Progressive for First Time Wearer

[Cindy Hamlin]

My appointment is nearing and I know it will be that time . I have all the classic signs: print getting smaller, light not bright enough, eyes ache....

• I will be a horrific progressive wearer.
• I don't adapt well to changes.
• I spend most of my day (8-10 hours) on a PC.
• My frame has a "B" measurement of 29.

So give me the recommendations and tell me why.

[ziggy]

Like wine, I hope we only get better with age! I just found out last friday I need my first pair, I feel your pain:o . I ordered the AO/SOLA B-Active for my self, nice wide mid and near range. My "B" is only 30. A buddy of mine just got the new les by Kodak," precise", I think. Second pair for him he said it works great! Good luck

[ikon44]

I am resisting it, but now when i have to put a new screw in a frame i need to

take my specs off.:cheers:

[drk]

Forget about the intermediate zone. Emerging presbyopes (+1.00-+1.25 adds) have enough accommodation to not need the intermediate, and don't worry, you won't need to tilt your head to see the computer screen!

With a low add, you really can't go that wrong in your choice. If you are worried about your sensitivity, use a top-of-the-line type progressive, like Panamic or SolaOne or Gradal. If you can swing it, try to get an individualized progressive like a Zeiss Individual and tell us how it works!

Oh, about the B of 29! That doesn't really tell as much as the distance to the top and bottom of your lens. It sounds like with that frame you're going to need the short-corridor treatment! Even with a 16 high seg, that leaves only 13 mm for distance viewing, both minimums. Get a big old-lady frame, for crying out loud!;)

[For-Life]

Cindy, what do you sell your first time presbyopes?

[Pete Hanlin]

Cindy,

Let me know what your script is and we'll get you hooked up with some Varilux Ellipse lenses. After all, I want my cousin to be able to actually see! The Ellipse will leave you with a nice wide distance area in the top of your frames, while providing the extra bit of plus you are now needing to read.

Just drop me an email,
Pete

[Andrew Weiss]

I've experienced that one lens design doesn't necessarily work well for all people and all Rxs. So, in no particular order, here are the short-corridor lenses that I've used and had people adjust to well.

-- Zeiss Brevity, or, for maximum ease, Zeiss Individual Short. The Individual is a great lens at a high price. Great especially for Rxs with high cyls or severe anisomotropia. 1.6 only, and only with Carat AR. The Brevity is a fine short-corridor lens with a large-ish reading area.

-- Rodenstock XS. Maybe one of the most underrated and underused lenses. Very smooth peripheral and easy to use. Maybe a bit squeezed on the corridor in higher adds.

-- Seiko Proceed Short. Great for high-minus Rxs. Has a 0mm drop to the corridor, thus decreasing the amount of prism thinning necessary to make a cosmeticly-attractive lens.

-- And, of course, the Ellipse. I haven't had a lot of experience with it, but one of or Drs is wearing it and loves it, especially the intermediate and reading areas.

So Cindy, what's your Rx? That may determine what's your best lens options.

On the other hand, I'd never turn down an offer for a free lens, especially one as good as the Ellipse :)

And, BTW, I never liked the AO Compact. It's more like a blended bifocal than a progressive. At this point I don't use it at all.

[Cindy Hamlin]

Thanks for the input guys! I am due for the eye exam in August, but am feeling like I can't wait that long. My eyes are screaming!

My rx is usually:

-1.75-1.00 180
-1.75-0.75 10

or there abouts. The only thing that seems to change is my cyl -0.25 one way or the other.

I am going to schedule my eye exam for later this month. I just wanted to get enough info for an informed choice. There is nothing I hate more than spending money and regretting the choice!

As far as which I recommend...I formerly worked for a chain store and was limited to their selection. I have not dispensed for about 4 years now as I was happily middle management! So most of what I dispensed is probably gone, refined or retired!

I am interested in your thoughts on the computer progressives. Do you dispense many? What is the success rate? I ask because I spend most of my day in a cube and staring at a PC monitor now. I am recruiting for a title insurance company. I decided to, after the layoff, switch industries. I loved the optical industry, but the customer part was starting to make me weary! ;)

So let me hear it. Let's get the Opti-braintrust working on this. It can be like MTV's real world without the 20-somethings, midriff tops, and cameras.

[Luckyshot]

Your RX isn't so high that you really need the more expensive no-lines (Zeiss, Seiko, ect), but your small frame will limit your choices primarily to these higher-end lenses. I wear a Seiko SV lense (very high myop) and love that lense! My customers that don't mind paying for it are always very happy with it as well.

[Rophod]

Cindy,

How far away is the computer monitor and even though it is not nice:finger: to ask a girl what her age is, it is relevant to your question, so how old are you?

