progressive ratings on a 1 to 10

[ilanh]

Based on a literature review and some independent research, I have arrived at a grading scale and some conclusions regarding what types of progressives may work best for certain patient needs. I would welcome any comments. I have only included the ones I use the most. The grading is not arbitrary but culled from various Sheedy reports. Some immediate questions may come to mind eg: why do so many of is use designs that have poor reading eg: gradal top, definity? Why is Image considered a "budget lens" when it appears to be an excellent balanced lens? Should Solamax only be used for people who take off their glasses for most distance tasks? Why use Percepta if it's interm is so poor?

Progressives for different folks: (grading ranges from 1-10/worst-best)
-Gradal Top

8 for distance, 10 for interm and 3 for near (needs larger seg hts).

Summary: Excellent for people who need glasses for distance and intermediate. Since it's poor for reading it would do better in those who take their glasses off to read. Good for larger lenses.

-Genesis

10 for distance, 6 for intermediate, 6 for near (better reading with SH 18-22).

Summary: Good all-purpose balanced design.

-Image

8 for distance, 7 for intermediate, 4 near (better reading with SH 16).

Summary: Similar to Genesis but reading gets quite poor at larger seg heights. Should probably be used for driving polarized glasses, smaller seg heights or people who don't need glasses to read.

-Sola Percepta
9 for distance, 3 for intermed, 6 for near.

Summary: Great for distance/Near users. Would not use with anyone who needs computers.

-SolaMax

1 for distance, 8 intermed, 9 near

Summary: For those who need primarily intermediate and near vision and do quite well at distance even without glasses. Great as an occupational computer glasses with distance thrown in as an after-thought.

-Sola VIP
7 for distance, 5 intermediate, 9 near (especially good for larger SH)

Summary: A budget choice for those who need distance and near. Not great for intermed.

Sola XL
4 for distance, 7 interm, 5 near (needs larger SH)

Summary: Very average for everything

Shamir Piccolo
5 for distance, 5 interm, 10 near

Summary: Small seg heights who mainly want near.

Definity
7 distance, 9 interm, 2 near

Summary: For those who need glasses for distance and computer but can see well to read by taking off glasses.

Comfort
5 distance, 6 interm, 6 near

Summary: Average all around.

Summary of the different types:

Great all around: Genesis

Distance mainly: Genesis, Gradal, Percepta, Image

Distance and interm: Gradal, Definity, Image, Genesis

Distance and near: Percepta, VIP, Genesis

Interm and near:Solamax

[AWTECH]

Your idea is very good, Unfortunately I don't think the conclusions can be supported by science or statistical based facts.

We see this today as we begin to market an individualized PAL design, developed by the company that patented the process of custom individual backside progressive lenses. Almost every new account we approach wants to try the lens to prove that it works. (This company has over 10 years of experience with the production of these lenses. They have been producing hundreds or more per day for over 10 years. Do you really think they don't work?).

While your idea sounds like a good method it is flawed by the power of the brain and the marketing hype that has previously been stored by the brain. Company "x" makes the best lens is what you believe, it is then almost impossible to judge a lens made by company "y" and give it a fair grade. The reason is that a lens by Company "x" compared to a lens by company "y" can only be tested in this manner if the test person does not have any knowledge of the lens manufacturer of either lens. Then they will judge the lens based on their view of the performance. (they also would have to be produced by the same lab in the same manner fitted to the same frames. Both frames would have to be adjusted the same etc.) Another example is that different frame designs will cause different lenses to perform differently. Some frames will cut off more of a usable zone than others. In this example the lens design would be influenced by the frame the patient has selected. If you cut off a lot of the reading with a particular frame you would then want to make sure that the intermediate was skewed to wide and favoring the lower portion of the channel with power closer to the desired reading power.

What actually happens is that this sort of testing using some test results combined with personal experience, and patients comments draws false conclusions.

Your idea could be helpful as sort of cheat sheet, (like Cliff Notes in school), for new opticians to refer to.

[lensgeek]

I applaud you for not only reading the 12+ pages of Dr. Sheedy's independent progressive lens research, but also, for taking the time to summarize your interpretation...this should make for some interesting discussion!

[ilanh]

I would like to point out that my conclusions are not just based on the Sheedy reports (there have been 2 major reports over the last 5 years). They are also based on actually reviewing and comparing the designs in a very accurate software application which gives very precise measurements of the different zones and astig isopter plots. For this simple grading system I did not dwell on "hard" or "soft" designs and I assumed that every lens is fit at its optimal seg height.

[Barry Santini]

The best progressive for *all* ranges.....

...simply starts with the best *refractive findings*....

I'll take an appropritate, optimal refraction and VIP over any, state of the art progressive with a less-than-appropriate refraction any day

Barry

[lensgeek]

The appropriate refraction should be a given whether it be a progressive, FT bifocal or single vision lens choice. This type of comparison falls outside of Ilanh's summary of various progressives fit within the manufacturers recommended fitting heights and, of course, fabricated to the patients accurate Rx.