# Optical Forums > Progressive Lens Discussion Forum >  Lined VS Progressive

## April_01

If a patient is used to wearing a FT28, would you recommend going with a progressive? I have had a lot of controversy with this question at my current work place. Some say it will be better for the continuous line of vision from top to bottom. Others say keep them in the FT28 because they won't get as wide of a reading area in a progressive. After telling the patient the pros and cons it is ultimatly their decision, however, I would like to know you opinions.Thanks in advance.

April

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## chip anderson

Somewhat it is a question of add power.  If the add is under +2.00 patient will probably not need help at intermediate distances (patient may see better at near, far and intermediate with lined bifocal).   If add is over +2.00 patient will have a gap in which he cannot see with a lined bifocal, then a progressive (no line) bifocal or a lined trifocal may be indicated.  

Personally I keep a laurenette with progressive and a straight top bi(tri)focal on the dispensing table.  95% of customers who did not have preference in mind go for the no-line after trying same over their old S-V lenses.

Even if the patient chooses wrong, he had a chance to make an informed decision on his own.

Chip

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## For-Life

Here is a rule of thumb for me.  If the patient wants to go into a PAL from a Flat Top then they will have no problems.  If the patient is indifferent between the two and are happy with the Flat Top then they can have problems with the PAL.  I have a lot of new customers who previously wore Flat Tops asking to go into PAL's and they love them.  But I have found in the past not to do the customer a favour and push them into a PAL from a Flat top.

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## JennyP

Also: when wife wants to put hubby in a progressive make sure hubby wants it too... she can't adapt for him....and he probably has a wider peripheral field that he wants to use than she does..... she may be perfectly happy in a progressive but that doesn't mean he will be!

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## optiboarder

I agree with other replies. The option to switch is totally up to the customer. For some people its: "don't fix, if it ain't broken".  If the patient is 70 y.o. and has been happilly wearing FT for the last 20+ years, he probably would not be very happy with the change. The decision depends on their willingness to try new things, their Rx, their budget. In my area, they freak out when I tell them the price of Progressives vs. FTs or even separate pairs. And we dont even charge that much. Most customers do understand the ease of use of Progressives vs. 3 pairs of glasses. Eventually, they give Progressives a try.

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## optiboarder

Something else I forgot. The'll be much more succesfull in change, if (depending on Rx) their Intermediate Rx is clearly making a difference. Like for computer use, dashboard in the car etc.

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## Spexvet

> Here is a rule of thumb for me. If the patient wants to go into a PAL from a Flat Top then they will have no problems. If the patient is indifferent between the two and are happy with the Flat Top then they can have problems with the PAL. I have a lot of new customers who previously wore Flat Tops asking to go into PAL's and they love them. But I have found in the past not to do the customer a favour and push them into a PAL from a Flat top.


I concur. But I address the choice with EVERY patient. The last thing you want is to assume the patient wants to continue wearing a flat top, and at dispensing says "why do these lenses have lines? I thought I was getting those new invisible bifocals". So I Say "you are currently wearing lined bifocals, would you like your new ones to have the line, or would you like the bifocal to be invisible". Watch their reaction. As For Life said, they have to want it. If I read any interest, I show them how each lens works, describe pros AND cons of each, and let them decide. If they seem leery, I still show them and give pro/con, then recommend that they stay with the type they're used to.

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## Eddie G's

I've converted a Trifocal wearer and a couple of FT wearers to the Zeiss "GRADAL TOP" progressive recently and they absolutely loved it! :) 
This lens is amazing!!!
:cheers:

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## Texas Ranger

Since we do about 90% Vx lenses, I'd say that it is easier to deal with pal designs as a first multifocal lens. We convert many pts to vx, it's their choice, if they can't wear it, we redo the order in a lined lens at no extra charge, so the risk to them is the difference in cost, and they understand that going into it. saves a lot of hard feeling when they come up with "you sold me something that didn't work" bit...in any deal, salesmanship is about allowing an honestly informed pt buy what they choose, and you be as much of a safety net as possible; I once fint a 92 yr old lady with Vx Comforts and AR, she was totally amazed that in her 50 years of wear glasses, no one had told her there was anything available besides FT glass bifocals....when I told her we had been fitting vx for 20 years, and AR for longer, and that whoever she went to likely "assumed" she wouldn't be interested since she had worn the same ting for so long, her comment was "well, who they hell were they not to tell me about them, I've hated these lines all my life"...so, tell everyone, they have a right to have the opportunity to say no, but don't say no for them by not giving them a choice...

