Do you lower progressive fitting heights on tall patients?

[Happylady]

[Quince]

When I'm working with someone over 6' I ask them to stand after I have dotted their lenses. I will redot (I'm 5' 7" so a fairly average height) and then check the difference. I usually end up going right inbetween my measurements (commonly 4mm difference so I will drop my seg 2mm) but this will depend on how they answer lifestyle questions.

I used to drop my segs on sunglasses but with the lens styles we use now I find it unnecessary. What I will do is often times put someone in a short corridor for their clear pair and long for their suns.

[rbaker]

Also, do not forget to add 4MM to the distance PD for those obese customers.

[ajonesgirl]

When I'm working with someone over 6' I ask them to stand after I have dotted their lenses. I will redot (I'm 5' 7" so a fairly average height) and then check the difference. I usually end up going right inbetween my measurements (commonly 4mm difference so I will drop my seg 2mm) but this will depend on how they answer lifestyle questions.

I used to drop my segs on sunglasses but with the lens styles we use now I find it unnecessary. What I will do is often times put someone in a short corridor for their clear pair and long for their suns.

Why do you choose short for clear and long for sun? I used to frequently lower the height a couple of mms on suns, after discussing with patient, but then would put them in a short corridor to bring the full near power up higher in the lens. I don't do it much these days, with the digital design.

[Quince]

We have gotten better feedback with this set-up. In my experience, people like to focus on the distance for suns. The intermediate is nice for the dash but the reading is rarely used. If we have someone who wants to read on the beach, or whatever similar situation, I will switch to a short.

[Happylady]

Quince-do you wear progressives? I hated the lower fitting heights in my sunglasses, I had to lift my head slightly to read comfortably. I rarely drop for suns. I figure it like this- if a person is very comfortable with their clear progressives, there is no need to change the fitting for sunglasses. My distance is great in my non suns and they are fit on my pupil. No need to drop in sunglasses.

[lensmanmd]

This will depend on the patient. For some reason, once the suns go on, they tend to do a little lean when behind the wheel. Cool factor, I guess. A 1-2mm drop works for them.
Though I rarely use my suns for reading, I prefer on center, myself. I’m getting older and find that the lean just doesn’t work for me anymore.

[optical24/7]

FF lenses aren't designed with the ERC 2mm above the fitting cross. Your patients will loose some of the peripheral compensations these designs give us.

[BizzyBobby23]

First post but have been reading on here for a while (great site btw) but felt the urge to finally join in here. I actually discussed this with a coworker recently who has about 20 years experience between working in the lab and on the floor and he said lowering seg ht on any progressive in an attempt to customize is a no-no bcz it throws off the optical center and then the pt is not seeing as clearly as they should. The optical center or prism cross should always be right over the pupil. If you lower the seg height you are also lowering this and thereby inducing prism. Best bet is to try to change the type of progressive to a longer corridor or small fit etc...

[optical24/7]

Welcome to the site Bizzy!

OC's are seldom at the fitting cross. Most all Plus power PAL's have prism thinning for cosmetics and minus powers have the OC at the PRP with residual prism 4mm above at the fitting cross. Prism isn't a problem if it's yoked, as long as it's not excessive. ( More prism ='s more LCA which can affect acuity)

[Quince]

Quince-do you wear progressives? I hated the lower fitting heights in my sunglasses, I had to lift my head slightly to read comfortably. I rarely drop for suns. I figure it like this- if a person is very comfortable with their clear progressives, there is no need to change the fitting for sunglasses. My distance is great in my non suns and they are fit on my pupil. No need to drop in sunglasses.

I don't wear Pals yet but I do wear anti-fatigue or power boost lenses. Not quite the same but somewhat similar concept.

To clarify- I used to drop segs more for conventional lenses, but with the switch to digital I tend to leave my sunglass segs at the same fitting for clear pairs. It is tall people I tend to drop my measurements on.

[DanLiv]

First post but have been reading on here for a while (great site btw) but felt the urge to finally join in here. I actually discussed this with a coworker recently who has about 20 years experience between working in the lab and on the floor and he said lowering seg ht on any progressive in an attempt to customize is a no-no bcz it throws off the optical center and then the pt is not seeing as clearly as they should.

I do drop fitting heights from time to time on finicky myopes and suns, but it is true this is throwing off the entire lens design. On cheap lenses, do what ya gotta do to make it work. But on even medium-tier digital lenses a lot of sophisticated design work by people smarter than me went into deciding exactly how everything should be arranged, and it all depends on accurate positioning of the fitting cross. When we fudge it we're throwing out some of the original design in favor of our own. May often work, but with modern lens designs I think it's a lot less useful/necessary than it was in the days of traditional fixed designs.

[lensmanmd]

I do drop fitting heights from time to time on finicky myopes and suns, but it is true this is throwing off the entire lens design. On cheap lenses, do what ya gotta do to make it work. But on even medium-tier digital lenses a lot of sophisticated design work by people smarter than me went into deciding exactly how everything should be arranged, and it all depends on accurate positioning of the fitting cross. When we fudge it we're throwing out some of the original design in favor of our own. May often work, but with modern lens designs I think it's a lot less useful/necessary than it was in the days of traditional fixed designs.

+1. Preach, sir Dan.

[optical24/7]

I do drop fitting heights from time to time on finicky myopes and suns, but it is true this is throwing off the entire lens design. On cheap lenses, do what ya gotta do to make it work. But on even medium-tier digital lenses a lot of sophisticated design work by people smarter than me went into deciding exactly how everything should be arranged, and it all depends on accurate positioning of the fitting cross. When we fudge it we're throwing out some of the original design in favor of our own. May often work, but with modern lens designs I think it's a lot less useful/necessary than it was in the days of traditional fixed designs.

Exactly what I was saying in post #8. You can fudge old designs like an Image, but you're monkeying with the intended design of digitally compensated lenses, even SV's.

[Lab Insight]

I do drop fitting heights from time to time on finicky myopes and suns, but it is true this is throwing off the entire lens design. On cheap lenses, do what ya gotta do to make it work. But on even medium-tier digital lenses a lot of sophisticated design work by people smarter than me went into deciding exactly how everything should be arranged, and it all depends on accurate positioning of the fitting cross. When we fudge it we're throwing out some of the original design in favor of our own. May often work, but with modern lens designs I think it's a lot less useful/necessary than it was in the days of traditional fixed designs.

It's rather strange that with all of the marketing hype now a days from companies like Hoya, Essilor, Nikon, Zeiss etc. on the numerous personalization and lifestyle customization points, none ever ask about height or posture.

It's all about age and previous design. Hoya claims their MYstyle can closely duplicate their competitor's best brands. Makes you wonder if they are all toting the same designs and products???