[Cindy Hamlin]

Monitor is arm's length away and age is irrelevant! :)


Actually, I am celebrating the 12th anniversary of my 29th birthday this year!:cheers:

[LO1007]

I would like to recommend you try the Hoya Summit CD, it's the short corridor progressive (14mm min. fitting hgt) that is really easy to use and adapt to. I have a friend that could not wear any other progressive, low RX with a low add, got the CD last week and called to tell me he loved it, and had not taken them off since he got them. The CD has a great wide usable intermediate, the progressive is very comfortable to use at any distance and for any task.

Just my recommendation!!

[harry a saake]

Hey Pete, are you going to,have the midget deliver the ellipse to your cousin Cindy:cheers:

[drk]

Hey, Cindy:

Seriously, you don't need a computer Rx at your age unless you're experiencing eyestrain/fatigue. I don't need to tell you that you don't need a computer lens until you're about 47, or have about a +1.50-+1.75 add (you know, trifocal age).

If you do have eyestrain/fatigue, then you need a SV lens, probably just about +0.50 to +0.75 over your distance Rx. You do not need a computer lens yet.

Sorry!

[Lee Prewitt]

Cindy,


My advice is to use a Shamir Picollo for your everyday Rx and a Shamir Office for your computer Rx. I will respectfully disagree with drk on the need of a computer Rx. I'm sure that he is correct based on relative age and add power but the research on CVS, Computer Vision Syndrome, goes well beyond the need for a simple add. I fit 20-somethings in computer Rx all the time and it truly relieves the symptoms that they are having. Check www.prio.com for more info on CVS and its causes. As for the Picollo, a wonderful SV like lens that will not only give you great distance vision but clean wide near as well. Good luck on your choice.

[Rophod]

My appointment is nearing and I know it will be that time . I have all the classic signs: print getting smaller, light not bright enough, eyes ache....

• I will be a horrific progressive wearer.
• I don't adapt well to changes.
• I spend most of my day (8-10 hours) on a PC.
• My frame has a "B" measurement of 29.

So give me the recommendations and tell me why.

Cindy due to the fact that you are symptomatic and you are at the computer 8-10 hours a day I would suggest a SV low plus lens to be determined by your working distance and accommodative test. As Drk suggested maybe in the range of + 0.50 to 1.00. All general purpose progressive will give you no help at the computer unless your monitor is very low in your field of view and even if you can see the print on the screen you are still doing a heck of a lot of near work which is very taxing on your eyes. You can use this Rx at work and at home when you need it. You could also try an Access lens which is designed to give plus in the straight ahead position and at your desk and also decreases in plus above the midline to allow you better range. When your need increases then going with a progressive is a good idea for general use and still use a SV lens or computer lens like the Access for work. Also think about the use of artifical tears since people at computers tend to blink almost half the normal rate resulting in dry eye symptoms.

[Cindy Hamlin]

Thanks all for your input. I mentioned the PC glasses since I have heard progressive users complain all the time about the neck strain and finding the right "spot". The PC glasses came out after I had stopped dispensing and I wanted to learn more about it.

Thanks all for the input. I will consider all of my options and weigh them against the optician who is at the office I will be examined at. She has been in practice over 40 years and I tremendously respect her opinion.

I will let all of you know what I decide.

[Homer]

I find it ironic that people who make their living from selling eyeglasses are not into multiple solutions.

Why is is one RX equals one pair of glasses?

Secondly, what does the eye examination have to do with reality?

Contributing on the board would indicate you have a fair knowledeg of and access to various products. Just find out what works. I mean, what to the Doc's really know anyway (most, not all, live in an unreal world of spining dials, digital readouts and pathology)?

I, though much older, am in nearly your situation, Rx wise. First Try a Shamir Office with using 1.25 add as a reference, or perhaps a Zeiss RD without the conpensation so that you get full distance in the upper and a generous, useable mid section, with even more help for closer work. Where is the Premi when we need it?

There are so many wonderful products out there - not to mention your "cousin's" offer - that this is a wonderful time in the history of the world to be turning presbyopic.
:cheers: Welcome from the rest of us!

[Cindy Hamlin]

Thansk, Homer! At least being of the industry I knew what was happening. I haven't gotten to arm's length yet, but it is starting nonetheless.

Thanks for your input.

[drk]

Thanks for dismissing an OD's opinion's validity by the outrageous propaganda that we are not connected with the "real world". You obviously know what you're talking about, Mr. Smart Guy.

Everyone here should also know that "CVS" is a garbage diagnosis based on specious theories, and the PRIO corporation is a bad joke.

While no one ever died from wearing uneeded plus at near, IN GENERAL no emerging presbyope needs a multifocal lens for computer distance! Think it through!

