 Most individuals’ visual activities differ widely because of varied
occupations, hobbies and environments. This is especially true for
the presbyope. Special lens styles and materials are appropriate for
specific activities and most ECPs agree that providing the best personalized solution can best meet the wearer’s needs. However,
practically speaking, most presbyopes wear one primary pair of
eyeglasses most of the time. Knowing how to choose a progressive
lens designed for work and play is often difficult but identifying
one can be a rewarding solution for the patient and the practice.
In a slowing economy, when consumers may be shifting their
economic priorities, the identity of useful products that meet
multiple needs can
be your effective
response to their situation. How does
one determine a progressive that can
meet both the work
and lifestyle needs of
patients when only
one pair of glasses is
being purchased?
CRITICAL DESIGN
AND MATERIAL
FEATURES
When choosing the
best general-purpose
design that is balanced for work and
play, the science
behind the lens
should use a variety
of ray tracing techniques to predict the size of clear vision and
utility. Then they should be
confirmed with wearer tests. A
general-purpose lens considers the distance vision needs
of the myope, the near that
hyperopes require and balances the design by base
curve targeting the particular needs of the way that
each uses their eyes.
In addition, a variety
of prescriptions and
personal eyewear preferences provide an
opportunity to deliver
the benefits of thinner lenses for better looks and lighter lenses for
improved comfort. Therefore, any
lens that can be used as a general-purpose design should be available in
a variety of materials, including polarized, to ensure that all the practical
needs and wants can be answered.
X-CEL OPTICAL COMPANY AND FREEDOMID
X-Cel Optical Company has been a U.S. lens manufacturer since
1937 with a reputation for quality optics and a wide variety of specialty lenses in unique lens materials and lens designs for patients’
work or recreational activities. The FreedomID progressive from
X-Cel is an “integrated design” i.e., designed as a general-purpose
lens to meet the occupational and lifestyle needs of the patient. FreedomID offers improved visual acuity, fit, easy adaptation and
the benefits of several choices of lens materials to provide eyewear
for the different activities in their lives.
PROGRESSIVE LENS BASICS
Today, a progressive lens design uses the data from studies of the
range of activities most patients experience through their daily
work and recreation. Using the data, a lens designer can define
and create an integrated design to balance a variety of needs. The
design must be a versatile lens that overlaps the normal boundaries
of competing progressive lenses. Wide viewing angles at distance
and near along with a uniform corridor width would make for an
easily adapting lens and a smooth transition from distance to near.
 As a practical option, ECPs try to use a progressive lens that will
satisfy the greatest number of patients. This requires lenses with
the utility to provide good visual acuity for the widest variety of
visual activities possible. That means at work, as well as at play.
This necessitates a general-purpose lens with a minimum fitting
height of 17mm. Given the variety of frame sizes and the fact that
frames have increased slightly from the very small “B” measurements of a few years ago, 17mm ensures the corridor width is
wide enough for the critical tasks at mid-range. Remember the
shorter the corridor, the narrower it becomes; there is reduced
clear mid-range vision and more blur is created at its boundaries.
The longer the corridor, the wider it becomes, but the more that a
patient will have to depress their eyes to see near. 17mm is an
accepted fitting height that meets the variety of smaller frames
chosen while providing a midsized corridor for use in normal
daily visual activities.
Another design target that better meets the majority of wearers
is to design lenses for typical presbyopes i.e., those whose horizontal eye movements exceed vertical movements in common
visual tasks such as driving, reading, computer use, TV viewing
and spectator events. Therefore, the gradient of blur or unwanted
astigmatism should be reduced in the areas of the lens where
patients exercise the most horizontal eye movement so that a “normal” visual field can be delivered.
WEARER’S VIEW DESIGN
 Wearer’s View technology is the basis for the design of FreedomID progressives created for the variety of uses a patient needs from
their glasses. Research begins by considering the physiological
needs of the patient and measurements are made with the latest
ray tracing technology to develop Wearer’s View, which emulates
normal use of the human eye in different situations. Field-of-view, angular relationships, vertex distance and pantoscopic tilt are all
components of the design. Also
considered are lens parameters
such as index and thickness.
