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Thread: When should A Progresive should Not be recommended ?

  1. #51
    Eyes eastward... Uilleann's Avatar
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    An emerging pres. pt. should be the *perfect* PAL candidate almost every time in my own estimation. The low adds (+0.75 - +1.25 usually) offer the absolute widest reading and intermediate zones when compared against higher adds of say +2.25 and up later in life. Particularly in lower overall Rx's, non-adapt issues should be virtually a non-issue with a properly fit lens coupled with proper patient education and realistic expectations of lens performance.

    Shouldn't be hard to do with any number of lenses available today - digitally surfaced or not. I would side with the doc in this case. Best to you both though, of course! :cheers::cheers::cheers:

  2. #52
    Optician Extraordinaire
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    Plus, if they don't want a distance area they really don't need an office type lens yet because with a low add they should be able to see the computer distance and the reading distance with the same correction. So all they would need would be a reading only correction. Which they can buy at the drugstore. So they don't need your glasses.

    If someone really does want just reading glasses make sure he/she understands the glasses will blur the distance. People getting their first reading correction usually don't realize this.

    So listen to your doctor/boss, she isn't wrong. For some people just reading is fine but for many people progressives will serve them better, especially if you think long term.

  3. #53
    Eyes eastward... Uilleann's Avatar
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    Years before I was a dispenser, I was working at our local planetarium. I was in my early/mid twenties at the time. I was having a difficult time seeing the darkened monitors in the star theater during star/laser shows. I had a great knowledge of astronomical optics and applications back then, but didn't know about ophthalmic optics yet. And for the life of me, I couldn't figure out why my new *expensive* glasses (reading/computer SV) worked so very well for the computers, but blurred horribly when I'd look up at the dome. Ideally, I could have used a low add progressive design even then for my occupation.

    Presently, I've just had a new set of glasses made up with Essilor's Anti-Fatigue lens, which gives a +0.60 diopter bump over my light myopic correction towards the bottom of the lens. I've only had them about a week, but I can say that I feel more comfortable reading without looking under my lenses. There is zero swim or distortion in the lens, and it's a nice to have that tiny bit of plus there for all the near stuff I'm used to seeing without glasses. And no - I'm not *quite* ready to admit defeat and jump into a progressive for the time being. Give me another five-ten years for that. :p But when I reach my mid forties, I will certainly be reaching for a nice, low add progressive as I 'emerge' myself into the joys of presbyopia.

    :cheers::cheers::cheers:

  4. #54
    Bad address email on file D.J. Roff, ABOM's Avatar
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    Quote Originally Posted by SailorEd View Post
    I totally agree with you. We do it all the time. With office lenses or readers they take them off and put them on and take them off and put them on and ditto, ditto, and ditto.

    Those that get those eventually will come back in and get progressives anyway. They can put them on and leave them on while driving, reading and whatever they are doing. It's a GOOD idea.
    BUT... it doesn't always work.

    I talk to my patients about this all the time, stressing the lifestyle-enhancing aspects of NOT having to take glasses off all the time, NOT having to hunt for a pair of readers, etc. Yes, it's a good idea. But if I'm going to have a non-adapt, 99% of the time, this is where it's going to happen. I think that's what EyeGurl was trying to say. It doesn't mean we shouldn't try, it just means we have to do a lot of education with those patients... and be prepared for some hand-holding.

    Best solution for these folks is multiple pairs, like a progressive for everyday and an Office lens for work... but that's a tough sell, if someone has worn NO glasses for 43 years. Again, worth trying, just be a realist.

  5. #55
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    Quote Originally Posted by D.J. Roff, ABOM View Post
    It doesn't mean we shouldn't try, it just means we have to do a lot of education with those patients... and be prepared for some hand-holding.

    Best solution for these folks is multiple pairs, like a progressive for everyday and an Office lens for work... but that's a tough sell, if someone has worn NO glasses for 43 years. Again, worth trying, just be a realist.
    And there it is ... the "golden rule" in opticianry (and most other things). EDUCATION! We have to educate. Our patients don't really know what's out there. They have no idea what a Near Variable Focus lens is. We have to tell them. I have a pair of (something or other) Peepers. What they are is a double small B measurement rectangle that a person slides behind their glasses. The power in the rectangles is plus 1.12. Those wearing lined bifocals or progressives put them on and look straight ahead at an object that I am holding about "screen length" away and are amazed that they can look "straight on" without having to raise their head to bring the screen into focus. That's the way I demonstrate office lenses. Even if they don't buy right then, I've put it in their minds and many, many times, they've come back after a few months and bought a pair. I sold a lady a pair that worked down at our courthouse. Within two weeks 4 of her co-workers came in to get them (none of them current patients). Word spreads quickly. Two of them want to Wally World and asked for them and they didn't know what they were talking about.

    Yes, first educate the patient what is out there and then allow the patient to make an INFORMED decision. Education is the key.

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