Trouble switching Varilux short-corridors

[boredoptician]

I have a hyperope who was quite underpowered in an Ellipse with a +.75 add that he wore for years. He is now having trouble adapting to a New Comfort Short with a much higher (+2.25) add power in an almost identical frame. The main complaint is that the intermediate and near fields of vision are so narrow that they aren't functional.

So the question is... How much of the adaptation problem is the shift between the Ellipse and the New Comfort Short? How much of the adaptation problem is the shift to the higher add power?

I could switch him back to an Ellipse, but that won't solve anything if the problem is caused by the difference in the optics associated with the higher add power. If the add power isn't the problem, I could switch him to a more advanced (and expensive) lens like a Seiko Surmount or similar.

Any thoughts?

[Fezz]

I think that the drastic change in add power is causing the issue!

[Wes]

As the add increases in power, the intermediate narrows, as does the reading, but to a lesser degree. Most progressive wearers get used to incremental decreases in the seg width as they age and the add gradually increases. Your patient went from one extreme to the other, and is having the same difficulty adjusting that flat top wearers have when attempting to switch to a progressive with a high add. If he's a heavy intermediate and near user, put him in an office lens as a second pair. If you can bring the lens closer to the eye, the intermediate field of vision will appear wider. Lastly, you may need to try a backside surfaced wide corridor lens.

[Happylady]

Any progressive is going to be much narrower with a +2.25 add then with a +.75 add. My husband is a hyperope with a +2.50 add and does well with the Physio Short in Trivex.

[Uncle Fester]

Go to this site. Scroll down about 1/3 and read "Optics of Progressive Umbilic". View 3 pictures of contour plots of add powers as they increase and how see how that effects the width of a corridor.

http://www.opticampus.com/cecourse.p...essive_lenses/

[snotbagel]

Part of the problem may be the choice of an essilor short corridor lens: some are digitally surfaced, presenting a whole different set of optics from back surface designs. Many Hyperopes don't tolerate this switch all that well.

[NCspecs]

With that kind of add change I would have definitely chosen a different progressive design, the seiko surmount being my favorite right now. I also like the Individual for this issue as well but it sound like price is an issue?