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Thread: A PAL paradigm shift

  1. #1
    What's up? drk's Avatar
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    A PAL paradigm shift

    So I had a meeting with an Essilor rep this week about their PAL products. The one take-away that stuck in my mind, because it seems to be repeated by other lens manufacturers is "removing the obstacles to PAL lenses FOR EMERGING PRESBYOPES". By that, I mean someone with a +1.00 add.


    For example, Essilor has developed a PAL called "Liberty 3.0" (not to be confused with the older "Liberty" for grandpa flat-top design...although it's going to definitely be confused) that only goes to a +1.50 and is a cheap entry-level model.
    Shamir has it's own "training wheels" design (called "My First PAL") and I assume there are others. (Zeiss has their "Light" series, e.g.)


    Some of these lenses are el-cheapo, because they want to "remove the cost barrier".


    And without a doubt, VSP (and to a lesser-extent EyeMed) are increasingly selling groups this "standard progressive" feature. (Which pays us jack-squat, BTW. Let's talk about that, too). The giant vision-care plans have created a market for these lesser-expensive PALs, and the now-almost completely free-form companies are stripping bells and whistles (oftentimes useless bells and whistles, at that) off their super-customized designs and calling it a new lens. I think not; they're just a lot of the same designs with the default options set to zero or almost.


    So what do we do? Do we sacrifice on emerging presbyopes? I say...well...yes. Hear me out and see if this is a valid take.

    By way of digression, you know how all these "near boost for your awesome 5G phone" lenses are proliferating? Eyezen, Shamir Relax. Zeiss Digital. All these lenses are just the same old progressive technology with baby adds being marketed to goofballs to go with their blue-light coatings so they can look at Tik-tok for hours in high definition. Why not, if you're a lens company, market expensive stuff to a wide-as-possible audience?


    What I'm saying is that the concepts behind PALs are subtly changing. Whereas it used to be "Hey grandma, time for a bifocal... yes, it's 'your time'" then to "NO-LINE bifocals, so no one will know you're getting old" emerged. The experience was like taking a bitter spoonful of cod liver oil.


    Fast-forward to todays "tech is our god" society. Why do you think blue light filters are so compelling to the average numbskull? Yes, there's the Luddite "cOmPUterS huRT YOuR eYEs" contingent, but there is a lesser-recognized "I like gaming. I like Twitter" contingent that think that blue light filters are F-I-R-E because it's part of the online scene. Those are the same people that will shell out an extra $200 for a blue light filter plus "near boost" lens package.


    Digression #2: "There are only two things you sell. Good feelings, and solutions to problems." ---famous anonymous smart business guy.


    "Selling a delicious Starbucks latte (good feelings) is a heck of a lot easier than selling a new muffler (solution to problem). Try to sell good feelings" ---drk


    So, having said all that,

    1. I'm re-inventing/re-marketing lenses in my office. We are going to de-emphasize the now toxic word "progressive lens" because everyone now has a bad story they've heard. YOU KNOW THIS IS TRUE! We are just prescribing lenses with "focusing help for reading and making your eyes feel way more comfortable". (Same way we'd describe these anti-fatigue lenses to 30-somethings, if we were that craven to do such a thing, which we aren't. Same way Essilor-Shamir-Zeiss, etc market these boutique lenses...read their marketing to see how they do it. And heck, if you want to really go wild, combine the concept of AR coating to the mix in a package..."these lenses relax your eyes for reading and make everything crystal clear".)


    2.We also are going to prescribe immediately, and we're going to prescribe NOT even +1.00, but +0.75. Why?
    a. because it's impossible to screw up a +0.75 add, either by a stripped-down design or a sloppy optician.
    b. because they're mostly free, anymore, because of the VCPs sneaking this into the mix, and because there are fantastic, inexpensive designs that the lab's computer entry person can select and flip a digital switch.
    c. there are almost no adapation effects with an add that low, I've found.


    You are a hero! Jump on this stuff at the first hint of trouble and be pro-active. You gotta sell the good feelings. "Comfortable, clear vision" (yay!) vs. "first pair of bifocals" (really?).




    Why would you ever DO THIS? Why give away the milk when they can buy the cow? Because you don't want what we have now...the in-denial, cheap, no not me!, 49-year-old who now finally is complaining that they can't see and you now are faced prescribing a +1.75 add COLD. And then they moan up a storm for the rest of your life. Train them. Train them early. Take away the stigma. Take away the obstacles.


    Now, of course, when their add jumps to even +1.25, you have to have "the talk" perhaps. I won't use basic designs on any non-emergent presbyope. If someone's +2.00, you need all the technology you can get on them. So, they will have to upgrade at that point. (I'm working on the sales pitch, but it will go something like "you now need a more advanced lens. Pay up.")

