Sunday, July 13, 2008

Don't Be Cheap with Progressive Lenses



While all of us would like to feel eternally young, when we reach age 40 or so the need for the dreaded “B” word (bifocal) will eventually be broached by your eye care practitioner. Line bifocals go all the way back to Benjamin Franklin. These allow you to focus from distance to near without having to take glasses on and off or to remove glasses to focus at one distance or the other.

The reading need begins around age 40 give or take a few years one way or the other. It gradually changes and increases over about a five to seven year period and then stabilizes out. This is caused by a gradual change in the ability of the crystalline lens inside of the eye to change shape. This changing in shape allows one to focus from distance to near and back. Tiny attachments to the lens called zonules gradually lose their abilty to cause the lens to change shape and hence to allow focusing at different distances. This is a natural maturing (aging) change and will happen to all of us.

As a member of the baby boomer generation I recognize the yearning to resist crossing over to this dark side of aging, but alas there is nothing that we can do about it. In light of this fact then let us go with the best type of correction for this condition. While line bifocals were OK many years ago, in today’s computer using society these are not very ergonomically practical. The distance portion gives great distance acuity and the reading portion gives great reading at book and magazine distances. However, the computer distance (usually approximately 20-24 inches) becomes a complete blur or at the very least very difficult to see without getting closer to the screen and then craning one’s neck and causing all kinds of neck and shoulder pain.

This then brings us to our discussion of progressive lenses also known as no line bifocals. These lenses have been around for over 20 years and have gone through a number of generations. Each new change in technology has gotten better and better such that the newest lenses work quite well for most people. While the earlier generations of these lenses are still available and are less expensive they also carry with them the inherent problems and side effects of those earlier generations.

The earlier generations have narrow reading areas, peripheral distortions and hard to find intermediate distances. Either you or someone you know may have tried one of these earlier types of progressives and could not get used to them. This is certainly understandable with these earlier lens designs. They unfortunately are still sold on a regular basis many times because they are cheaper.

Come on people, this is your sight. This is how you make your living. Don’t be cheap when it comes to correcting your vision properly! This now brings us to the point in the discussion of the newest generation of progressive lens technology. This newest generation has come about over about the last year or so. There are several companies that have come out with their own version of these new lenses. You may hear the buzz phrase of “digital surfacing” bandied about in conjunction with these new lenses.

Bear in mind that digital surfacing is just a manufacturing technique as opposed to a lens design. Digital surfacing simply means that it can reproduce any lens design perfectly time after time even if it is an older lens design. Don’t be confused between ‘lens design’ and ‘digital surfacing’. I have tried all of these new lens designs. To be perfectly honest I did not think that I would notice much of a difference before I tried the first one. I am happy to report that I was pleasantly surprised and shocked at what a huge difference there is in these new lenses from everything that we have had in the past. This is a giant leap in technology.

A good comparison in layman’s terms would be the difference between a regular TV and an HD TV. Everything is clearer and sharper. Contrast sensitivity is improved therefore making night driving easier and better. Wider reading and intermediate areas are found and larger depth of field can be seen. Almost immediate adaptation occurs from patient feedback. We have patients in our office who could not adapt to any of the earlier generations and wore two separate pairs of glasses. I convinced them to give these new lenses a try and we have not had one single non adapt. As eye care physicians, we owe it to our patients to not only educate our patients but to promote these newer lenses. We are not doing our patients a favor by continuing to offer only the ‘older 14 year old technology’ simply because we do so out of habit or we can’t get our opticians out of the habit. We owe it to our patients to offer the absolutely very best that is on the market today.

Brand names for these newer lenses are as follows:

  • Truclear and Truclear HD- These lenses are exclusive to Vision Source practices across the United States and Canada. Pros; Good value. Truclear HD can go into amaller frame sizes. Con: not available in all materials at this time.
  • Kodak Unique- Available to most independent practices and opticians. Available in most materials . Can go into smaller frame sizes
  • Physio and Physio 360-Same as above but also available in the thinnest lens available today.
  • Hoya ID- In my opinion this is the best progressive lens in the world today. Not only does it have the great contrast sensitivity, wider reading areas etc. but the intermediate area for computer distances is incredible. I can sit at 40 inches from my computer screen and it is just as clear as if I were at 15 inches. Amazing clarity at all distances. This lens is perfect for pilots with great undistorted and crisp acuity at all distances. We recommend this lens to any pilot with presbyopia(over 40 with a reading add).


    mermaid said...

    I spent a fortune on the most advanced progressive lenses available (over $500 just for the lenses!) from a qualified and reputable optometrist. I stuck with them for six weeks and he changed them twice in that time. Frankly, they are horrendous! If I try to read or use a computer in them I get a headache in five minutes. For distance vision everything is distorted. Tomorrow, I'm taking them back and asking for single vision lenses and I am really looking forward to the prospect of being able to see again! Progressive lenses don't work for everyone.

    EyeDocNick said...

    While it is true that not 100% of people can wear a progressive lens, I will state that we have had 100% success with the Hoya ID lens. With this lens not only do patients love it but it is truly a "wow" experience when they put this lens on. They always rave about how everything is so clear and no distortion. There are definitely different qualities of progressive lenses out there. I have had several patients who tried many of the "older" lenses in the past and could never get used to them and had to wear separate pairs of glasses. These patient tried these lenses and were pleasantly surprised and could finally wear progressives for the first time. These are not cheap lenses by any stretch, but the point is that they work. I hope you don't give up in the future. Best of luck!

    Theresa said...

    Can you give me any updated info on Progressive lenses. I want new glasses and went I got my current pair 2 years ago I was very confused. I had gone to several local optical centers looking at frames and each one used different lingo about their lens choices. The prices also varied greatly. Thanks.

    jade said...

    Theresa, did you ever receive a reply...I am having the same trouble as you....thanks