Once these are determined, a
design can be created using patented optimization software and maintaining strict control of
the surface parameters of the lens. Consequently, FreedomID provides wide viewing zones at both distance and near, along with
minimum unwanted astigmatism.
The progressive surfaces created are confirmed using Rotlex
instruments employing Moire Deflectometry and Interferometry.
These techniques allow surface analysis and reconstruction so the
target design and resulting designs can be verified. In this way, the
lab processing the lens, the dispensing ECP and patient are
assured of receiving the intended design.
MULTI-DESIGN BY PRESCRIPTION
To increase the wearability of progressives, modern Wearer’s View
technology incorporates the effects of the distance prescription
into the design by base curve. That means the effects of a minus
lens and the base in prism induced when the wearer converges is
considered in the location of the near zone. Myopes converge less
due to the prism so there is less inset of the near to account for
this. The base curve for plano and near plano prescriptions utilize
standard insets of 2 to 2.5mm while the base curves used for
hyperopic prescriptions take into account the extra convergence
that is required from the base out prism induced. As a result, the
near zone is inset more. This is called variable inset and a feature
of FreedomID lenses.
The design also incorporates flattened and aspheric curves. This
provides lenses that will be as thin as possible and cosmetically
superior. The midsize corridor works well in both smaller and
larger frames.
ASSESSING PATIENT WANTS AND NEEDS
 Once design is chosen, then meeting a patient’s other wants and
needs for their eyewear is essential for the highest satisfaction.
Also, having the flexibility to offer the same lens design in a variety
of lens materials allows an expanded range of benefits. How do
you know what patients want?
Consider a Visual Assessment survey form that can simply identify the patient’s needs, a benefit to both you and the patient. It
can ask questions that open up a dialogue between you and the
patient. Consider providing this to patients as they check in at
reception or when they enter the optical department.
Questions that ask
patients about results
that benefit them allow
you to discuss how you
can answer that need
directly. For example,
“automatically focus
at any distance” or
“automatically adjust
to different lighting
conditions” are
opportunities to discuss how their
existing bifocals
have only two limited ranges of
vision, or that
their lenses do
nothing when
they go outdoors
into the bright sun or an over-cast and glary day. In the first instance, progressives can be prescribed to provide that much-needed clear mid-range vision missing
for presbyopes with adds of +1.75 or greater. In the second instance,
lenses that automatically adjust to changes outdoors add comfort and
ensure 100 percent UV protection for the wearer.
Scratches, glare, reflections or safety may not have occurred to
the patient. This assessment form makes it easy to cover the
options and suggest everything right for every patient.
OPPORTUNITIES FOR EYEWEAR
In an ideal world everyone who enters your office that needed eye-wear would own multiple pairs with specific application to their
individual needs. After all, the majority of people are like you and
me. They enjoy a wide range of activities in their work and their
recreational lives. This also includes activities in stressful environments and lighting conditions.
The opportunities are as follows: approximately 80 percent of all
eyeglass wearers only purchase one pair of glasses every two to
two-and-a-half years. That means explanations of the benefits of
multiple pairs would increase the chances for sales to that 80 percent. In addition, if only 30 percent of the lenses sold are sold as
anti-reflective lenses, then AR is a 70 percent opportunity. What
is it in your practice?
Only about 16 percent of the glasses sold are photochromic; that
would create an opportunity in almost 85 percent of all the people seen. And when describing sunglass options when patients
answer the assessment that they are interested in protecting their
eyes from the damages of ultraviolet lenses, it’s a polarized opportunity for the way they absorb UV and eliminate blinding glare.
(Source: VisionWatch, a study conducted by Jobson Medical
Information and Vision Council.)
THE RIGHT PRIMARY PAIR
 The sad news is not only do most people lack the benefits of multiple pairs, but they also often struggle with the most basic of primary pairs. The point is: Since multiple pairs are not being used
as they should, the best place to begin is in the placement of a
superior primary pair.
When we view the areas of everyday need such as driving, reading, TV viewing, computer use, shopping, spectator events and
general work and play, lenses like FreedomID not only perform
well for those tasks, but can also exceed expectations. If your
patient could only have one pair, choose that pair critically.
