data from the actual wearer's eyes need to be captured before any wavefront correction could be applied. And I believe that this was probably doclabs's point. That said, it is certainly possible to minimize the higher-order aberrations produced by the progressive lens, itself, by optimizing the lens design accordingly, which is the heart of Essilor's claim.

[optigrrl]

Physio 360 (among many others) is an improvement to normal front side progressives. However, they do not surface the front side. It is a cast normal front side progressive that they say is digitally designed (marketing). The distance/intermed/near are all done on the front side (confronted essilor on this and they admitted this -pre-moulded progressive). The backside of the progressive is aspheric/atoric and that is where the freeform component comes it. This asphericity allows for less abberation in the periphery.

Dont take my word for it. To find out if you have a front side progressive and an aspheric inside curve (physio 360 while physio is just a normal conventional prog) simply use a sag gauge on the front of the progressive in different areas and u will see that all of the progression is on the front of the lens. If you clock the back (on the two meridians) you will see that there is only the slightest amount of asphericity. An improvement or conventional progressives but by no means the holy grail. Fully internal progressive are the real deal.

With respect to essilor claiming their fix higher order abberations well, its a marketing lie. Why? You need to know what you are correcting for. You need an abberometer which measures a persons eye and the higher order abberations therein (opthonics does this). The you can use that mapping to recreate and fix the higher order abberations. However you must ask yourself... if someone adjust their glasses or moves their eyes... that fix is out the door because that fix is at a fixed point only. Marketing is what these big vendors do best. Their staff simply spout what they are told and like to dazzle and wow people with a whole bunch of complexities that are more weighted towards marketing vs truth. That said it is definately an improvement over normal progressives, however i believe fully internal progressive (sag on front reads spherical and full progression on back) is the way to go. Overcomes the inherent weaknesses of having to look through lens material before you can even get to the active curves of the lens (the progression on the front side of progressives)

Also there are dual patents issued in north america for fully internal progressives. Seiko has one, and so does Zeiss/Sola. This means everytime someone produces any internal progressive (their own included), they have to pay just over $3US each. This is the most probably reason why Essilor has not come out with there own fully internal yet (however i suspect they will because the patents are being fought in court). Keep in mind the Essilors and big vendors are marketing machines that know exactly how to successfully launch products and create buzz.

Cheers,

doclabs

Thank you for putting it so succinctly. Don't forget the Hoya iD.

[kapthree]

I see that Physio increases contrast sensitivity by up to 30%. Are there clinical trials or research on this?

[Tim Thurn]

I did speak to our R & D team about this and I can't remember if they were internal measures or outside, I'll get back on that one.

[Tim Thurn]

I see that Physio increases contrast sensitivity by up to 30%. Are there clinical trials or research on this?

Sorry for the late response, been a bit busy to look at the forum. The measures are simulations done by our R & D, measuring the gain in the contrast sensitivity function averaged across a particular lens e.g in this case Physio versus Panamic and for varing pupil sizes. I was sent a whole powerpoint about it by Celine Carimalo the chief researcher on Physio.

Hope this helps.

Regards

Tim

[Bobie]

Wave Front Free Form technology that used in Physio is technology of 1993. ( Rodenstock Multigressiv 2 )

[Tim Thurn]

Wave Front Free Form technology that used in Physio is technology of 1993. ( Rodenstock Multigressiv 2 )

I am not sure how something that has just been patented in the last few years can be 1993 but you obviously have an axe to grind to push your sales. I find this type of discussion very disheartening, particularly in a place like Thailand. Around Asia in general the market is wanting to use the new technologies but often lacks the confidence, it is our job as manufacturers to build confidence in the use of progressives not undermine it by attacking the products we all wish to sell.

There is plenty of room for all out there, if you are going to make comments supply the data that goes with it. I read just the other day in a Chinese newspaper that a prominent Internet pioneer is now anti the lack of regualtion of comment on the net as people can say anything without backing it up. The comment the other day about Gradal is the same, there will always be anecdotal points to be made about any product but where are the details - there are so many factors to consider; base curves; Rx; thickness and the wearer's own perception etc. There are many cases where the lens design gets blamed when it is just good old aniseikonia, as with any type of lens, altering perception and needing patient adaptation.

If you want to prove something do the research, give the data, back up your content. We spend $1 million a year educating practitioners and educators across the Asia Pacific through Varilux Academy once they have the skills they can see for themselves which products work for them.