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## drk

All of these responses are great.  I wish there was a flowchart that could guide me to unqualified success when designing lenses for patients, making it a "hard science".  But, as mentioned before, there are too many factors to consider, and some of them are not quantifiable.  Human beings are far too complex, and it truly is under the rubrick of an "art".  And every artist is different and subjective, and creates some masterpieces and some that go into the trash.

I will say, though, that progressive manufacturers want you to dispense their lenses, and financially indemnify you (although not the patient!) if you are aggressive with their product.  I'd be sure to be honest with the patient as if they were your own parent, and if they want to put up the money to try, then go for it.

I would also say that dispenser confidence is premium.  Don't save the patient $50 at retail and give them a middle-of-the-road progressive.  Dispense the best, and know that if they can't adapt to that, the experiment can be over right there without second-guessing on your part.

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## Tjcjdc9462

I work in a large private practice of MD's and most of our patients are geriatrics.  We have no problem at all usually switching someone from a FT to a PAL with the selection of PAL's we have available to us.  We use a combination of the Essilor Natural and the Hoya PAL's.  The success rate is very good with either of these products, although I do explain the pros and cons of each type of multifocal with the patient.  In this day and age of tremendous computer use the PAL usually sells itself.  We offer the patient a 60 day exchange policy for non-adapt.  This is strictly a exchange only policy, they do not get the difference back for the less expensive FT's and since the PAL companies stand behind their product they allow us to return them as a non-adapt.

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## Chris Ryser

> *This is strictly a exchange only policy, they do not get the difference back for the less expensive FT's and since the PAL companies stand behind their product they allow us to return them as a non-adapt.*
> __________________
> :idea: Burned Out


This looks like everybody is making enough profit to have the cost of a switch back to ST included in the selling price so that all you have to do sit back  wait, and HOPE the patient does not want to switch back and you can keep the extra's paid for the switch back process.

Lets not forget that all plastic lenses are moulded. To mould a ST lens does not cost anymore than to make a single vision or a progressive one. A mould can produce thousands of lenses before it has to be discarded. To manufacture a mould, I might even dare saying that it is not easier to make a mould for an ST lens than a progressive. Actually when coming down to brass tag moulding, there is no difference in making a single vision lens or making a progressive, and that goes for every brand or no brand product.

In the old day's of glass lenses there was a sizable difference between the different types of lenses because some required a lot more labour to produce the blanks, so there was a difference in price from one to another.

The price difference from one to another type of lens has been kept up ever since, even if it is actually not justified anymore.

Polycarbonate lenses are even more accentuated when comparing price to manufacturing cost. Lenses are injection moulded often in pairs of 6 lenses per mould and take only a few seconds to pop out of the mould, however these lenses will then have to be hard coated.

These remarks have been made to clarify the point of manufacturing and selling, compared to the cost factor.

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## Tjcjdc9462

In our practice we do not sit back and wait and hope that someone is a non-adapt so that we can pocket the money.  Our #1 goal is to serve the patient.  We very rarely have to change someone out of a progressive for a non-adapt, but if they feel they need to then they have that benefit.  That is called customer service.  I have never had anyone to accuse us of trying to just make money off non-adapts.  We are trained professionals in a private practice, not commisssion hungry sales people in a retail environment just trying to make a sale to benefit our pocket book.  Also, it sounds to me like you are just a book smart lab tech that has never sat face to face with a patient in a professional setting/  Big Difference!!!!!!!!:hammer:

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## Robert Martellaro

> If a patient is used to wearing a FT28, would you recommend going with a progressive?


If the client is motivated and/or if the advantages outweigh the disadvantages (for the client) I'll do it. 

Robert

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## For-Life

> This looks like everybody is making enough profit to have the cost of a switch back to ST included in the selling price so that all you have to do sit back wait, and HOPE the patient does not want to switch back and you can keep the extra's paid for the switch back process.
> 
> Lets not forget that all plastic lenses are moulded. To mould a ST lens does not cost anymore than to make a single vision or a progressive one. A mould can produce thousands of lenses before it has to be discarded. To manufacture a mould, I might even dare saying that it is not easier to make a mould for an ST lens than a progressive. Actually when coming down to brass tag moulding, there is no difference in making a single vision lens or making a progressive, and that goes for every brand or no brand product.
> 
> In the old day's of glass lenses there was a sizable difference between the different types of lenses because some required a lot more labour to produce the blanks, so there was a difference in price from one to another.
> 
> The price difference from one to another type of lens has been kept up ever since, even if it is actually not justified anymore.
> 
> Polycarbonate lenses are even more accentuated when comparing price to manufacturing cost. Lenses are injection moulded often in pairs of 6 lenses per mould and take only a few seconds to pop out of the mould, however these lenses will then have to be hard coated.
> ...