Using the answers on the assessment form determine a plan for
the patient. Daytime driving usually requires a sunglass tint, preferably polarized. But no tint is really suited for nighttime use. Even
photochromics are pretty ineffective during the day when driving
since the windshield blocks most of the triggering ultraviolet light.
A contrast-enhancing lens like Autumn Gold may work well for
daytime or foggy day driving.
Two pairs of glasses best satisfy comfortable and safe day and
nighttime driving; one for sun (polarized preferred) for day and
AR clear lenses for night. The best solution for continuous vision
would be the use of progressive lenses to provide easy access to
distance, intermediate and near.
Accidental flying debris, a stray elbow, a ball traveling at high
speed or a doubles partner’s racket—these are just a few things
that could spell tragedy for the home or sports enthusiast. Approximately 35,000 sports-related eye injuries occur every year and even
more eye injuries occur at home. What adds to the tragedy is most
of these injuries can be prevented. Protection from impact should
be a primary concern to everyone involved in these seemingly
harmless activities.
A solution is Aris Trivex lenses to add that margin of safety. They
are available in clear or Transitions lenses, tinted for sunglasses or
for contrast enhancement. Outdoor activities that run the gambit
require a lens that can respond instantaneously to the task. As circumstances change, people often don’t have time to reach for
another pair of glasses. A lens that is progressive, always on the job
and ready to respond in an instant provides convenience, comfort
and safety to any wearer. Be sure to explain material options that
suit every outdoor situation.
Computer use has become a regular part of almost everyone’s
life. Long hours at the computer are a major cause for visual discomfort often leading to other uncomfortable physical symptoms.
In addition we are faced on a daily basis with computerized checkout counters, ATMs and automated airline kiosks. The need for a
lens that can respond to a range of visual tasks is a constant in
modern life. Choose the right lenses to fit the task. In high adds
all progressives intermediate narrows and may no longer be adequate for long term computer use. Consider lenses made especially for computer users and explain the benefits to the patient.
ENCOURAGING ANOTHER PAIR
The ability to dispense visual
freedom means patients have
all the kinds of lenses they
need. However, just getting
to that next pair is difficult
but there are lots of opportunities.
Leaving the topic of lens
selection solely in the
hands of the dispenser
doesn’t effectively use the
power of the doctor’s recommendation or the waiting time the patient may
spend in reception. We
suggest it should be a
“total experience” for the
patient. Everyone should
be involved. The reception area and exam time
must be used to prompt
the patient for the lens
decisions that will conclude his or her visit.
 The visual assessment
form should be handed out in reception as
a prerequisite for the exam
and fitting that is to come. The information provided by the
patient will save the doctor and dispenser time as it is a springboard to a positive visit. It will stimulate thoughts and questions
about lenses on the part of the patient.
It continues during the exam with the doctor assessing the
patients’ medical, visual and lifestyle needs. Be sure to provide
patients with specific recommendations for lenses and explain that
the dispensary staff will provide further education. “Prescribe” is
the operative word. Success with any lens is improved when the
doctor discusses it.
When the doctor prescribes lenses and lens treatments, it provides the patient with the confidence to make an important decision based not just on price or fashion. Decisions should be made
based on the benefits that lens designs and properties provide.
Patients appreciate professional advice on the written prescription,
reinforced by verbal recommendations. How extensive it is, is up
to the doctor.
IT CONCLUDES IN THE DISPENSARY
Remember that all the preparation ends in optical. Keep it simple,
avoid drawing pictures or getting bogged down with verbal descriptions and use the manufacturer’s material since it usually has the benefits bulleted for easy reference. Work from the Visual Assessment
form and the doctor’s recommendation, and demonstrate the recommendations as the best choice for what you understand about
their needs. Use the form to develop a plan, keep good professional
samples and practice your delivery. Avoid pictures and explanations
that rely on negative concepts for clarification. For progressives, negative words such as distortion, blur, corridor, swim and channel confuse the patient and miss the points that should be made.
Achieving success means satisfying patients in all walks of life with
superior vision from the eyeglasses you recommend and deliver. |