The death of SVNO

[drk]

I just can't bring myself to recommend this design any longer, for patients that are full presbyopes. It's SO MUCH nicer to have a PAL and put half the add at the top.

You all should be my accomplice in murder.

[Don Gilman]

I just can't bring myself to recommend this design any longer, for patients that are full presbyopes. It's SO MUCH nicer to have a PAL and put half the add at the top.

You all should be my accomplice in murder.

Been wearing that for years,,,,EZ PZ. Actually our software has a formula that calculates the distance from the screen that they would like to sit. not were they now sit , but were would they would be comfortable sitting and then calculates the % to put in the top.

[DanLiv]

Isn't this the intention of Shamir Computer/Workspace and other computer progressives? They work great, and unless you get a screamin' deal on an inexpensive progressive design, they are less costly than progressives too. They are harder to fudge around with if you want to customize the computer Rx, but it's doable. And I only have to alter Shamir's default design maybe 5% of the time.

I used to use Eyezen's for computer/near designs in moderate presbyopes, and wore that myself. A few months ago I finally get myself into the Shamir Computer and it's way more comfortable and pleasant than my fudged Eyezen. And I was very pleasantly surprised to see the effect of the continuously reduced add all the way to the top of the lens. If I look out of the tip-top of the lens I can see clearly across the office; I could not with my Eyezen design. The only advantage I can think to fudging a progressive is to have simple control over the different powers, and maybe a wider computer Rx straight ahead for people with multi-monitor displays.

But I completely agree with your point, there is very little good reason to limit customers to the narrow 6" range of clear vision in single NVO, especially when a computer progressive is only moderately more than a good digital SV.

Do you not use the computer progressive designs drk?

[drk]

Here's the darn shame of it.
a. I love love love the computer designs.
b. They seem to price out about the same as any other quality PAL design.
c. But the basturdos at the VCPs are now doing covered "s-t-a-n-d-a-r-d" progressives and whatwith a mere +1.00 or +1.25 effective progression after the fudge, I feel scruples when charging them for the true computer design (unless they have a need for an individualized lens and then it's tough toenails as Major Frank Burns would say).

[Sledzinator]

Here's the darn shame of it.
a. I love love love the computer designs.
b. They seem to price out about the same as any other quality PAL design.
c. But the basturdos at the VCPs are now doing covered "s-t-a-n-d-a-r-d" progressives and whatwith a mere +1.00 or +1.25 effective progression after the fudge, I feel scruples when charging them for the true computer design (unless they have a need for an individualized lens and then it's tough toenails as Major Frank Burns would say).

So I hope we aren't breaking any vcp rules here but we don't offer the covered progressive as an option unless they specifically ask for it. We have always started at F category progressives as it gives a good bang for the buck. Also from what I can tell the computer progressives are quite a bit less expensive than F category.

[NAICITPO]

So I hope we aren't breaking any vcp rules here but we don't offer the covered progressive as an option unless they specifically ask for it. We have always started at F category progressives as it gives a good bang for the buck. Also from what I can tell the computer progressives are quite a bit less expensive than F category.

VSP has a separate category for NVF and Eyemed has NVF lenses included in their progressive lens formulary. These are the two companies my office does the most, I would have to look at the formulary for other insurances.

Our retail cost for a standard progressive is the same price as the price for a NVF lens, and actually I believe they are similarly priced from the lab as well. We also try never to sell the standard progressive lens but if the patient refuses to pay anything we've found better success with any of the newer lenses that are digital.

We have been really liking the customer reaction to the Hoya iD Space/Screen/Zoom for NVF's, the space has been a big hit with emerging presbyopes who still have some accommodation.

[DanLiv]

Here's the darn shame of it.
c. But the basturdos at the VCPs are now doing covered "s-t-a-n-d-a-r-d" progressives and whatwith a mere +1.00 or +1.25 effective progression after the fudge, I feel scruples when charging them for the true computer design.