When paying for a progressive you are usually paying for the research and development, not just the lens.

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## ikon44

April, the other thing you need to do is educate your patient at the very begining you will often get prescriptions like R/L +0.25  ADD +1.50  readers only
Instead of making them a pair of +1.75 spheres offer them Interview or office and describe them as flexible reading lenses, rather than varifocals, most people
will find them more useful than single vision lenses, then when they do require to 
wear specs for distance as well as near, they are comfortable with the concept 
and will see the benefit of the varifocal over bifocals.

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## Chris Ryser

> *In our practice we do not sit back and wait and hope ................*
> 
> *...................... Also, it sounds to me like you are just a book smart lab tech that has never sat face to face with a patient in a professional setting/ Big Difference!!!!!!!!:hammer:*


Thanks for the compliment. At least it got me 6 out of 10 top positions on GOOGLE search *Results 1 - 10 of 2,560 for* *chris ryser:* at 8.15am today.

Actually it is more the other way round. After a lot of years in the retail end sitting as you say above "face to face", owning and running a frame import company representing 2 of the major manufacturers for 20 years while also having a wholesale laboratory. Also having made several inventions of products you are using on a daily basis I feel pretty qualified to comment in matters I can back up when needed. This is also why I do post under my real name on the Optiboard and not under my Social Iinsurance number.
:cheers:

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## Pete Hanlin

Regardless of which PAL you use, when fit correctly PALs usually receive higher marks for visual comfort than segmented bi- or tri-focals.  This has been confirmed by various wearer tests performed both by manufacturers of PAL lenses and by the health professions.

There will always be patients with individual circumstances- environmental or personal- which present challenges to successful PAL use, so I am not suggesting that PALs are for everyone.  However, aside from the obvious cosmetic advantages inherent with PALs, there are several optical advantages as well...

1.) elimination of image jump
2.) provision of an infinite number of intermediate zones
3.) superior peripheral properties

By "superior peripheral properties," I refer to the binocularity of the wearer in the near zone.  While it is true that a FT28 provides a wider "reading" zone than any PAL available, it is important to allow for a few considerations.  First, few patients use the entire- or even the majority- of their bifocal segment width.  In fact, some patients will use hardly any of it.  Particularly with patients who primarily employ head movements to see peripheral objects, the eye covers a relatively small portion of the lens during distance and near vision.

In other words, the bifocal segment is often "overkill."  Besides the seg line, there is also a curved "side" to the bifocal segment.  This line also provides some image jump and creates a disturbance in the near periphery.  In early PALs, although the line was eliminated induced near periphery prism (from the rotation of a single design) caused visual discomfort.  Additionally (pun intended), the hardness of these designs often created a sphere slope that offered little improvement over a FT design.

As designs have progressed (pun once more intended), "zones" have actually grown smaller- and larger.  Smaller, because modern designs are much softer- with the exception of short corridor PALs- than their predecessors.  Larger, because a truly modern and advanced design will focus on providing binocular vision over a wider area to the patient.

Levels of aberration are only one small component of a PAL design.  Placement and smoothness of that aberration (which is present in all designs- and is mathematically both inevitable and approximately equal when the entire surface is considered) is what makes the design more or less comfortable.

In short, most bifocal wearers will be more comfortable in a pair of properly fit progressive addition lenses.  I would agree that patients with ADD powers over +2.50 are probably not the best "conversion" candidates (for personal as well as optical reasons), but most other patients should be considered good candidates.  The rare exception will be someone who needs an unusually large area of vision specific to a particular focal length.

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## April_01

Thank you for all of your advice!

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## Tjcjdc9462

Obviously, CHRIS RYSER, you think you have seen and done it all. If you insult someone's job, you better get ready to be insulted right back. Since we are tooting our own horn, I work for one of the largest practices in the South East. Our number 1 goal and priority is serving our patients. I am a licensed optician with 13 years of customer service and 2 years of lab tech experience. Obviously, I also know both sides as well. And as to the little funny about the "social number", that is to guard against freaks on the internet not because I doubt my ability as a professional.:finger:

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## sjthielen

We try progressives on almost all of our patients.  New technology is to the benefit of all, and who are we to say that some patients deserve the best and others do not.  By the way we give the difference between the progressive and flat top back to the patient in case of a non- adapt, we rarely have to do this but it shows the patient my confidence in the product and also my ability to fit and dispense.

