Since IOL implanting, I am 1.0D myopic bilaterally, with some of that as
astigmatism.  I see quite sharply from my fingertips at arms' length, and across
the room to TV, etc.  Can drive legally without eyeglasses, but prefer
mildly minus eyeglasses for night driving.  (I consider myself quite lucky
as I needed over -5D  plus -1.5D cylinder over my natural eyes).

Walgreens +1.25 readers work well for me now, but add+2.0 Zennis on my
script are slightly more comfortable on the long term.

For me, tripane or progressive lenses would have an almost plano center.
Before implantation, I preferred single vision glasses for each occasion,
as I could never get used to even bifocals (or they could not be made right?).  

No eye doctor yet (I have seen three since implantation) mentioned the
possibility of single-vision glasses for close, and for distance.  One
irreverent lady-tech suggest to try Walgreens readers.  I have a very
nifty pair of rimless reading glasses which cost less than $31 postpaid
from Zenni -- they are slim and slide down my nose in a useful way.
I am about to order a pair of Zenni's convertible sunglasses for driving
(night and day).

So, my question would be:  would the Doctor advise the patient of less
expensive possibilities before signing him up for a pair of $400 eyeglasses?

I have another burning question, too:  How many recipients of implants
come out with their eyes so well adjusted for good eyeglassless midvision?
I expect I am quite lucky to have had the surgeon I happened to find, who
seemed to know how and where and how much to use the blade.  The
optician who works with him is probably not so lucky -- well he won't be if
all the patients come out with the kind of vision I have, and if they find out
about Zenni.

--
Dicky

You left out the invoice prices!  I can understand why, and don't
begrudge the professional secrets.  A reasonable markup on an invoice
price probably couldn't viably sustain a practice.  Customers need to
understand that they're not only buying the frames, but renting the
expertise necessary to get them happily fitted.

For the $340 setup, I'd imaging you'd charge between $510 and $680, but
it does raise some interesting questions.  Forgive my ignorance if I ask
them.

Let's say that there's a certain amount of time, labor, tools, know-how,
etc, that all bubble down to something approximating the somewhat fixed
expenses of running an practice.  Now, let's assume that your practice
clears an amount above and beyond the invoice for materials on each pair
of low-cost single correction vanilla spectacles sold.  Let's say, for
argument's sake, that this number is $100.  Further, let's assume that
the optical shop is a cash business, and there's no nasty insurance
compensation issues to deal with.  So, push comes to shove, you're
selling a pair of glasses for $100 over invoice.

Now, most optical shops maintain an inventory of frames.  Keeping an
inventory of expensive frames is obviously more expensive than
maintaining an inventory of inexpensive frames, so I can see a markup
above and beyond the $100 above invoice for the cheap glasss.  

Enter progressives.  This is a luxury item, and folks expect to pay more.  
Certainly, the base cost of the lenses is more, but from the optical
shops point of view, other than the increased cost of the lenses, what
are the additional costs for the optical shop that merit an increased
markup?  Are they harder to fit?  How much harder?  Is there a
certification or training process? Is there a problem finding opticians
qualified to dispense?  

Is there a higher loss because of quality control or customer
satisfaction that the distibutor won't eat?  I assume these lenses are
not routinely inventoried, so the added costs of that doesn't do
anything.

Let's face it, we're being held to the standards created by Walmart.

DrG