Yea that is tempting to get them the cheaper almost-as-good design, but now that I wear them I'm too excited to get people into them. I did use to use Eyezens for accommodative insufficiency young people, but now the covered standard progressive is cheaper than the "SV" Eyezen. In the computer design, in addition to the ability to get a bit of functional distance when needed, I also notice the lower peripheries seem to have less plus, which is freakin' great for glancing down and to the left or right to see reading materials, which don't need the same magnification as the central near vision. I don't know if this is intentional (if so, kudos you brilliant Israelis!) or just an artifact of my particular Rx, but it was a wonderful surprise.

So I hope we aren't breaking any vcp rules here but we don't offer the covered progressive as an option unless they specifically ask for it. We have always started at F category progressives as it gives a good bang for the buck. Also from what I can tell the computer progressives are quite a bit less expensive than F category.

Insurance does not force you to offer product you don't want to, it only controls pricing on what you do choose to sell. If your business chooses to sell only top progressives and a customer wants only the cheapest of covered option, you are free to deny them and say "we don't do that". Few places do this of course, but you are free to.

[lensmanmd]

All I can say is thank goodness that my business is self contained, meaning no EyeMed, VSP, etc.

Computer PALs are a godsend. IOT, Zeiss, Shamir, whatever. Add various modalities, and voila. Plus, the savings overall. And, for you savvy ones, another option to increase multiples. Think about it. One for true desk work, and another for boardroom presentations. Add a daily wear PAL and sun PAL. 4 pairs at a sitting.

You’re welcome. Great TED talk.

[Uncle Fester]

I just can't bring myself to recommend this design (single vision computer) any longer, for patients that are full presbyopes. It's SO MUCH nicer to have a PAL and put half the add at the top.

Methinks Mr. Ryser just rolled over in his grave.

[juno]

All I can say is thank goodness that my business is self contained, meaning no EyeMed, VSP, etc.

Computer PALs are a godsend. IOT, Zeiss, Shamir, whatever. Add various modalities, and voila. Plus, the savings overall. And, for you savvy ones, another option to increase multiples. Think about it. One for true desk work, and another for boardroom presentations. Add a daily wear PAL and sun PAL. 4 pairs at a sitting.

You’re welcome. Great TED talk.

Not to be a dick about this, but how often are you getting patients who would A.) want that full spectrum of lenses; and B.) be willing to pay for it? I absolutely talk up office style lenses (and sooooo many professions are now basically in that demographic, not merely accountants or whatever), but often patients feel like they're going hog-wild when ordering clear + suns at the same time. Throwing in a third pair is... atypical at best, regardless of their needs. Doesn't mean it doesn't happen, but it feels like folks are playing make-believe when they theory-craft these ultra-multiple sales scenarios

edit: this probably came off more hostile than I intended. For my office's market and demographics, this reads as a wildly-improbable fantasy scenario. Maybe in a denser and more affluent market, it is more typical? It still seems to me like a patient rocking in for a 4 pair sale is going to be a rare occurrence at best, and you're more likely to get PAL/suns/office lens at most? But maybe in those areas that have lots of C suite execs and salaryfolk, they're more willing to switch between two different mid-range glasses than my gut tells me?

[AngeHamm]

Not to be a dick about this, but how often are you getting patients who would A.) want that full spectrum of lenses; and B.) be willing to pay for it? I absolutely talk up office style lenses (and sooooo many professions are now basically in that demographic, not merely accountants or whatever), but often patients feel like they're going hog-wild when ordering clear + suns at the same time. Throwing in a third pair is... atypical at best, regardless of their needs. Doesn't mean it doesn't happen, but it feels like folks are playing make-believe when they theory-craft these ultra-multiple sales scenarios

edit: this probably came off more hostile than I intended. For my office's market and demographics, this reads as a wildly-improbable fantasy scenario. Maybe in a denser and more affluent market, it is more typical? It still seems to me like a patient rocking in for a 4 pair sale is going to be a rare occurrence at best, and you're more likely to get PAL/suns/office lens at most? But maybe in those areas that have lots of C suite execs and salaryfolk, they're more willing to switch between two different mid-range glasses than my gut tells me?