If an emerging presbyope has enough accommodation to focus at 40 cm with a +1.00 add (+2.50 demand - +1.00 add = +1.50D accommodation) , then they have enough accommodation to focus at 66 cm (+1.50 demand) without an add. Shoot, play it conservatively and say they could use +0.50D help at 66cm, and +1.00 at 40 cm. Does that really REQUIRE a multifocal? NO!

Geez, if Cindy were my patient, I'd:
1. Prescribe a decent progressive, like a Panamic (or Ellipse if she insisted on the smaller frame), then...

2. IF (big IF) she had problems with accommodative fatigue on the computer, I'd recommend a pair of SVNO lenses with about a +0.75 add.

'Nuff said!

[Pete Hanlin]

The largest work on the subject of CVS (Diagnosing and Treating Computer-Related Vision Problems) was written by Optometrists, and the profession of Optometry in general seems to be fascinated at the prospects of yet another sub-specialty. So, CVS isn't solely the creation of PRIO.

That said, there are also a lot of Optometric Physicians like drk who have a more moderate view of the effects of long-term computer use on the visual system. I am inclined to agree with drk's opinion- I'm not convinced that computers present any particular additional challenges to vision/eye health than other long-term intermediate activities.

I wish visual therapy could garner the attention CVS has. In my opinion, VT offers a lot more to patient in the sense of actual improvement of the visual system. Although VT can also turn into a rather "faddish" sub-specialty, I would recommend anyone who is interested read the book 20/20 is Not Enough (forget the OD author's name, but it was a good read and very compelling for the benefits of VT).

Anyway, I'm just waiting for Cindy to send me her script, and then I'm going to have either a Varilux Ellipse or Varilux Panamic made up (depending upon the frame) and a Nikon On-Line (just to see if Cindy actually likes the concept of a computer lens).

[drk]

Thanks for backing me up, Pete.

I agree, that a certain subset of Optometry is driving the "CVS" bus. Unfortunately, Optometry has it's share of unscientific kooks. PRIO's along for the gravy train, selling awfully expensive near point testers to unscientific doctors!

"CVS" is malarky. It's made to sound scary to patients, third party payors, and legislators, and has been used as a bogeyman to try to get government or private industry to subsidize computer-specific eyewear for workers.

The "syndrome" consists of dry eyes and accommodative disorders. Big deal! Try reading on your back porch in Arizona for an hour: Desert Vision Syndrome! Call the Dr!

I'm not discounting the problems people have, just the creation of something that doesn't exist in order to sell, sell, sell.

The PRIO corporation's main assertion is that a pixel is somehow more difficult to focus on because it is not uniformly illuminated/ has fuzzy borders ("Gaussian") and thus causes the accommodative system to relax and refocus. Well, that's not necessarily unique to an accommodative stimulus that is "Gaussian", and what's more, even if it is true, then a simple low plus Rx is all that is indicated. They want you to believe that you have to test on their computer simulator to get the correct Rx. "Let's see...+0.87, no, +1.00, no, +1.12, let's get this thing EXACT! I'm glad for my PRIO tester!"

HOGWASH.:angry:

[Judy Canty]

Thanks, drk. All this time I thought that I was missing something important..that it wasn't just snake oil.

[Lee Prewitt]

I'm not discounting the problems people have, just the creation of something that doesn't exist in order to sell, sell, sell.

drk,

If people are having "problems" when using a computer, is not CVS putting a name on the problem? I am not discounting your opinion as it all being hogwash, (I don't really believe things about VT, sorry Pete) but I have found a wealth of research from around the world that supports the notion that CVS is a real and legitimate concern and that proper diagnosis and treatment can alleviate the symptoms. This is difficult for me to ignore when true scientists, including optometrists, have done credible research and drawn valid conclusions.

As for PRIO, I think they went astray when they began hawking frames. All that research seemed dulled by the obvious aspect of sales. Does that mean that a Dr. can't diagnose and treat CVS without their tester? That is Hogwash! CVS is more than a pair of glasses. It encompasses a huge arena including ergonomics, engineering, visual tasking and yes eyewear. I don't think that 75% of computer users can be ignored when they complain about their vision. Nor the 14.5% of all patients that see their Dr. with symptoms from CVS. Is CVS becoming a subset of optometry? Definitely but so is punctal plugs, surgical co-management, contact lenses and the like. Optometry is certainly in a position be the gate keeper of this subset and yes...we will sell some glasses along the way.

[drk]

Thanks, Judy and Lee.
Lee, is not CVS just another term for accommodative fatigue/spasm and/or dry eye? If so, I don't mind the moniker, as long as it's not cloaked in esoterica about "Gaussian" stimuli and some new word they invented for "resting focal point" or whatever, designed to amaze and confuse!