Progressive Lenses

[Shanebug]

I'm wearing contacts but hate having to wear readers on top of them. I have astigmatism so would most likely have to use RGPs if I wanted to try a bifocal/multifocal contact.

I'm thinking about going with a progressive regular glasses scheme. I tried Varilux several years ago and gave up on them. I probably didn't give it a thorough try.

What is the latest and greatest in progressives. Also, on top of that, I am thinking of Transition lenses. Do I have a good plan? Also, if I go with Transition lenses, which version is good?

Any other coatings I should consider?

I do spend a lot of time at work staring at a computer.

[mrba]

I'm thinking about going with a progressive regular glasses scheme. I tried Varilux several years ago and gave up on them. I probably didn't give it a thorough try.

What would you consider a thurough try?

[Shanebug]

I would wear them during the day and then go back to my single vision glasses at night. I probably gave up after about a week. There may have been a day or two during the week that I didn't wear them at all. My doc said a couple of days for adjusting, but most people I talk to know, said their doc said a couple of weeks. That's why I feel I didn't give them a fair shot.

[mrba]

It takes anywhere from a day to months actually. All depends on the desighn of the lens and the psychology of the patient.

[Shanebug]

I don't have the fortitude to try "months"! I'm about -1.25 in both eyes for distance, some astigmatism in each eye. I can read without glasses, but can't read very well when I have my distance glasses on.

Does that provide any indication of my success probability?

[Pete Hanlin]

If your ADD power (the "+X.XX" noted on your script) is somewhere around +1.25, my guess is you may still have trouble adapting to PALs.

With a distance Rx of -1.25 and an ADD of about +1.25, you would probably be inclined to take your eyewear off when reading, since you a.) won't really need the intermediate powers, and b.) have eyes that work really well without correction at a reading distance.

That is not to say you shouldn't try a PAL again, I'm just pointing out that motivation has a lot to do with PAL adaptation. If your ADD is a bit higher now (in the +2.00 range), you may find you are a bit more motivated to adapt to the progressives now. If you do try PALs again, my (obviously biased) suggestion would be to try a Varilux Panamic fit by a skilled eye care practitioner.

RGP bifocal lenses are an interesting product as well- but they are tricky to fit and take some adaptation as well. As you indicate, your astigmatism is probably just a bit high for a soft bifocal contact lens like the AcuVue product. Of course, there is also monovision as well if you stay with the contacts...

[Shanebug]

Pete, Thanks for your comments. You have hit the nail on the head regarding my previous history. I have the ability to just take off the glasses and read fine, so it will take some discipline. I really want to get out of taking glasses on and off. That's why I'm getting out of contacts in the first place, because I have to keep throwing on my readers (especially in low light). When I wear just distance glasses I am doing the same thing, just in the opposite.

I'm thinking that I will try the progressives and give my plain distance glasses to my buddy to keep away from me for two weeks. That would force me to give them an honest try.

Thanks for the recommendation on Varilux Panamic. That sounds like the way to go.

I tried modified monovision and regular monovision and it worked pretty well, but I felt I was giving up a little in depth perception. I especially felt compromised with night driving.

One eye is only .75 astigmatism so that is where he tried the mulit-focal lens. I think the main problem was that the astigmatism was too much for me to be happy with the distance vision I got out of the multi-focal.

I don't think I'm up to the hassle of RGP.

[Pete Hanlin]

Wow, I wish all patients were willing to "give their distance glasses to a friend!" It sounds as if you are going to be giving it an honest college-try. That's all an optician can ask, and often far more than we get!

Given your history and the reason you are purchasing PALs (i.e., to be able to keep the glasses on all the time), I would suggest you make sure the frame you select offers at least 20mm or so between the bottom of the frame and your pupil center.

As we've discussed, you are able to read quite well without any correction. Therefore, for any solution to be tolerable for you, you'll have to compromise your near vision as little as possible. Picking a small frame is going to restrict your near vision (I don't care whose PAL design you purchase) to the point that you will probably get back into the habit of taking the glasses off.

Also, I would highly recommend you have AR (anti-reflection coating) placed on your lenses. Once more, by removing a limitation (reflections), you will have more natural vision and should be less inclined to remove your eyewear.

The trick is creating eyewear that you basically won't even notice you're wearing- if your optician can accomplish that, you'll have no trouble leaving them on.