[Pete Hanlin]

P.S. Doesn't Pete Hanlin post here, anymore?
Not nearly as often as I used to, unfortunately. Between travel and work, there just isn't much time left in the day anymore.

Y'all take a pretty dim view of marketing people. I work with ours every day, and they're a pretty nice- and responsible- bunch of folks. Their challenge is trying to communicate product benefits to an audience who often doesn't really understand the product!

In this thread alone there are misconceptions that would be clarified if one simply read the marketing provided with the product:
1.) Varilux Physio has a digitally-molded front and a traditionally surfaced back.
2.) Varilux Physio 360 shares the same front- but has a 360 Digitally Surfaced back.
3.) DEFINITY has +0.75 ADD on the back surface- with the remainder on the front (so a +2.00 ADD with have +1.25 on the front and +0.75 on the back).
4.) Putting all the progressive & distance power on the back surface of a PAL is a concept currently used by at least 4 manufacturers.

Finally, its one thing to have a real eye care professional who is confused and wants some illumination- but perhaps folks with financial interests in other products could spare us all the fabricated indignation when a major manufacturer brings a product to market.

PS- Varilux Physio 360 isn't the Bugatti of progressives, its the Jaguar XKR!
PPS- Statements of "PAL X works soooo much better than PAL Y" are silly (and you can make X and Y any design you want).

[dbracer]

PPS- Statements of "PAL X works soooo much better than PAL Y" are silly (and you can make X and Y any design you want).

Pete,

I haven't looked into things well enough, yet, to separate the wheat from the chaff on some of your other "defense tactic" statements. But in 30 years of prescribing all the PA's out there, I can say the quote hereinabove is true without a doubt.

I ain't never prescribed a PA that works every time for every one, nor have I had a patient that will accept every PA at any time.

Respectfully,
dbracer

[Darryl Meister]

I ain't never prescribed a PA that works every time for every one, nor have I had a patient that will accept every PA at any time

I don't think it's possible for a single progressive lens design to work for everyone, simply because many people have vastly different visual needs. prescription requirements specific to that individual wearer. The presbyope who spends much of her day at a desk may benefit from a lens design with larger intermediate and near zones, whereas a commercial driver may benefit from a lens design with a large, clear distance zone. Similarly, a low hyperope who generally removes her spectacles to drive may prefer a larger near zone, whereas a low myope who removes her spectacles to read may prefer a larger distance zone. Individualized customization of lens designs based on this type of wearer feedback is one of the most meaningful applications of free-form technology, in my opinion.

[dbracer]

To Darryl Meister, Kyle, Tim Thurn, Awtech,

Let me ask a few questions here that confuse me about some of your comments. Please understand I’m not arguing with you. Ya’all seem pretty intelligent to me, and my retriever’s IQ is 10 points above mine. So you’ve nothin’ to fear from me.

I don’t care whose lens is best. I just want to know some things. I want to clear-up what seems illogical.

First a short explanation so we’re on the same page, as far as I can tell, in our understanding.

Zernike coordinates are simply Cartesian coordinates with elevation (piston), tilt and yaw. There are millions of them on a cornea. But, ocular surgeons have found that if they work with that many, they get lost in the forest for the trees. So, 30 or 40 are adequate.

Now I’m sure an aberrometer could be used in any kind of optics, but to date, the name is, sorta, reserved for intra-ocular aberrations, but aberrometer is by no means a “patented” exclusive for ocular work. For example, a tonometer measures ocular pressures, but tension is measured in other professions also: vascular tension for example. They use tonometers.

Now aberration within the eye isn’t a problem unless a given eye is “missed with” such as by refractive surgery. What I mean is that I’ve never heard of an individual having problems with aberrations unless they’ve had cornea work or a disease causing the same effect. The exception here being aberration caused by an optical device, and that’s not intra-ocular that is extra-ocular. Extra-ocular problems don’t have to do with intra-ocular aberrations. Right?

So in dealing with glasses and incident light the eye, intra-ocular aberration doesn’t come into play because the eye has no aberration problems as long as we can make the incident light resemble that to which it is accustomed.

So why would and optical lens engineer need to determine individual corneal aberration since the eye itself doesn’t have any problems? It hasn’t been altered to cause intra-ocular aberration such that wave front analysis and Zernike polynomials are needed.