    But that first pair in training wheels (that you are subsidizing in reduced reimbursement--or not, because they may have just said "no-I-want-single-vision-keep-away-from-me-with-your-voodoo-I'll-just-remove-my-glasses/get-readers/squint"--and you won't get paid, anyway!) will be very instrumental in getting them mentally adapted and visually adapted to the heavier PAL lift of moderate to advanced presbyopia!
    Last edited by drk; 01-28-2023 at 06:10 PM.

  2. #2
    Eyes eastward... Uilleann's Avatar
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    I'm smellin what you're sellin here Doc.

    Though, I think back to my own experience nigh on 15 years back myself. Roughly mid 30's, and I didn't *need* a PAL for my light myopic SRx, and the work we do in the clinic. But I wanted to try them, and get that first hand experience. My first add was a simple +1.00, and I took the whole power. Can't remember the lens design exactly, but would have been either an E or Z set of lenses. Hung those suckers on my nose and my reation was exactly: "What a nothingburger!" I couldn't "see" the add area of the lens even when I tried, except for noticing the reduced accomidative need at near that I was keenly looking for. It felt about as buttery smooth, and easy to adapt to as anything.

    I had tried one of E's early "anti-fatigue" lenses with something like a +0.60, and it actually gave me headaches, without any perceptual benefit down low. However, the "true PAL" design several years later though, worked a real treat.

    I said all that only to say this: Are we running a real risk of making it too complicated for our patients? Is this another solution desperately searching for a problem? Does it simply equate to just more noise in the machine? Capisci?

  3. #3
    OptiWizard KrystleClear's Avatar
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    I have been catching up on all the marketing propaganda and I did the "Transitions Specialist" training thing. They suggest asking your patients questions that seem silly to me like "Do you ever squint when it's too sunny outside?" Like, yeah, everyone does. But the idea is it makes them feel like they have a special problem you with your great expertise have a special solution for. It seems so stupid but it works. You could have your opticians ask more lifestyle questions. "Do you spend a lot of time on the computer?" "Do your eyes ever get tired from staring at the computer or your phone?" They will almost always say yes. And then you can explain the solution, be it a baby PAL or blue light coating or even an intermediate only single vision lens. And you are right, drk, the verbage is very important. It's an anti-fatigue lens... tooootally not a progressive of course. Top it off with a quality AR, and you've got a killer pair of specs. I just try to not oversell or overpromise anything. I educate them on how someone may help them.
    Krystle

  4. #4
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    Put your idea into a chat bot and it came up with this script; Stress reduction lenses are lenses designed to provide focusing help for reading and improve eye comfort. They are designed to alleviate the strain and fatigue often associated with prolonged reading and screen time. These lenses are a comfortable and convenient solution for those who spend a lot of time reading or using digital devices. By reducing stress and strain on the eyes, these lenses help you see more clearly and comfortably, giving you a better overall visual experience.

  5. #5
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    I'm 33, been wearing digital lenses with an 0.50 add since I was 25 and loved them from the start. As my add inevitably increases, I know it will be an easy transition. In the meantime, my eyes are always really comfortable

  6. #6
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Quote Originally Posted by Robert_S View Post
    I'm 33, been wearing digital lenses with an 0.50 add since I was 25 and loved them from the start. As my add inevitably increases, I know it will be an easy transition. In the meantime, my eyes are always really comfortable
    Are we really dealing with an add power here?

    Is this an accommodation issue or something else?
    Magnification?

    I'll bet someone can find me the perfect thread to explain this and drk can then put it in the Hall of Fame Forum!!!


    Or are we making one here???

  7. #7
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    Quote Originally Posted by Robert_S View Post
    I'm 33, been wearing digital lenses with an 0.50 add since I was 25 and loved them from the start. As my add inevitably increases, I know it will be an easy transition. In the meantime, my eyes are always really comfortable
    I'm in a similar boat as you, and frankly, opposite feelings. I'm in digital lenses with a slight boost, and really honestly, I don't notice anything at all unless I kick my head way back and look for it. I still get the boost, because my glasses are straight fire and I want them to be around as long as I can w/o having to get new lenses. I don't notice any accomadative issues when I read out the top or the boost, and I have never really had issues (yet) with eyestrain while reading or anything. But I know there will come a point soon that my body will commit the cruelest betrayal and I will need multi-focal lenses. It's for then, when my phone gets a little harder to read otherwise, that I have these glasses that will hopefully bridge/off-set the need to jump straight into a PAL or BF.

    This is hopefully also subtly training my brain to make that jump to a PAL (most likely, along w/ a computer or office lens at some point) easier and more intuitive. I'll let you know how that shakes out, because I'm slated to hit that point a little before you do

  8. #8
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
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    Me want Robert S' and Juno prescriptions... Grunt

    50% success sounds about right for me but after a dozen tries me decided not worth pain in head from Neanderthals with club in hand wanting refund.

    But me no refund. Me have bigger club!!!

  9. #9
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    High minus, -7ish OU with some cyl OD

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