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## Texas Ranger

About refunding non-adapts; we don't either, and I don't understand Chris's reasoning on why we should; #1. we educate the pt as to the pros and cons so they can make an educated choice; then THEY choose the PAL, knowing the cost, and with a thorough understanding that there would be a non-adapt exchange, without refund. #2. in non-adapts, you have to go through the whole fitting process twice, and many are in, perhaps drill mounts, etc, that require a great deal of finish lab work; we do everything surfaced uncut, so non-adapts create a lot of extra in house labor. We have had this policy since we started fitting pal lenses in '77. If pts understand the risk, there is no problem, they can choose to have someone else do them who lets them have a "free trial" of the pal, so they have no financial commitment to the trial, so they will be less likely to adapt to them...

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## drk

What Texas said! Higher cost of progressives is justified by a higher professional component to measure, dispense, troubleshoot, educate, etc. Don't let anyone shame you on that! If someone wants to try a progressive, it's on their dollar, not mine.

Remember, new boarders, that Chris is a lovable curmudgeon. He's like Dana Carvey's grouchy old man..."In my day, we had to fine lenses with shabby scraps of sandpaper until our fingers bled...and WE LIKED IT-WE LOVED IT!:) 
Seriously, don't be offended because he offers an excellent point of view. 

Plus, Chris didn't say that you were making out on non-adapts, he suggested that we all are making out on successfully-fitted progressives, since there is enough profit margin to finance a no-charge remake back to a segment if there's a non-adapt. That's true, we are all benefitting: retailers, lab owners, lens manufacturers, and patients, really. Is there anything wrong with buying a product that is higher-priced because there is a guarantee built-in? Nope, happens all the time.

Perhaps there is a market for a "no-frills, no-guarantees" progressive, but just because they're not presented that way, it doesn't mean it's unethical.
Chris, your beer glass is half-empty, again. Let's fill 'er up!!!:cheers:

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## Tjcjdc9462

Finally Texas, someone who has some knowledge of what's going on.  You are absolutely correct in the fact that it is our responsibility to educate the patient on the pros and cons of PAL's.  If we do our job correctly (fitting, adjusting, explaing the lens design), then we will not have a lot of people coming back for non-adapts.  It is our duty to help the patient and if I feel that a progressive will not benefit the patient, then I certainly don't recommend one to them.  I am there to help the patient and not to just try to sell them a more expensive lens.:)

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## Chris Ryser

> *About refunding non-adapts; we don't either, and I don't understand Chris's reasoning on why we should; ...................*


Actually I never said "we should".  ......................

*I am really critizising the practice of refundung non adapts, exchanging non adapts and so forth.* I been saying all the way long that an optician should recognize the need for a certain type of lenses and make the patient aware that what he wants or buy's is right and or wrong and then there will be no freebe exhanges or refunds.

When progressives were introduced in the late 1950's in Europe, opticians had to learn to whom *NOT* to sell them. It was only on this continent that the practise started to refund or exchange non adapts started in the late 60's and early 70's.

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## April_01

"In this day and age of tremendous computer use the PAL usually sells itself."


Isn't this worse for computer use because of the limited intermediate area? Or is that when you would rec. computer glasses?

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## For-Life

A PAL is better for computer use than a flat top because it gives the patient an intermediate area.  I find most patients love PAL's for computer work, and only a handful need a second pair for computer work.

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## drk

Until age 48 or so, when their add exceeds +1.50 (trifocal age), it doesn't matter what form of lens they're in, since they can accommodate with the distance portion of the lens.

After that, a progressive beats a flat-top, but a computer lens beats both.

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## Chris Ryser

> *Isn't this worse for computer use because of the limited intermediate area? Or is that when you would rec. computer glasses?*


You just hit the nail on the head April. Working on the comp[uter you can have all the PALS and dump them.

Working many hours a day on the computer I prefer to wear my ST35 specially made for the distance to the screen. The segment line mounted at lower edge of pupil which gives me the largest reading part available these days. 

Therefore most of all the fanatics of progressive lenses on the Optiboard do not admit that the old straight top lenses do still have some value for many reasons. I personally still like the clarity of a large field of vision for near as well as for distance.

I usually wear my progressives at a cocktail party to look fashionable and when the consumation of a few Scotches lets me forget the disturbance of the distortion of progressive lenses.
:cheers:

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## sjthielen

Why drive a car? Horse and buggy is just as effective

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## Chris Ryser

> *Why drive a car? Horse and buggy is just as effective*


Good argument...............comparison............. but for the wrong subject.

Being a professional that had been part of the progressive market since its inception in the mid 1950's I have developed an opinion that there is a use for everything as the need arises. 

There are situations where a progressive definitely takes second place even if you guy's might have been brainwashed by manufacturers publicity or by your own greed to sell the more expensive item in each and every case. One track minds are not able to take a middle of the road attitude and are guided by other motives.

