Drops 2mm

[PattyO]

I go in on Saturdays to help a friend. She just took over a optical and well I felt she had so many problems with progressive's because, she fits many.
Then it got to be too much, even proven wearer's were haveing troubles.
Against my advice she use's "cheap" progressives. Ok thats ok ..I just found out that she believes that all center height should be dropped 2mm's. In both metal and plastic frames. I never heard of this..has anyone? And should this be done. Is this the reason why I'm getting many problems. Many can not read. If it's a Plastic frame I'm tilting it all over.Please let me know if you have heard of this. PattyO

[BMH]

Well you didn't give a survey option of fitting on center pupil as recommended by the lens manufacturer. If you have a rule of dropping 2mm perhaps the fitter should evaluate the technique used for measuring. Perhaps the fitter is sitting lower than the pt. causing seg. hts to be off a bit high.

Not knowing your background or the "freind" you are helping makes it a bit difficult to advise you. It sounds like training on progressive lens fitting is the real need. There are many reasons that people have adaptation issues with progressives other than low segs. Perhaps the lens design is the issue.

Please ask more question... but your survey is not going to help you.

My survey answer is: I fit lenses on center pupil with about 10 degrees of panto. After determining a seg ht I choose a lens design that will give adaquate reading power.

[obxeyeguy]

I voted twice, 1mm down, which is the way I have fit for many years, and also that the lens choice is cheap.:D

[Happylady]

I think it depends on the lens. Some lenses need to be fit pupil center and some do better dropped.

[MarcE]

Let's see:
She fits 2mm low going against mfgs advice
She uses "cheap" lenses
Most cheap lenses are older designs
most older designs have higher FH or said another way, longer corridors
The symptom the patients are having are "Many can not read."

Yes! you are right. She is cutting off the add or making the patient drop their eyes too low.

I agree w/ obxeyeguy. Cheap (older) lenses and lowered FH only work if the "B" is 40mm.

If she wants to stay cheap (which is not a good idea IMO). Try the Natural or Ovation and fit them right on the pupil.

[KStraker]

As someone else said, I fit them on center and then choose the best lens for the ht. It does not have to be an expensive lens to function well. Adding pantoscopic tilt will give the illusion of lowering the seg ht from the wearers prospective. Retroscopic tilt will raise the seg ht. If you lower the seg ht and then add more panto, your are effectivelyl reducing the ht even more. There are plenty of new cheaper lenses that can be fit in to a smaller b meaurement. Polycore Micro and Concrod Micra are two good ones.

[gmanlook]

I can't take the poll cause you don't have a choice for center pupil!! This is where I fit (center pupil) but, taking that into account..I always check the old ones and dot them up to see if PD's were measured right and also where the height is measured. From that point if they were measured low originally, I ask them if they have any trouble with their current pair...like having to tilt there head back to see....I have seen lots of people doing the drop thing but don't agree with it except for the people that come in and for one reason or another were fit low. I believe the key is to ask questions. Gary:finger:

[mike.elmes]

I used to work at a previous outfit that had a perpetual 2for1.We were using Navigator and Navigator short progressives. Talk about problems! Since leaving that place and going independent, we now use only the best of the best progressives and almost never a problem.....the problems people had with the nav short was the peripheral distortion, not so much the reading.

[Happylady]

There are people that perfer a lower fit height so it's good to always dot up the old progressives and see where they are being worn.

I have a few patients that like a slightly lower height and I also note it in their file. I always pull the file when a repeat patient comes in.

[PattyO]

I'd like to Thank all for your answer''s. I myself fit on center ans also ask questions on the use of te lens. The Rx is also a factor to me. I do try to dot and check pt's old progessives. It's just that I just got back into the field and I needed to ask if I was outdated with the 2mm drop. When i learned how to fit that did not existed...just add .25 to the add. That would be another good poll. Anyway Thank you all ...great answers PattyO

[chip anderson]

According to all lens manufacturers one should not add .25 to the add.
However many OMD's put: "if progressive add +.25 to add."
Also some doctors seem to be a bit wimpy about adding more to the add at the proper ages, perhaps from the flack they get when they first Rx bifocals, subconciously fearing more of the same with each change.

Chip

[PattyO]

:)Is this correct! I must check it out , Chip, you are saying not to add .25 to the add. Interesting. I like to hear from (I wish everyone ) on what Progressive's you have had good results with. I understand the essence
so to say of the (operation) is a factor...Like how much will this person spend. In a perfect world $ should not be the factor...but...there are many factors.......
Share with me some success stories...The" run of the mill" Progressive.
The best for the short B's. 16yrs ago it was all Verilux for me and nothing else. I'd love to hear your feedback. PattyO

[chip anderson]

No I didn't say don't add .25, I said: "Every progressive lens manufacturer says don't add +.25 to the add."

Chip

[drk]

Chip, I remember when that was standard practice, and I think it's a vestigal organ.

Nonetheless, if you have someone you know is going segmented, you will go a little easy on the add to give max range of focus, and if you know you're going progressive, you will be slightly more aggressive in add power.