"WOW! This is, like...*freaky-clear*!"

[Barry Santini]

Another new, very-satisfied Autograph II SV wearer.

Rx:

-1.00 -0.75 x 110
-1.00 -1.00 x 80

Cr-39 Auto II SV w/ AR.

Compare with Orma Avance. Not much more, but much more impact on your client's vision.
If you *really* want to see what free-form technology can do for your vision, look beyond all the progressive hype, and try SV.

Soon, everyone will be doing these lenses. So why don't *you* start today!

Barry

[sharpstick777]

Thanks Barry... We will be ordering them soon.

What lab are you using? Have they replaced all your Aspheric lenses or are you offering 3 levels of SV lenses to patients?

Sharpstick

[ezrich]

sharpstick try digital eye lab. yes patients really like autograph 11 sv's.

[Barry Santini]

Thanks Barry... We will be ordering them soon.

What lab are you using? Have they replaced all your Aspheric lenses or are you offering 3 levels of SV lenses to patients?

Sharpstick

I only offer/supply Auto II SV for Cyl powers 0.75D and above. Otherwise, yes, there is a 3 tier SV hierarchy in my office:

1. Stock uncoated or less-expensive AR
2. Stk Crizal Avance AR (mostly poly and 1.67)
3. Auto II w/ AR, in all materials.

FWIW

Barry

[Happylady]

How is the AR on the Autograph ll compared to Avance? Especially down the road a year I wonder how it compares.

[barryh66]

How is the AR on the Autograph ll compared to Avance? Especially down the road a year I wonder how it compares.

Essilor labs are now pulling essilor stock to use crizal on them with my Autograph II.

[Robert Martellaro]

How is the AR on the Autograph ll compared to Avance? Especially down the road a year I wonder how it compares.

You can get any coating you want- the lenses should all be naked plastic. I'm getting the Autograph with the Crizal coatings from Soderberg.

[Jacqui]

I'm getting the Autograph with the Crizal coatings from Soderberg.

Which Soderberg?? I may send some work their way.

[Robert Martellaro]

Jacqui,

They're done in Minneapolis at Walman. Soderberg got the ball rolling when they put in a Schneider at their Madison Wi Lab about five or six years ago.

[Jacqui]

Thanks Robert, I'll contact Minneapolis. When I seen Soderberg in Madison a few years back, they were using a DAC for most things.

[Robert Martellaro]

You're right, it was a DAC. Walman/Soderberg are definitely using a Schneider now. Was the DAC really sitting on a 2000 pound slab of concrete?

You might enjoy talking to Norb Tausch at Soderberg in Oak Creek Wi- 1.800.677.0680. Don't call until next week.

[Jacqui]

Don't remember about the concrete, but it wouldn't surprise me. I'll call Norb, I do know him.

[Scrumblydumpus]

I just got my auto 2 SV's in today!

Heres my RX:
-4.50 -1.00 x 178
-4.25 -1.00 x 168

Its the same rx I have been wearing for 2 years now, so thats not a variable.

Well, I have got to say it is a noticeable difference. Everything does seem clearer, particularly around the periphery of my lens. Its pretty amazing, and while I do like it, I cant really say if the improvement is enough to warrant what a customer would pay for it.

[Johns]

I cant really say if the improvement is enough to warrant what a customer would pay for it.

Just tell them that there will be an "adjustment period". (An adjustment to having less cash in their pocket!:D)

[libellule]

I have had great feedback about the Hoya Nulux SV lenses...a coworker is a -9.25 and -11.25....she loves them...mush more peripheral, greater FoV.

I am not as familiar with the Auto II SV lens....although I have been very happy with Shamir. I will have to get the lowdown from my Shamir rep at our convention this weekend.

[Scrumblydumpus]

I got these after the shamir rep talked them up to me. my favorite part was him telling me the lenses would be made "accurate to within 1/100th of a diopter".

Which is cool, but exams are only done to 1/4th... sometimes 1/8th of a diopter increments. It didnt keep me from insisting on the doctor giving me an RX accurate to the 1/100th of a diopter.

[sharpstick777]

My issue with current aspherics is that there is no way to tell how well they made the aspheric curves. Theoretically I can just heat a lens blank, bend it, and its technically ashperic. Ideally, each base curve of a lens would be optimized with a different aspheric curve based on a targeted RX, but no manufacturer has been willing to verify (to me) this is done. Also ideally, they would have base curve in one diopter increments. Still even with this they can only target one "middle" approximate RX. It probably won't make a difference at a -2.00 but when get up to a -8.00 or higher a noticable difference could result, esp. in .5 or 1 base curves.