In my eyes the best optician will outweigh all factors involved with a patient/ customer as : 

age..........job..........type of use ............esthetic..............financial position situation ect

and then recommend the lens best suited for the patients best use by forgetting which type makes the most cash in your pocket. 

You might say that you have never had problemsselling all the various progressives and patients have adapted very well. 

But you might never have lost a second thought if a particular patient would have been better off with as you say............a horse and buggy lens.

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## chip anderson

I paint and vien artificial eyes.  This is rather fine work.  I am 61 years old.  I can see to do it much better with 7/28 *Glass* lenses.  Yes I have used most progressive bifocals, and have used 7/28 plastic lenses.  I have used all of these with and without ARC, etc.   I see fine details and color better with *uncoated glass!*

I get all my lenses and frames free so cost is not a factor.   Yes other materials are lighter and I can appreciate this on my nose.  Professionally I am willing to put up with lousy cosmetics, jumps (which I don't mind) and less happy sinuses to see better.

Now does this get me rejected as a competent optician?

Chip:hammer:

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## Chris Ryser

> *I can see to do it much better with 7/28 Glass lenses...............  I see fine details and color better with uncoated glass! ...............*
> 
> *..........................Now does this get me rejected as a competent optician?*
> 
> Chip:hammer:


Thanks Chip, maybe we the old  generation have learned more in the old days or have gathered more expierience over time than the new generation.

It is a fact that when over 60 years old vision is not as good as it was in previous years, and it does not matter how perfect the lens prescription is. Having had my 69th birthday a few month ago I can testify to that fact.

What disturbs me is that the young wave opticians seem to use, believe and accept big advertising by manufacturers as the holy temple of knowdledge and wisdom.

Manufacturers advertising is big time influence peddling and should be investigated with a sceptical mind. Sales reps have a one track mind and are only interested to sell their products over others, which is fine and should be so.

But the optical retailer should use his own brain power to learn and judge that a manufactuerer wants to sell only his product and will bend the truth if needed. 

No product or concept is perfect for each and every case on the market and dealing with the public the best optician is the one who knows which product is best for different patients and different uses.

Therefore sjthielen has some learning to do before classifiyng a category to "horse and buggy" without a valid explanation.

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## hcjilson

there are a multitude of solutions to specific problems. For the purpose of this thread, and I think what the originator intended, was for an all purpose everyday pair of spectacles.

In that regard, I think what sjthielen was saying is something I learned from a Varilux seminar. Lined bifocals are essentially 200 year old technology. They are extremely limited in the benefits of vision compared with progressive lenses. Why would anyone want to solve the everyday visual requirements of a person with 200 year old technology when you can do better?

That having been said, no one should denegrate the older technology when circumstances allow them to be used to solve specialized problems.I use them all the time fitting golf, occupational, and sporting glasses.

Chip, You will NEVER be rejected as a competent optician in my book!  :bbg:............after all, You ARE going to show me how to make a "Franklin", aren't you??

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## Chris Ryser

> In 1784 Benjamin Franklin had an optician called Sykes, who had a business at the Place du Palais-Royale in France, cut lenses in half and mount two different prescriptions in frames for him so that he didnt have to keep changing his spectacles every time he wanted to read, he had been wearing spectacles since 1776. In 1784 he admitted that he could not distinguish a letter even of large print. By inventing bifocals he managed to save himself precious time! Or, as he put it: I therefore had formerly two pairs of spectacles, which I shifted occasionally, as in traveling I sometimes read, and often wanted to regard the prospects. Finding this change troublesome, and not always sufficiently ready, I had the glasses cut and a half of each kind associated ; in the same circle By this means, as I wear my own spectacles constant1 1 have only to move my eyes Up or down, as I want to see distinctly far or near, e proper glasses being always ready. The only thing that held the two half lenses together vas the frame itself.






While progressive bifocals are preferred by many people , not all individuals can adapt to wearing these lenses comfortably . The reason is because these lenses have peripheral optical zones on the sides which cause an optical distortion . Some individuals are annoyed by these lateral distortion effects and may get a sense of motion sickness with progressive lenses . These individuals are better off wearing regular 'line bifocals' which do not have peripheral distortion effects .

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## hcjilson

Annoyment and inability to adapt are 2 different things. The anatomical fact is that when accomodating for near vision, the eyes converge, not diverge. Peripheral distortion is rarely a problem with a properly fitted progressive. The distortion occurs in areas not normally used (extreme nasal and temporal edges).The original "hard designed lenses" presented the wearer with a narrow corridor and a lot of distortion. Today's "soft" designs have drastically reduced this effect, and from what I have heard from my only Definity wearer (to date) is that its virtually eliminated.I maintain that anyone who can adapt to lined bifocals can adapt to progressives.

hj

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## Spexvet

I agree with hcjilson.

