Progressive help

[fivetradejack]

I have a patient who has ordered a pair of spx with Progressive lenses and ARC. She has worn them for a few days now and likes the distance and likes the reading, however, she finds that her peripheral is more blurred than with her older pair. The older pair are set in rounded frames with a 36-38 B and add of 2.00. The pair she has picked up has a B of 25 with an add of 2.25. I also switched her from a comfort to a kodak precise short for the height difference. She is adamant about keeping the smaller frame, but wants that peripheral back. Any suggestions?

RX

-3.00 -0.75 x 025 PD 29.0
-2.75 -2.25 x 157 PD 29.5
Add 2.25 O.U.
OC/Fitting-15
A-52 B-25 ED-54 DBL-16

[fivetradejack]

Just an update my doctor has just ordered an AO Compact in the same frame with a bumped up add and a 12mm seg ht.

[chip anderson]

If you had an increase in add powe, especially a dramatic one can have these results.

C

[Andrew Weiss]

Also you moved her from a longer corridor to a short-corridor lens. In my experience, there is more cross-cyl distortion in the short-corridor ones than the longer ones --- even ones that use the same basic design criteria, like the Definity and the Definity Short.

[Uncle Fester]

I agree with Andrew.

For the future you may want to always prepare the patient for this as my experience in going from any longer to shorter corridor creates just this complaint more often than not. I find they're more accepting of it if they're expecting it.

Increased add power also is increasing unwanted astigmatism even in the same progressive lens type.

The good news is the Ryser Equation may apply and she'll come to accept them over time.

[Chris Ryser]

.........................however, she finds that her peripheral is more blurred than with her older pair.

Old hat..................as you increase the add, the side distortion gets more disturbing. It is there and can get used to...............but not just by everybody. So you have to tell or warn and advise the patient about it.

[Happylady]

I have a patient who has ordered a pair of spx with Progressive lenses and ARC. She has worn them for a few days now and likes the distance and likes the reading, however, she finds that her peripheral is more blurred than with her older pair. The older pair are set in rounded frames with a 36-38 B and add of 2.00. The pair she has picked up has a B of 25 with an add of 2.25. I also switched her from a comfort to a kodak precise short for the height difference. She is adamant about keeping the smaller frame, but wants that peripheral back. Any suggestions?

RX

-3.00 -0.75 x 025 PD 29.0
-2.75 -2.25 x 157 PD 29.5
Add 2.25 O.U.
OC/Fitting-15
A-52 B-25 ED-54 DBL-16

Make sure they sit close to her face with good face form and a good tilt on the botton.Tell her she needs to give it at least 2 weeks to get used to the different progressive. Tell her you will check with her then. If it is still bothering her a great deal try switching her to the Varilux Ellipse, it has a wide field of vision for a short progressive.

[Happylady]

Just an update my doctor has just ordered an AO Compact in the same frame with a bumped up add and a 12mm seg ht.

Is this for the patient or the doctor? I have heard a lot of bad things about the Ultra Short Compact.

[Robert Martellaro]

I have a patient who has ordered a pair of spx with Progressive lenses and ARC. She has worn them for a few days now and likes the distance and likes the reading, however, she finds that her peripheral is more blurred than with her older pair. The older pair are set in rounded frames with a 36-38 B and add of 2.00. The pair she has picked up has a B of 25 with an add of 2.25. I also switched her from a comfort to a kodak precise short for the height difference. She is adamant about keeping the smaller frame, but wants that peripheral back. Any suggestions?

RX

-3.00 -0.75 x 025 PD 29.0
-2.75 -2.25 x 157 PD 29.5
Add 2.25 O.U.
OC/Fitting-15
A-52 B-25 ED-54 DBL-16

Except for some of the hard designs (VIP), all of the short corridor lenses will offer varying but generally significant degrees of blurred vision on the distance periphery. Your choices are pretty much limited to- adapt to the blur, or use a moderate length design (Physio, GT2) for general purpose and separate readers if there are frequent close tasks.

Just an update my doctor has just ordered an AO Compact in the same frame with a bumped up add and a 12mm seg ht.

Lowering the fitting cross will increase the vertical imbalance (note the powers at ninety degrees), possibly enough to cause discomfort even on the distance gaze. I also wouldn't expect much improvement with the peripheral blur if you lower the FC and bump the Add power.

[fivetradejack]

The doctor prescribed these specifically for the patient. So I already ordered them. I dont think they will work at all given past results with ao compact. It feels like he was hoping to give a quick answer to appease the patient after we told her she would be better off going back to a similar sized frame to her old one.

[xiaowei]

Old hat..................as you increase the add, the side distortion gets more disturbing. It is there and can get used to...............but not just by everybody. So you have to tell or warn and advise the patient about it.

Yep, but an increase from 2.00 to 2.25 is nothing compared to the decrease in corridor length when going from std to short (and possible different design layouts i.e. hard/soft/multi).
This is "Minquitz theorem" par excellence! What counts is add increase per mm corridor.

[For-Life]

Simple solution. Move her to the Elipse. I am not one to say "move the person to this lens." But the Comfort is a high level lens. The Precise is not. The Comfort has a wider distance, the Precise does not. The Elipse is rather close, if not having a wider reading. Keep the 15mm height.

[Fezz]

I suggest a round 22!!!!

Problem solved!

[tntborden]

I suggest a round 22!!!!

Problem solved!

Wow! The most single under used lens on the planet. But Fezz, why would we use that, it doesn't cost enough.

Thomas

[Fezz]

Wow! The most single under used lens on the planet. But Fezz, why would we use that, it doesn't cost enough.

Thomas

Thomas,

Don't be silly. Some of us are getting these "high tech" progressives for less than our old friend Kryptok!

:cheers::cheers::cheers:

[chip anderson]

I'm gonna look stupid for asking but why use a seg. type with base down prism on a patient with minus distance power?

Chip

[Fezz]

Why not? We have already bumped the add, lowered the seg and created general visual mayhem!


Come on Chipster!

Join the Revolution!!!

:cheers::cheers::cheers::cheers:

[MarcE]

Wow! The most single under used lens on the planet. But Fezz, why would we use that, it doesn't cost enough.

Thomas

We use it quite a bit. Now if it just came in poly. I know TRO does them, but they don't seem to want the work any more.

[gmanlook]

I find personaly that as the B gets smaller you lose intermediate...that's somthing that I don't like but the peripheral problem I would check the wrap on the new one compared to the old one..sometimes it's just a matter of giving it more or sometimes less wrap. Good luck..Gary

[Freedom]

This case is Normal because short corridor is more distortion than
standard corridor in every case.

and the other the new is more add than the old glasses.
Because more add come with more distortion in the same Rx.

This case ... if change to Varilux ellipe ... will better than Kodax precise
and will better if to Varilux ellipe 360

and adjust fitting high from 15 to 16 and adjust nose pad little wide.

Good Luck.