First time pal wearer

[Now I See]

Hi guys and gals!

I have a new PAL wearer. Her RX is:

OD -1.00 +0.50 x 055
OS -1.00 +0.75 x 150
ADD +2.00 ou

PD 27.5/28.5
seg 16.0

She gets motion sickness, so I really wanted to give her a good lens, so she would have a great first experience....I was going to use the Seiko Supercede, but after talking with the lab, I got the impression that the Element would give us a better (i.e. less swimmy) result. IMO these lenses are really swimmy. I'm disappointed, but luckily the patient is a terrific customer and is willing to let me give it another go.

At this point, I'm going to switch her to a different design...but I just wanted to know if any of you have had similar experiences? What do you guys and gals use for first time pal wearers?

[mike.elmes]

Definity short....if you are from the usa, nikon i digital if in Canada.

[Happylady]

I have worn many different progressives and the Definity Short is one of the least swimmy. Mine are a +2.25 add and I rarely notice that I am wearing a progressive.

I have a pair of Varilux Ellipse and while I can wear them I definitly notice that I am wearing a progressive much more. I do think the reading area is slightly better on the Ellipse, though.

[OCP]

Hi guys and gals!

I have a new PAL wearer. Her RX is:

OD -1.00 +0.50 x 055
OS -1.00 +0.75 x 150
ADD +2.00 ou

PD 27.5/28.5
seg 16.0

She gets motion sickness, so I really wanted to give her a good lens, so she would have a great first experience....I was going to use the Seiko Supercede, but after talking with the lab, I got the impression that the Element would give us a better (i.e. less swimmy) result. IMO these lenses are really swimmy. I'm disappointed, but luckily the patient is a terrific customer and is willing to let me give it another go.

At this point, I'm going to switch her to a different design...but I just wanted to know if any of you have had similar experiences? What do you guys and gals use for first time pal wearers?

Actually this is a difficult issue. Changing to a more soft design, will give her less swim, but smaller reading and distance area.
It´s a question about plague or cholera. If your client realy don´t want to try anymore, you must tell her, that you can change to less swim but this will give her a smaller vision area. She will understand and maybe she will try the Element a bit more to get used to it.
If she don´t want to try anymore, you must tell her, that a change will be on her own risk, and then change to a more soft design like the Definity.

Mike

[Now I See]

Thanks everyone! I'm not sure this particular lab can get the Definity, but when I get back into the office, I'm going to check into that lens, and see what we can come up with. I've never used the Definity, but I have heard lots of good things about it.

Thanks again for your input! :)

[OCP]

Thanks everyone! I'm not sure this particular lab can get the Definity, but when I get back into the office, I'm going to check into that lens, and see what we can come up with. I've never used the Definity, but I have heard lots of good things about it.

Thanks again for your input! :)

Heather

Remember to tell her that she will feel a significant smaller reading area with the Definity. The Element has a very large reading area comparing to Definity.

Mike

[Chris Ryser]

She gets motion sickness, so I really wanted to give her a good lens, so she would have a great first experience....I was going to use the Seiko Supercede, but after talking with the lab, I got the impression that the Element would give us a better (i.e. less swimmy) result. IMO these lenses are really swimmy. I'm disappointed, but luckily the patient is a terrific customer and is willing to let me give it another go.

Whatever the make of a progressive the is an old rule we learned years ago when taking ESSILORS fitting courses.

Start progressive wearers at low add..................never start them at an add of +2.00 or higher. Guaranteed non adapts, and motion sickness will continue. Put her back into a bifocal to which she was used.

[Now I See]

Whatever the make of a progressive the is an old rule we learned years ago when taking ESSILORS fitting courses.

Start progressive wearers at low add..................never start them at an add of +2.00 or higher. Guaranteed non adapts, and motion sickness will continue. Put her back into a bifocal to which she was used.

Thanks for your input, Chris. :) I did think about that high of an add in a pal for the first time. But, since she's never worn any multifocals, she's always worn SVD lenses, I felt like I could get her something that would work. On top of all that, she's very motivated, when I mentioned a lined BF, I thought she was going to gag! ;) LOL! Seriously, though, she really doesn't want a line, if she can help it, and I told her we might have no choice....but, we (me and the patient) really want to give this another try.

[jpways]

The other option would be to try the AtLast lens (assuming that you're using a lab that can get it). We just fit our first patient that could wear a progressive due to the peripheral distortion/swim and she loves it. The Trivex/1.67 composite (AtLast/67) is pricy (similar price, maybe a little more than a ST-28 in 1.67 depending on your lab) but the newer composite Poly/1.67 (AtLast/59) is supposed to be less, but I haven't gotten a price on it yet.

[rinselberg]

The other option would be to try the AtLast lens (assuming that you're using a lab that can get it). We just fit our first patient that could wear a progressive due to the peripheral distortion/swim and she loves it. The Trivex/1.67 composite (AtLast/67) is pricy (similar price, maybe a little more than a ST-28 in 1.67 depending on your lab) but the newer composite Poly/1.67 (AtLast/59) is supposed to be less, but I haven't gotten a price on it yet.

Oops, a typo. The AtLast Composite 67 is a bonding of Trivex (1.53) front surface with High Index (1.67) back surface. The AtLast Composite 59 is a bonding of Trivex (1.53) front surface with poly (1.59) back surface. See the AtLast website.

[Robert Martellaro]

Thanks for your input, Chris. :) I did think about that high of an add in a pal for the first time. But, since she's never worn any multifocals, she's always worn SVD lenses, I felt like I could get her something that would work. On top of all that, she's very motivated, when I mentioned a lined BF, I thought she was going to gag! ;) LOL! Seriously, though, she really doesn't want a line, if she can help it, and I told her we might have no choice....but, we (me and the patient) really want to give this another try.

A long corridor, very soft design that's optimized for reduced skew distortion is your best bet for those that are super sensitive (motion). Definity and iD are designs that should be on the table. It's not unlikely that she'll need two pair though, either separate SV for far and near, or a PAL for general purpose with an auxiliary pair for distance or near.