The most fun I have in my occupation is "designing" glasses to meet my patients' needs. Listening to them will invariably give me information that will guide me to create the best solution to their needs. For the computer, Chris uses FT35s, I have success with a FT28 - the top with the intermediate power and the seg with full near power. Don't limit your options, be creative.

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## Texas Ranger

people that require eyewear at a PC NEED task specific computer glasses...all "everyday" wear lens designs when employed at the pc require the person to tilt their head up to look through a lens power lower in the lens design, whether it's a trifocal or PAL design. this is ergonomically damaging...people are generally quite pleased to find out that they can indeed have glasses made specifically for pc use that will give relief to their aching neck and shoulders. so what if they have to change their glasses..I wear the nikon online, put them on when I walk into the office in the morning and put my Panamics back on when I leave in the evening; with the online, I see clearly everywhere in a 5 ft. area, at eye level with pts or at the pc, or in the lab, i suppose a ft bif would be OK too, but i'm walking around a lot..someone said that people generally don't need a mid range rx until 48-50 yrs old, that's when they go over 1.50 adds, that's not my general experience, and if they could "accomodate" through their distance rx, still a lot of unnecessary eye strain?

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## Chris Ryser

> *In short, most bifocal wearers will be more comfortable in a pair of properly fit progressive addition lenses. I would agree that patients with ADD powers over +2.50 are probably not the best "conversion" candidates (for personal as well as optical reasons), but most other patients should be considered good candidates. The rare exception will be someone who needs an unusually large area of vision specific to a particular focal length.*
> 
> *Pete Hanlin, ABOM, LDO**Manager- US MQ & Technical Services**Essilor of America* _phanlin@essilorusa.com__sub specie aeternitatis_


I am going even a bit further than Pete Hanlin in above copied statement which is a soft approach to the fact by the representative of the largest manufacturer and the originators of progressive lenses.There are plenty cases out there, where a progressive is not the perfect solution and "horse and buggy" lenses are the better solution.Said that much on the subject, would maybe some of the progressive fanatics at least admit that it might be a good idea to sell a patient a second pair of old fashioned "horse and buggy" lenses for a specific job for which they would be better suited and make an additional sale?

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## Chris Ryser

> *Your local authorized Varilux distributor should have Varilux Liberty around August 9th, and the original materials will be CR-39 and Airwear (polycarbonate).* If your PAL sales have begun to flatten out, its time to quit ignoring the 50% of your presbyope base that is still wearing segmented lenses (that's right- only 51% of American presbyopes wear PALs). For those patients who have "tried PALs before," give them another chance at better vision and better cosmetics and fit *Varilux Liberty*. 
> 
> Just to clarify, this information is coming from someone who is _definitely_ (and proudly) associated with *Essilor/Varilux*, and I'll be happy to answer any questions you might have about the technical aspects of the product.
> *Pete Hanlin, ABOM, LDO**Manager- US MQ & Technical Services**Essilor of America* _phanlin@essilorusa.com_



I was not that wrong after all. There are still some 49% "horse and buggy" lens wearers next to me.
I just found this posting which I had not seen before, looks interesting.
I for sure will get myself a pair of those modern type lenses and find out if I am going to like them.

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## drk

For pure visual acuity at distance, intermediate, or near, segmented multifocals are superior, IMHO.  

I am defending my "48 or older" needs intermediate correction for the computer statement.  If someone younger with an acceptable amount of accommodation STILL has asthenopic symptoms with their dress Rx, THEN Rx computer glasses, but not before.

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## Spexvet

> [color=#006400][/left]
> 
> 
> 
> I was not that wrong after all. There are still some 49% "horse and buggy" lens wearers next to me. 
> I just found this posting which I had not seen before, looks interesting. 
> 
> 
> I for sure will get myself a pair of those modern type lenses and find out if I am going to like them.


No, Chris, don't do it! Don't give in to the dark side!:bbg:

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## Robert Martellaro

> If someone younger with an acceptable amount of accommodation STILL has asthenopic symptoms with their dress Rx, THEN Rx computer glasses, but not before.


Exactly. 

The "breakpoint" seems to be about +1.75, with most folks under this power nonsymptomatic, and most folks above experiencing one or more of the following; sore neck, eye strain, and blurred text. Much depends on the frequency of use and to some extent the distance to the monitor.

