What do you choose for a person who doesn't opt for a true computer glasses design, but you want to maximize intermediate utility in a general purpose pair of glasses?
What do you choose for a person who doesn't opt for a true computer glasses design, but you want to maximize intermediate utility in a general purpose pair of glasses?
For me the IOT lenses offer great versatility.
Each of the Camber Steady, Endless Steady, and the Essential Steady offer three different versions of each design. One that maximizes distance, one that maximizes intermediate, and one that maximizes near.
Endless Steady (intermediate) would be my choice for the bulk of these type of patients.
Scroll down from the top and you can see the variations in each design: https://www.iotlenses.com/Discover-o...ogressive.html
Would a 'short' corridor be better than long?
I think the opposite.
IMO, short corridor PALS are detrimental to intermediate use with less vertical area available.
I would go with the least minus/most plus for the distance, with the weakest add I could get away with for the individual patient.
I always stress to the patient that like one golf club does not get you all the way around the golf course, often one pair of glasses does not work for everything.
For a larger desktop and adds over 1.75, the add power needs to ramp up quicker and start a little higher up in the corridor to minimize chin lift. The trade-off is degraded distance vision on and off axis.Originally Posted by drk
Best regards,
Robert Martellaro
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
Good general answer. That would be the Shamir Autograph Intelligence?
scratch that. That design seems weird. What are they talking about? https://www.shamirlens.com/products/...ucts/item/238-
My current belief is the Auto II+, fit on pupil center.
Last edited by drk; 09-03-2023 at 08:33 PM.
This is tricky - as an increasing number of patients don't understand that their 2 - 32" 4k screens on a stand at level eye height (or higher), along with their docked laptop way over to one side, will never play nice with presbyopic eyes. Ask them to raise their seated position, or lower their monitors, or - worst of all - move their head side to side to take in their entire visual landscape, and more than a few have an absolute conniption. Asking all that of a single PAL of any stripe is asking the impossible.
That said, good education, and setting reasonable expectations for the patient from the outset solves many of these potential issues. Another side option is something like the Chemistrie system, with a full sized reader and/or computer clip over SV dist. It's more pieces yes, bit does offer that "edge-to-edge" option that a number of patients expect all PALS to function like.
I've used the Chemistrie Blue and Chemistrie + on several pts who won't/can't/refuse to use progressives and NVF options or as you state want that full width option.
My optician called me yesterday and asked if we can stop selling progressives LOL
I said why? She said she hasnt had a single complaint for a single vision or lined bifocal. But the progressive wearers say 'I cant see when I look to the far side of
my glasses'. Despite being told XYZ.
Lets face it. Progressives kinda suck
This is a professionally repugnant solution, but I've done it twice and made two customers happy: underminus the distance Rx. One guy we just did +0.25, barely noticeable DV but noticeably improved NV. The other firmly wanted a full +0.50 DV and insisted he could see distance fine (probably could, tons of people are walking around "fine" with half a diopter uncorrected myopia). They both kind of liked the idea of computer glasses, but just weren't in to switching pairs. That was before Chemistrie, now I do that simple +0.50 to +1.00 chem over progressives and it works wonders.
I disagree.
I think I heard this from John at Laramy K on one of his videos:
"Progressives are a compromise and compromised lens."
Perfect answer for a complainer.
And the late great Chris Ryser would wholeheartedly agree to your observation!
Ryser's Rule:
"The success of a progressive is directly proportional to the desire to wear a progressive."
Compared to what? There's no great options, just varying degrees of suckage.
I cringe when a doctor hands off and says they were thinking of a progressive lens and it is a 70 year old man who has never worn progressives before. I'm ambivalent putting anyone in a progressive for the first time with a high add power, but even more so with men. Maybe that's a personal bias, but it seems that women have more reason to try and pretend they aren't wearing bifocals than men (Ryser's Rule).
I recently had a 77 year old come out of the exam room and the doc was excited to tell him about the brand new progressive he is wearing (+1.50 add mind you). I walked the customer through a progressive lens and a bifocal lens and let him choose. He didn't want to deal with the "nonsense" is what he called the peripheral distortion of the progressive lens. I'm glad to know this now and I'm sure he is glad to not have to pay for the latest and greatest progressive lens and be disappointed. It's a conversation worth having with every new wearer but especially those with high adds where the lens will be at its worst. The doctor came back later and asked what I put him in, lined bifocal with transitions and a high end AR, and he said, "Yeah that makes sense." Like he already knew that it would be a bad idea to put him in a progressive and deal with that headache later.
Let's face it. Presbyopia kinda sucks.
Fixed it for you.
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This
Shortish -- you don't want the person to have to raise the head up so much. Remember, the area most appropriate for the computer distance isn't so far above the reading part of the lens, so with a long corridor progressive, the sweet spot will be kind of low. If you can't convince your patient that having INT/NV lenses is a good idea, perhaps you can persuade that person to lower the monitor so that he's looking downhill at it.
I could see using a IOT AH45 12.
no. not presbyopia. progressive lenses. theres only so many ways you can get distance to near in a lens without some compromises.
doesnt mean they dont work.
I saw someone last week who has 4 pairs of glasses but only wants to wear the ones from 2017.
is it the Rx? nope. Progressive lens design? nope. 2 of them were exactly the same except for one key thing
trivex. he doesnt like the polycarbonate. Even though he can technically read better with the newer glasses from 2 years ago. he likes the oldest one.
my real point is: all these fancy progressive lenses that are supposed to be way better..... nah. havent seen it in actual practice and usage
Again what are you comparing a "fancy progressive" to? If progressive aren't it for you--what is?
What's a fancy design?
Is a Comfort and a Comfort DRX in a mild rx an improved "fancy" upgrade?
What's the rx?
What are the designs tried?
FWIW- I have many examples of putting a top design lens on someone only to return to a 50 year old design.
It's xtremely rare in an average rx that materials matter- but I know an optician who swears poly sensitivity in a virtually plano distance rx! I'm too old and lazy at this point to double blind mask an experiment.
"The art of the troubleshoot"
Last edited by Uncle Fester; 10-10-2023 at 01:04 PM. Reason: tweak...
progressives are fine. I just find the marketing stuff nonsense. and often the accompanying price-tag
You will find no shortage of people here who think the marketing of the major lens companies is fancy mumbo jumbo. I think that is a separate issue from progressive lenses sucking. There is always going to be a compromise with progressive lenses, it doesn't mean the newer "fancier" progressive lenses aren't a better version of other progressive lenses. Nor does it mean that they aren't worth the cost people pay for them. Worth much like beauty, is in the eye of the beholder.
You don't like progressive lenses, cool.
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