I get that three- or four-pair sale about three or four times a year at best.

[KrystleClear]

I feel like I usually run into this issue with patients who just got cataract surgery who did NOT opt for the premium implant like PanOptix and still need near correction. They just think that the lens implants mean all they need now are readers and even though I thoroughly explain that near vision only lenses will only correct between ~12 to ~16 inches from their eyeballs and they still will need something for that intermediate zone, especially if they spend a lot of time using a computer or ipad. I had to make up little forms for them to sign stating they understand near vision only means near vision only. A nice set of computer progressives or heck, even a computer bifocal, is worth it in the long run.

[drk]

As to the multiple-pair thing, that's a feature and a bug of VCPs.

They're back every year for more.
You have to creatively suggest what they need.
They have a collection of glasses.
You have to work harder for the same money, though.

[lensmanmd]

Not to be a dick about this, but how often are you getting patients who would A.) want that full spectrum of lenses; and B.) be willing to pay for it? I absolutely talk up office style lenses (and sooooo many professions are now basically in that demographic, not merely accountants or whatever), but often patients feel like they're going hog-wild when ordering clear + suns at the same time. Throwing in a third pair is... atypical at best, regardless of their needs. Doesn't mean it doesn't happen, but it feels like folks are playing make-believe when they theory-craft these ultra-multiple sales scenarios

edit: this probably came off more hostile than I intended. For my office's market and demographics, this reads as a wildly-improbable fantasy scenario. Maybe in a denser and more affluent market, it is more typical? It still seems to me like a patient rocking in for a 4 pair sale is going to be a rare occurrence at best, and you're more likely to get PAL/suns/office lens at most? But maybe in those areas that have lots of C suite execs and salaryfolk, they're more willing to switch between two different mid-range glasses than my gut tells me?

No worries. No offense taken. If you don't try, you wont get it. That's my motto.

2 pairs can be difficult, but more common. 3 pairs? Tough, but doable. 4 pairs? In the scenario presented, it is possible, but that would be mostly for sales execs. What's the harm in presenting it as such, though?
My lab sees 4 pair sales more often than you would imagine.

[Prentice Pro 9000]

Been wearing that for years,,,,EZ PZ. Actually our software has a formula that calculates the distance from the screen that they would like to sit. not were they now sit , but were would they would be comfortable sitting and then calculates the % to put in the top.

what company and what lens?

[Prentice Pro 9000]

Isn't this the intention of Shamir Computer/Workspace and other computer progressives? They work great, and unless you get a screamin' deal on an inexpensive progressive design, they are less costly than progressives too. They are harder to fudge around with if you want to customize the computer Rx, but it's doable. And I only have to alter Shamir's default design maybe 5% of the time.

I used to use Eyezen's for computer/near designs in moderate presbyopes, and wore that myself. A few months ago I finally get myself into the Shamir Computer and it's way more comfortable and pleasant than my fudged Eyezen. And I was very pleasantly surprised to see the effect of the continuously reduced add all the way to the top of the lens. If I look out of the tip-top of the lens I can see clearly across the office; I could not with my Eyezen design. The only advantage I can think to fudging a progressive is to have simple control over the different powers, and maybe a wider computer Rx straight ahead for people with multi-monitor displays.

But I completely agree with your point, there is very little good reason to limit customers to the narrow 6" range of clear vision in single NVO, especially when a computer progressive is only moderately more than a good digital SV.

Do you not use the computer progressive designs drk?

The multi monitor thing is why I’ve always preferred to fudge a standard progressive. I like to use a short corridor to harden the design and widen the intermediate at the top just a bit. I really hope somebody comes out with a lens that does this soon. I’m really glad somebody else out there seems to understand what I’ve been saying all along.