Good luck to you, and let us know how things turn out!

PS- With soft bifocal contact lenses, the doctor is usually trying to get you to something called "20/Happy." Individuals who have the capacity to see quite well (such as yourself) are often the toughest to bring up to 20/Happy. For example, if you didn't have solid binocular vision, you wouldn't have noticed the degradation in your vision while wearing the monovision! I used to be quite nearsighted (before LASIK). Now that I see 20/20 without eyewear, I find I'm much pickier regarding my vision, and STILL wear glasses to get it just "perfect." Ah well...

[Shanebug]

Pete - Here's what I did. Now tell me how I faired.

1. Went with Varilux Panamic. Almost went with Shamir Genesis. They said they are new and have had great results.

2. Transition lenses

3. Crizal coating

4. Sillouette rimless frame

5. Not sure on how "tall" the lenses are, but they aren't the really narrow ones, so hope I am okay.


20/happy was exactly what my doc called the bifocal contacts. I'm like you. If I don't see "perfectly", I'm not going to go for it.

Let me know how I did!

[Laurie]

Hi Shanebug

Hi Shanebug,

I would give the Shamir Genesis a try. It is an excellent design.

: )

Laurie

[mrba]

if you are going to spend that much money try the Gradal individual by Zeiss. Truly the finest with no competetor...

[Pete Hanlin]

As you can see, various PAL designs each have their own advocates. Both Shamir and Zeiss make quality products, and- when fit by a skilled optician- their lenses work very well.

Likewise with Varilux Panamic- the key will be in the accuracy of the fit. The design concept behind your Panamic lenses is called "Global Design Management." The lens is designed to provide both eyes with similar peripheral images. This provides comfortable vision with minimal swim and perceived distortion. The concept is a bit different from most other lenses on the market (including past designs by Essilor/Varilux), and I've had a lot of success with it when I was dispensing.

Speaking of dispensing, a good fit will be necessary to benefit from the design. The skill of the optician will always impact your eyewear as much- or even more- than the design. This is because even the best designs by Essilor/Varilux, Shamir, Zeiss, or any other manufacturer will not work optimally if they are not centered in front of your pupil. We'll assume the fit is excellent for now, and if you have any difficulty, we can troubleshoot from there.

I look forward to hearing your perceptions of your new eyewear. You didn't mention the lens material (Transitions is available in many different materials), but since you have selected the Silhouette frame I am assuming you will be receiving polycarbonate lenses. Combined with the lightness of the titanium frame, the polycarbonate lenses are going to provide you with extremely light eyewear- so you should be able to "forget you have them on" once you get used to them.

Also, the Crizal AR will greatly reduce reflections and is one of the most durable AR you can purchase- so you should see and look better in your eyewear, and they should hold up well. Overall, I'd say you've made a pretty sound investment (and I'm sure it felt like an investment, because quality eyewear doesn't come inexpensively these days)!

[Shanebug]

The optician said that the Shamir Genesis doesn't come in Transistions. He did say that the wife of the owner of the practice has tried every progressive there is, with no success, and is doing great with the Shamir lenses.

I did get polycarbonate lenses because of the need to drill for the Silhouette rimless frame.

They said it will be about 10 days before I get them. Once I do, I will post a status report as to my first impressions.

I'm really anxious to give them a try.

[Shanebug]

Initial Report on Progressives

I got my new progressives about 4 days ago. I am feeling pretty confident that they are going to be the answer for me.

I took a long run in them in hot sunny weather and they stayed right in place. These are a light pair of glasses and feel so comfortable.

The transitions are working out well, also. I wouldn't mind if they got a little darker, but, all in all, I can function just fine outside without sunglasses.

My biggest fear was getting adapted to progressive lenses. So far, it seems to be coming along nicely. A tip the Optician gave me is helpful. He said when looking at close up objects, start in the distance part of the lens and then move my head up until the words/object are in focus. That seems to me working.

I feel like I am having to point my head lower than I am used to to keep the distance part of the lens in place. That is probably just part of getting used to them.

I went to the store and could see across the store and close up without having to put readers on. What a great feeling.

I am feeling good about my decision to abandon contacts and readers.

[mrba]

Genesis is available in cr39 transitions as well as 1.60 highi index transitions.