The other advantage is atoricity (it compensates for different curves in both meridians). Although there is the Sola Vizio, atoric lenses have almost disappeared (Hoya told me their US Nulux is not atoric, but the Japanese version is). So that leaves the Vizio 1.66 and Optima Poly in Atoric in US. The last time I ordered a Vizio the lab person had never even heard of the lens.

I hope to try a new Shamir SV auto II soon, but I am looking a for good test patient.

Sharpstick

[yayasister]

Have you tried Nulux, Sharpstick? I think you might be pleasantly surprised. Nulux ep is HOYA's Bi-Aspheric Single Vision Lens design using free form technology. Nulux ep delivers clear vision edge to edge, calculated visual acuity at every point on the lens, and it's visually optimized for all powers. It's a great lens and Yep...I work for Hoya. :)

[Barry Santini]

Have you tried Nulux, Sharpstick? I think you might be pleasantly surprised. Nulux ep is HOYA's Bi-Aspheric Single Vision Lens design using free form technology. Nulux ep delivers clear vision edge to edge, calculated visual acuity at every point on the lens, and it's visually optimized for all powers. It's a great lens and Yep...I work for Hoya. :)

As with my own Hoya IDs, My NuLux EP did not provide the promised vision benefit/performance.

And I do not know why...

Barry

[Chris Ryser]

st

I got these after the shamir rep talked them up to me. my favorite part was him telling me the lenses would be made "accurate to within 1/100th of a diopter".

I would just love to see the one doctor refractionist who can test any eye in the world and make an RX close to a 1/100th dioptre accuracy is this not at truckload full of B......S ????????????????? :D :bbg:

[Barry Santini]

st


I would just love to see the one doctor refractionist who can test any eye in the world and make an RX close to a 1/100th dioptre accuracy is this not at truckload full of B......S ????????????????? :D :bbg:

Actually Chris, it may not so much of a truckload as you think. Although the degree of precision we're speaking about may be a truckload, the newer and upcoming wavefront auto refractors just may provide the type of more comprehensive/global refractive information that FF terchnology can use to simply improve the sweet spot of any lenses performance.

FWIW

Barry

[Pete Hanlin]

I think claims of "0.01 diopter precision" should be taken with a grain of salt.

First, unless the laboratory is individually measuring the sag of each lens, there will be some loss of precision due to fluctuations in the front curvature of the lens (ISO allows up to 0.09 diopter tolerance- although most manufacturers maintain a tighter tolerance).

Second, the digital surfacing (or freeform, or whatever you want to call it) process itself must be tightly controlled, or accuracy will wander from lens to lens. Installing digital surfacing is not "plug and play" for a lab accustomed to traditional surfacing. Yes, you can get the machines up and working in short order- but without experience and well-developed process control you will not produce consistent product.

Finally, there is a reason the industry has established 0.25 diopter steps for refraction. Mainly, most people would have a very difficult time discerning the difference between 0.125 diopter increments (never mind 0.01 diopter increments). Yes, I suppose there are some patients out there who can tell a difference between a 0.50 and a 0.56 diopter lens (most of them are probably engineers :^), but by and large a refraction ends when the patient can no longer discern between "2 or 3, 3 or 4, 4 or 5," and most often that point is reached with 0.25 diopter increments. Heck, my own distance power (post-lasik) is OD -0.50 sph and OS -0.25 sph, and I don't even wear glasses (I have 20/20 vision without them).

Regarding wavefront correction- you can measure wavefront aberration in the eye (sort of- keep in mind the tear film itself will cause some aberration, and it changes with each blink), but you cannot correct it with a lens having vertex distance > 0. You can possibly incorporate aberrometer readings into the prescription to create a "hyper-accurate" Rx (this is actually the mechanism behind Ophthonix lenses and a lens currently sold by Zeiss in Europe), but at the end of the day refraction is a subjective thing.

I'm a bit tired of reading claims of "6x the resolution" associated with digital surfacing (aka, freeform or whatever). Even if you have a lens that is accurate to 0.01 vs. 0.06, the resolution will not be 6x better.
Websters defines "resolution:" 6 a: the process or capability of making distinguishable the individual parts of an object, closely adjacent optical images, or sources of light b: a measure of the sharpness of an image or of the fineness with which a device (as a video display, printer, or scanner) can produce or record such an image usually expressed as the total number or density of pixels in the image <a resolution of 1200 dots per inch>

So, at the most a lens that is accurate to 0.01 diopter has 6x the accuracy- not 6x the resolution. Let's illustrate the difference... Say you have a thermostat in your house (you know, the old fashioned kind that is round with a little needle and dial). Let's suppose that thermostat keeps the temperature in the room within 1 degree of its setting- that's probably an acceptable level of performance for the vast majority of us. Now, we have access to a super-duper terrrific DIGITAL thermostat that can keep the room within 0.1 degres of its setting. Well, while the thermostat may be 10x as accurate, it will not be 10x better- at least perceptually, because humans are not capable of resolving 0.1 degree variations in ambient temperature (at least I'm not).

