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Thread: Fundamentals of Progressive Lens Design

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    Master OptiBoarder Darryl Meister's Avatar
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    Fundamentals of Progressive Lens Design

    Article on the "Fundamentals of Progressive Lens Design" published in the VisionCare Product News:

    Fundamentals of Progressive Lens Design
    Darryl J. Meister, ABOM

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    Quote Originally Posted by Darryl Meister View Post
    Article on the "Fundamentals of Progressive Lens Design" published in the VisionCare Product News:

    Fundamentals of Progressive Lens Design
    Thanks again, I have a copy of this one in print and when compared to your previously posted article from Europe, I feel ashamed. While the US is learning how these new fangled progressives work Europe is learning how progressives are optimized and how they can be improved. I appreciate the article none the less and really enjoy the image of the cylinder cross section being inserted into a executive bifocal as an example of how blending two curves work, I get more "Oh so that's how they work" with that image then anything else I show opticians, patients, or family. The Minkwitz theorom is also an important concept to know with progressives especially with newer shorter designs becoming the norm, understanding of this theorom leads to better lens choices based on patient experiences and needs. I also like the visual requirements laid out in the end, mentally I categorize all complaints into these categories when dealing with patients that return and it helps me to better understand where I missed in the needs assessment during the initial fitting and also helps me to fine tune my delivery procedure to instill confidence in their ability to utilize the lens. I find that those four categories can describe every non-adapt that I have had in a PAL and they also give me clues as to how to correct my fitting and dispensing skills.

    For example:
    Good Critical Vision - If a patient has a complaint about good critical vision then their may be an issue with the script, the fabrication, of the chosen design. Naturally I start with the fabrication and make sure all measurements are proper and the power is as prescribed. Then I perform a more thorough needs assessment to make sure that the lens I chose was adequate for the particular needs. Finally our office will call the prescriber or check the charts to make sure that the script we were provided was correct and check the visual acuity to the patients BVA.

    Good Dynamic Vision - We try to ensure this by using the newest in lens technology, it has been a long time since I have had patients complain of swim. I still get patients that complain of curved lines and such but newer lens design have come to a point where the ratio of distortion is really low, I rely on many of the Shamir designs for this reason.

    Binocular Vision - I don't know of too many current designs that are not asymmetrical but I do know that not all lens designs are "design by prescription", I try to utilize lenses that are both optimized for the varying powers that will go into a base curve and the add to ensure the most accurate alignment of corridor reducing any issues associated with binocular issues in the near segment. I also take measurements in both distant and near gazes and supply that to the lab and if I see any great disparity between the two then I will order a variable inset lens design.

    Ergonomic Utility - I take a different approach on this I know that lenses are designed how they are designed here and I try to fit what I feel is appropriate, but I also encourage patients to adapt their environment to their condition. It is very important to say condition and not lenses, patients want lenses that work the way they want them to work, but their condition is what we are correcting and presbyopia, short of IOL's and even they are shaky, is a fact of life. That means raising chairs, leaning chairs back slightly, and lowering monitors. I often tell the patients I will do my part in choosing the best design if they chose the best combination of options to adjust the environment. I do like the newer short corridors as they allow patients to reach the reading with less down gaze, and the sacrifice even works to my advantage I try and inform patients of a task specific pair early on in presbyopia so that when their adds reach the +2.00 level they are used to hearing me talk about task specific pairs and they are aware that the "one pair fits all approach" has run it's course.

    Anyway, lots of blabbing but I have used this course of yours from Opticampus for it's full potential in my office and it has served us well.

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