Robert

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## chip anderson

Anyone here familiar with a product (back insert) called P.C. Peepers.  These are inserts you put behind the glasses for computer use.  Power is +1.12  covers the top part of lenses.  Allows patient to retain near  and cylinder in present glasses but brings the computer into perfect focus.  Retails for about $25.00.  Have sold a lot of them and everyone that buys one comes back for more for family members or co-workers.  
Has a nice little "nose" that clips on to monitor so they can be parked there.

And no, other than selling some retail I have no interest in them or mfg.

Chip:cheers:

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## hcjilson

Chris- If you were to look at market share pre Soft design vs today you would be astounded at the market share increase of PALs, and its growing geometrically.

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## April_01

We sell Pc Peekers at our office and get the same review.

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## Chris Ryser

> *Chris- If you were to look at market share pre Soft design vs today you would be astounded at the market share increase of PALs, and its growing geometrically*.


Harry, I do not dispute the facts that 51% of wearers use PALs and or that the number is increasing according per spokesman Pete of Essilor fame. Actually above figure means *half*. Therefore all of you that push 100% PALs must have created a reputation in your neighbourhood that discourages the other half from entering your location.

I have a few PALs and I am not enthusiastic about them. I have sold lots of them when I was in the retail at a time  you had not even heard of them. I also discouraged customers from purchasing them if I knew it was not for them.  I am all for progress and modernisation having made several inventions that are now of daily use in the trade.

However I object personally to a systematic one track mind that leaves no leaway other than follow the brainwash by the major  manufacturing industry in the optical trade.

As in above posted quotes I like the sudden turnaround by Essilor to come with the lastest product: a new version of what has been called "horse and buggy lenses". Obviously they now have realized that there are quite a few non converts out there and to increase sales during tough times better cater to the other half of possible customers.

The same reasoning applies to AR coating sales. Not everybody needs it, not everybody can or wants to pay the extra value for it.

I also wonder that I have not seen a good thread on the Optiboard dealing with UV absorbtion which is probably much more urgent as there is so much fraud going on in that field by manufacturers as well as retailers.

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## sjthielen

I do not know of many fields of industry in which new technology was created to be inferior to old. Maybe I'm wrong, but there have been a ton of progressives made for different ranges of vision. I can't  think of a situation in which a bifocal could not be better replaced with some sort of progressive. I must be Brainwashed.

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## chip anderson

Stjellien(sp).

I am afraid that in today's world most "new technology" is created to *make money!*

Ivory soap is probably supperior to the latest new super zoomo germ/bacteria/odor eater out there.  At least it is for cleaning hands prior to contact lens insertion.

Chip

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## Chris Ryser

> * I must be Brainwashed.*


It is a fact that when you run into additions of + 2.00 and higher the progressive part becomes narrower and the reading segment gets smaller.

And that goes with progressives made by Essilor to the ones made on the Great Wall in China. They are all made on the same principle maybe with some minor variations. The higher the addition the smaller the usable part of the surface and the larger the distorted area.
Even the biggy manufacturers admit to that ever since they started to make these lenses.

How can you say that a small field of progressive vision and a small near field of vision including distortion  is better than looking through a reading segment that has 28 or 35 mm of clear unobstucted undistorted vision even if the principle is 15 years younger than the progressive lens.

I wish that some of you would look into the technical aspects on your own instaed converting manufacturers advertising into optical law.

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## dbracer

> This looks like everybody is making enough profit to have the cost of a switch back to ST included in the selling price so that all you have to do sit back  wait, and HOPE the patient does not want to switch back and you can keep the extra's paid for the switch back process.
> 
> Lets not forget that all plastic lenses are moulded. To mould a ST lens does not cost anymore than to make a single vision or a progressive one. A mould can produce thousands of lenses before it has to be discarded. To manufacture a mould, I might even dare saying that it is not easier to make a mould for an ST lens than a progressive. Actually when coming down to brass tag moulding, there is no difference in making a single vision lens or making a progressive, and that goes for every brand or no brand product.
> 
> In the old day's of glass lenses there was a sizable difference between the different types of lenses because some required a lot more labour to produce the blanks, so there was a difference in price from one to another.
> 
> The price difference from one to another type of lens has been kept up ever since, even if it is actually not justified anymore.
> 
> Polycarbonate lenses are even more accentuated when comparing price to manufacturing cost. Lenses are injection moulded often in pairs of 6 lenses per mould and take only a few seconds to pop out of the mould, however these lenses will then have to be hard coated.
> ...


Chris,

Some good points in here. 

Guys like me handle this stuff and frequently don't understand the hx behind much of what has happened.  We forget how everything is produced, or at least we don't think about all the costs involved.  