So if the light coming out of the back of the lens has properties similar to what the eye is accustomed, why would a company have to analyze each eye? Wouldn’t it be adequate to simply make incident wave fronts more of the normal type?



Respectfully,
dbracer

[Darryl Meister]

Zernike coordinates are simply Cartesian coordinates with elevation (piston), tilt and yaw. There are millions of them on a cornea. But, ocular surgeons have found that if they work with that many, they get lost in the forest for the trees. So, 30 or 40 are adequate.

I may not entirely understand your question here.

Typically, Zernike basis functions are generally expressed in either polar (radius, angle) coordinates (not entirely unlike a Fourier series) or, less commonly, Cartesian (x, y) coordinates. After measuring the height of a given surface, such as an aberrated wavefront, over a sufficient number of points, the surface can then be "fitted" with these Zernike basis functions using least-squares techniques. Just as you can build a rather complex looking house out of a combination of simpler shapes, such as squares and rectangles, Zernike basis functions can "build" a complex surface shape when added together.

However, the actual Zernike aberrations are generally expressed by their orders and modes, though the first few have relatively common-ish names like "defocus," "astigmatism at 045," "vertical coma," etcetera. Each Zernike aberration has a coefficient associated with it that indicates the quantity of that particular aberration present in the surface shape -- that is, the "size" of the basis function.

Now I’m sure an aberrometer could be used in any kind of optics, but to date, the name is, sorta, reserved for intra-ocular aberrations, but aberrometer is by no means a “patented” exclusive for ocular work.

True. Though, in other optical applications, the device is typically referred to as a wavefront sensor.

Now aberration within the eye isn’t a problem unless a given eye is “missed with” such as by refractive surgery.

Uncorrected higher-order aberrations can reduce the quality of vision to some extent, though probably less than most people are willing to tolerate, anyway. These aberrations generally limit the ultimate resolving power of the eye though, and once they are eliminated the resolving power of the eye becomes limited by diffraction and the neural density of the retinal mosaic.

So in dealing with glasses and incident light the eye, intra-ocular aberration doesn’t come into play because the eye has no aberration problems as long as we can make the incident light resemble to which it is accustomed...

Just so we're on the same page here, we have been discussing progressive lens designs that claim to reduce the higher-order aberrations produced by the spectacle lens, itself, not the higher-order aberrations of the wearer's actual eye -- though this is a common misconception. Due to the variation in refractive error across the surface, progressive lenses introduce coma-like and trefoil-like wavefront aberrations. Unfortunately, you cannot really eliminate these aberrations, just as you cannot eliminate unwanted surface astigmatism. However, you can manage them, just as you can choose to use either a "harder" or "softer" lens design to manage astigmatism accordingly. Lower gradients of power, for instance, will reduce coma; however, in order to obtain the desired change in Add power over a reasonable distance, you still need to have high gradients of power -- and, consequently, high coma -- somewhere along the progressive corridor.

So if the light coming out of the back of the lens has properties similar to what the eye is accustomed, why would a company have to analyze each eye? Wouldn’t it be adequate to simply make incident wave fronts more of the normal type?

Unfortunately, the only higher-order aberration that has an actual "trend" in the normal population is spherical aberration, which isn't actually produced by most spectacle lenses anyway, since the small pupil of the eye limits -- or "stops down" -- the diameter of the ray bundles leaving the spectacle lens. The other higher-order aberrations are pretty much "normally" (in the Gaussian sense) distributed.

[Pete Hanlin]

I haven't looked into things well enough, yet, to separate the wheat from the chaff on some of your other "defense tactic" statements.
Simply trying to clarify some of the (sometimes humorous) mistatements of fact regarding various products... Its amazing how some individuals can complain so vehemently about material they've obviously never read. Your dispensing experience is similar to my own- there's no peg that fits in every hole.

Personally, I think if you're using a PAL and are happy with its performance, then you obviously have a good thing going and should stick with it. Nearly any PAL is going to be better than a segmented bifocal when it comes to visual performance, so I'm more interested in seeing the market do a better job of recommending PALs to patients than I am in arguing how good one design is compared to another.

That said, I happen to work for the manufacturer of Varilux, DEFINITY, and other PALs. So, the most important thing to me is that I'm convinced Essilor's PALs are the best in the world (because it would be quite depressing if I didn't believe that)- if I'm able to convince others of the merits of Essilor's PALs, that's just icing on the cake.