By Tina Lahti, ABOC
With permission from IOT

Some of our most challenging patients are those who had no need for vision correction until they became presbyopes. They inevitably avoid corrective lenses until they have lost virtually all accommodation and come to you with a +2.50 add power, expecting you to fit them in lenses that can restore their natural vision. We opticians almost always recommend expensive progressive lenses, and these patients are often disappointed with them. Many revert to OTC readers thinking their glasses will never be great, so they may as well be cheap. Stop fighting these patients and start listening to them. Progressive addition lenses are an amazing solution for patients who already wear eyeglasses for distance vision, but they are not always the best solution for those who only want correction for near vision.  

Why are they sometimes unhappy with a PAL?

  • They do not want eyeglasses for distance vision: Even if the prescription calls for a bit of cylinder power or a small distance correction, they are perfectly happy with their natural distance vision. 

  • They have found a way to utilize the dashboard of their car: Perhaps they have moved their seat way back or just given up on the smaller displays. Whatever it is, they have been driving this way for years and they are perfectly fine with it.  

  • They fully utilize the display settings on their electronic devices: With full brightness and maximum text size they can read their messages. They do not care if everyone else can see them as well. 

What can you offer that is better than mono-focal reading glasses?

When you want your patient to experience more natural vision with a range of near and mid-range focal distances, consider a degressive lens. Degressive lenses are the inverse of progressive lenses. Progressive lenses increase in power from a distance focal length of optical infinity at the top, to a near focal length of around 40 centimeters at the bottom. Degressive lenses decrease in power from a near focal length of around 40 centimeters at the bottom to a focal length of your choosing at that top. 

When compared to progressive lenses, degressive lenses offer the following:

  • Much lower levels of peripheral aberrations

  • Significantly larger near and mid-range viewing areas

  • A higher patient value due to lower wholesale cost, degressive lenses are assumed to be second pairs and priced accordingly.

  • Immediate adaptation, even for first time wearers with high adds.

  • Lifestyle flexibility, they only wear them when they need them.

Best of all degressive lenses give the patient experience using lenses with many focal distances. All advanced presbyopes will appreciate that and may someday also appreciate progressive lenses.   

Why you may not have heard of degressive lenses

Optical suppliers often communicate with us using the language they want us to use with patients. There are many names for degressive lenses in the marketplace. They are most often referred to as office lenses but, as you might imagine, they can be useful for many people who do not spend their days sitting at a desk. 

What to look for in a degressive lens:

  • Flexibility: You are creating a completely customized solution for your patient. Avoid suppliers that unnecessarily limit your choice of lens materials, coatings, or treatments to the ones that are most profitable for them. 

  • Multiple focal lengths: Your expertise is the value you bring to the table. Make sure you have enough options to create the right pair of degressive lenses for your patient’s individual needs.

  • Value: good designs at reasonable prices. Eyeglasses with degressive lenses should be affordable for those who wish to treat them as an accessory and build an eyeglass wardrobe.

  • A trusted laboratory: As with any other custom crafted ophthalmic lens, a good laboratory makes all the difference. Even the best design will disappoint if it is poorly executed.