Add all this to the normal parity inflation, R&D, the loss factor, rising technology of equipment, the rising responsibility of the employer to the employee, increase responsibility to adhere to governmental regulation, increasing governmental regulation, and increasing taxes, and it answers the question of rising costs. 

I'm sure you're like me. You keep all three of your BMW's, both yachts and you're summer home locked away and from public knowledge. 

I have significant knowledge of retail, technical ophthalmics, edging etc., but I'm pretty ignorant of blanks, molding and surfacing. Interesting stuff. 

Respectfully,
dbracer

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## dbracer

> Stjellien(sp).
> 
> I am afraid that in today's world most "new technology" is created to *make money!* ...Chip


I sure hope, Chip, that new technology makes money. If not our, or at least my,  business would suffer terribly.

Nothin' wrong with making money. Many make more than I. More power to'em, as long as it's done honestly. 

I would imagine that most of the money made by the reputable companies is fairly honest. Well let's put it this way: Dollar for dollar I doubt if there "sins" are much worse than mine. 

I try to be honest, but I suppose, there are somethings that I do unconsciously, maybe even consciously, that are not as honest as they could be. God forgive me (no joke intended).

Respectfully,
dbracer

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## HarryChiling

> I'm sure you're like me. You keep all three of your BMW's, both yachts and you're summer home locked away and from public knowledge.


It's three bentleys and I keep them at the summer home.  It's so hard counting all my money that I had to hire FezzJohns Inc. to do it for me.  They're actually pretty good bean counters, but they're horrible with money it all seems to go into this black hole of an investment they call the beer slide.  They keep telling me that one day I will see a return, but right now they're in the R and D stage of it.  Just wish they didn't smell all hoped up on beer everytime they told me that. :D

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## dbracer

> ...black hole of an investment they call the *beer slide...*  :D


The Beer Slide...hummmm?

Considering what little investment I've done was in Aug. 2001! I'm going to have to look in to that one.

My investors keep telling me of the Scotch Undeyrocks. Which I assume is an old Highland conglomerate. You know, rare European precious mutual funds. But it sounds like the Beer Slide is doing better than mine. 

Sounds like yer breaking even. They keep asking me for moh money. 

dbracer

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## Fezz

> The Beer Slide...hummmm?
> 
> 
> Sounds like yer *breaking* even. They keep asking me for moh money. 
> 
> dbracer


 
Oh, we are breaking something alright! I'm not sure its even though!


:cheers::cheers::cheers::cheers::cheers:


FezzJohns, Inc.

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## dbracer

> Oh, we are breaking something alright! I'm not sure its even though
> :cheers::cheers::cheers::cheers::cheers:
> FezzJohns, Inc.


Well maybe not, but it looks like your having fun. I'm not!

dbracer

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## AngryFish

DrK, do you, as a standard practice, give your patients a choice between two or more different medications to treat an infection and then leave the final decision up to their limited understanding? The medications aren’t hard science in a way that guarantees an outcome either. The flow chart I would use would be based on your objective assessment of their needs. Your professional understanding of their need is far more compelling to them than I think you estimate. If I am your patient and you prescribe me the ninety dollar a week supply of the newest broad spectrum anti-biotic I am going to use it as directed. If it is out side of my means I will ask you if you could prescribe something else, but if an anti-biotic is what will best treat my condition I know you won’t prescribe an OTC homeopathic. The same is true with the lenses. It seems that the less invasive the remediation the more we, as optical professionals, become defensive and second guess ourselves and that does not serve the best interests of the patient/consumer.

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## dbracer

AngryFish,

I agree.     

I think?         


Respectfully,
dbracer

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## Chris Ryser

> *If a patient is used to wearing a FT28,* 
> April


 
One typical case where you should not change. Patient has clear vision through top and wide reading area,

Dont put him into a distrorted distance vision with a reading area that is ine new paper clomn wide, He will curse you from here to eternity.:hammer:

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## Kyle

It appears everyone else has posted an opinion on this so here are my 2 bits:

April, your initial situation was a very simple one and seemed to primarily question the differences of opinion in what product will work best for your ST wearing patient.

The plain and equally simple fact: you have no idea until you try.

Does that answer it?

Oh, and the idea that one person's experience with a lens qualifies them as an expert on the potential experience of another is like asking some random person on the street to wear and judge the effectiveness of the SRx worn by some other random person on the street.  "Gee, how do you like my vaulted prism lenses with 5 diopters of cyl?"

It's best always to strive for what is possible rather than be paralyzed by what you think is not. Fear is the mind killer.

Kyle

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