Point is this, digital surfacing opens the door for several design innovations- because it allows the designer to create "one-off" designs. However, many of the DS products on the market are not "one-off" designs (other than the fact that they may have different prescribed powers and some may have a bit of asphericity/atoricity). From a clinical perspective (i.e., the ability to measure improvement in performance in an objective setting across a normal distribution of subjects), I do not believe it is possible to discern a difference between lenses if the only difference is the process used to create the design (i.e., traditional vs. digital). It therefore comes down to the design of the lens- not the process used to manufacture it.

[Barry Santini]

First, unless the laboratory is individually measuring the sag of each lens, there will be some loss of precision due to fluctuations in the front curvature of the lens (ISO allows up to 0.09 diopter tolerance- although most manufacturers maintain a tighter tolerance).

A Very Good Point!

Second, the digital surfacing (or freeform, or whatever you want to call it) process itself must be tightly controlled, or accuracy will wander from lens to lens. Installing digital surfacing is not "plug and play" for a lab accustomed to traditional surfacing. Yes, you can get the machines up and working in short order- but without experience and well-developed process control you will not produce consistent product.

Another very good point!

Finally, there is a reason the industry has established 0.25 diopter steps for refraction. Mainly, most people would have a very difficult time discerning the difference between 0.125 diopter increments (never mind 0.01 diopter increments). Yes, I suppose there are some patients out there who can tell a difference between a 0.50 and a 0.56 diopter lens (most of them are probably engineers :^), but by and large a refraction ends when the patient can no longer discern between "2 or 3, 3 or 4, 4 or 5," and most often that point is reached with 0.25 diopter increments. Heck, my own distance power (post-lasik) is OD -0.50 sph and OS -0.25 sph, and I don't even wear glasses (I have 20/20 vision without them).

Ahem...here, I disgree with you.

I *agree* that, for standard focus, 0.25D may represent the "smallest" discernable difference for the average person. However, binocularly, 0.25D can make a *significant* difference to a person, particularly with respect to accomodative/binocular balance. Even 0.12D can eb a reasonable amount to discriminate in binocular balance testing. Although the standard duo-chrome test equals a 0.50D difference between the red and green, I'm sure those of us involved in refraction have had to interpolate the "flip" when neither the green nor the red side is "equally black" with respect to the lenses (hence, the 0.12D stated above). Remember, the duo-chrome test is as much a test of focus as it is of contrast, and contrast sensitivity/discrimination is many times more sensitive in people than straight resolution/focus.

Think of it this way: standard acuity/resolution testing is to binocular balance testing as standard threasholds of acuity are to Vernier Acuity, wherein a comparison is being made, and the thresholds of discrimination are many (up to 6x) times greater because of the number of retinal cells being fired (like a line vs. a point) Human beings vision systems are much more sensitive to making a sensory comparisons.

See this link for more info: http://www.photonics.com/directory/d...=5559&letter=v

Hope this sparks more discussion. Thanks for the great points, Pete!

Barry

[drk]

Barry, I think you're absolutely right about the need for a binocular refraction technique for those who have accommodation. I am a BIG fan of the R-G bichrome test for final sphere power. You are obviously aware of stabilization of accommodation that binocular fusion provides.

And you're right about binocular summation and improved recognition (Snellen, e.g.) acuity under binocular conditions, and the resultant overall increase in ability to judge sphere endpoint.

Where I lose you is the degree of accuracy needed. I would think any process that can deliver an eighth-diopter (~0.1 D) should be accurate enough for 99.999% of patients.

Granted, I like the concept of individualized SV lenses for the atoricity and base curve provision, but I don't get too excited about wavefront or 0.01 D tolerances.

[Barry Santini]

Barry, I think you're absolutely right about the need for a binocular refraction technique for those who have accommodation. I am a BIG fan of the R-G bichrome test for final sphere power. You are obviously aware of stabilization of accommodation that binocular fusion provides.

And you're right about binocular summation and improved recognition (Snellen, e.g.) acuity under binocular conditions, and the resultant overall increase in ability to judge sphere endpoint.

Where I lose you is the degree of accuracy needed. I would think any process that can deliver an eighth-diopter (~0.1 D) should be accurate enough for 99.999% of patients.

Granted, I like the concept of individualized SV lenses for the atoricity and base curve provision, but I don't get too excited about wavefront or 0.01 D tolerances.

Actually drk, I didn't mean to imply that I get tooexcited about 0.01D accuracy, either.

And 0.12D precision is good ebough for standard refraction protocol, IMHO.

I think techs are particularly undertrained with binocular refraction techniques.

Barry