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Medical Forum / General / Vision / January 2007Yet another progressive plea for help
...but I'm not a progressive newbie....I've been wearing progressives for 10-12 years. I haven't had a good experience with every lens, but have been reasonably happy. I've recently taken up golf as a new territory to conquer (a never ending quest, I'm sure) and the combination of the disappearing golf ball and it getting harder and harder to read caused a visit to the local OD. Results: New prescription: -.25 -1.25 x178 with a +2.75 add old prescription: -0 -1.25 x175 with a +2.5 add (this is for my left eye, I'm blind in the right one....consequently these are all polycarb lenses) My old prescription was made in a Rodenstock Life2. )I also have some sunglasses that are Zeiss Gradal (shorts I think) that I have had no problems with). Upon the recommendation of the optician, I had the new lens made with Zeiss Gradal Top because of his positive patient experience with wide corridor, good intermediate performance, etc. (I'm a full time computer geek, so intermediate is important.) When I got the lens, it was awful..I couldn't even wear it out of the store. Distance was about the same, intermediate was unusable...I couldn't see, and even the NV was restricted to the very bottom of the lens....it was just really a disaster. He checked the fit and lens itself and said everything appeared to be correct. We talked about it, and he agreed to get them made in Rodenstock Life2's. I'm wearing them now (about a week) and while the Zeiss issues immediately disappeared, the intermediate is poor...significantly worse than what I had before. NV is great, distance, while a little better on the golf course, is still not great (I'll lose the ball midflight IF I hit it further than 180 yards or so(which still is a rare occurence). So, can anyone recommend other brands that I can try, or is this about as good as it's going to get? While I know that it's probably a dumb idea, is an intraocular solution (ie, like cataract lens surgery) out of the question? I've heard of intraocular solutions for presbyopia, but they were more dreams than reality last I heard. I've never really thought about my vision or my handicap (I've had it since birth) this really sucks. I don't mind glasses...but things ought to be clear, at least most of the time. thanks for any advice. Dave > ...but I'm not a progressive newbie....I've been wearing progressives for > 10-12 years. I haven't had a good experience with every lens, but have [quoted text clipped - 47 lines] > > Dave Since you feel you need a safety lens because of only one eye, I would get Trivex lens instead. It is similar to polycarb in tensile strength and better in terms of impact resistance. That means you will be looking at Hoya or Younger progressives. Hoya has some top notch lenses, including the Id and the ECP. Trivex (about 42 abbe value) has much better optics than polycarb (abbe value of 30) which is optically the worst material that is generally dispensed for lenses. Trivex may not solve all your problems, but it just may solve some of them. > While I know that it's probably a dumb idea, is an intraocular solution > (ie, like cataract lens surgery) out of the question? I've heard of > intraocular solutions for presbyopia, but they were more dreams than > reality last I heard. I've never really thought about my vision or my > handicap (I've had it since birth) this really sucks. I don't mind > glasses...but things ought to be clear, at least most of the time. Forget the IOL. I don't think you'd find many surgeons in their right mind who would do it electively on someone with only one good eye. In addition, the multifocal and "focusing" varieties suck big time, and can leave you with a lifetime of sub normal vision. Why? Because the multifocals always have at least half the light reaching your retina out of focus. The "focusing" lenses don't focus much if any at all, and require more risky larger incisions. w.stacy, o.d. >...but I'm not a progressive newbie....I've been wearing progressives >for 10-12 years. I haven't had a good experience with every lens, but [quoted text clipped - 4 lines] >ball and it getting harder and harder to read caused a visit to the >local OD. Results: Try a light brown polarized tint. All of your glasses should be AR coated. >New prescription: >-.25 -1.25 x178 with a +2.75 add [quoted text clipped - 3 lines] >(this is for my left eye, I'm blind in the right one....consequently >these are all polycarb lenses) >My old prescription was made in a Rodenstock Life2. )I also have some >sunglasses that are Zeiss Gradal (shorts I think) that I have had no [quoted text clipped - 4 lines] >corridor, good intermediate performance, etc. (I'm a full time computer >geek, so intermediate is important.) Then you're a strong candidate for computer glasses considering the Rx and frequency of use. >When I got the lens, it was >awful..I couldn't even wear it out of the store. Distance was about the >same, intermediate was unusable...I couldn't see, and even the NV was >restricted to the very bottom of the lens....it was just really a >disaster. He checked the fit and lens itself and said everything >appeared to be correct. The GT has a very long distance from the far to near vision, generally not the best choice for higher adds. The newer GT2 is much better in this regard. Check the near PD. It may be less than normal or equal to the distance PD. If so, the corridor and near zone won't align properly with the eye. The increase in add power aggravates the situation and some thought should be given towards reducing this to +2.50. There are two solutions if the near PD is less than normal- turning the lens for the correct inset before the lens is surfaced, or use a lens that can be ordered with a specific inset to match the near PD. Examples of individualized/direct surfaced lenses are Hoya ID, Zeiss Individual, and Rodenstock Multigresssiv ILT. >We talked about it, and he agreed to get them made in Rodenstock >Life2's. I'm wearing them now (about a week) and while the Zeiss issues >immediately disappeared, the intermediate is poor...significantly worse >than what I had before. Probably due to the higher add power, possibly agravated by positional issues. >NV is great, distance, while a little better on >the golf course, is still not great (I'll lose the ball midflight IF I >hit it further than 180 yards or so(which still is a rare occurence) Again, probably due to the higher add power. Consider separate golf/driving/distance glasses, maybe with a bifocal set low. This will provide the best distance vision assuming the Rx is dead on. >So, can anyone recommend other brands that I can try, or is this about >as good as it's going to get? [quoted text clipped - 5 lines] >handicap (I've had it since birth) this really sucks. I don't mind >glasses...but things ought to be clear, at least most of the time. Like Dr. Stacy said, no surgery. For starters, it won't help, and the risks are much to high. If you find a doc who says otherwise post their name so they can be properly denounced. >thanks for any advice. > >Dave Hope this helps, Robert Martellaro ~~~~~~~~~~~~~~~~~~ Optician/Owner Roberts Optical Wauwatosa Wi. ~~~~~~~~~~~~~~~~~~ "An expert is a person who has made all the mistakes that can be made in a very narrow field." - Niels Bohr Many thanks for all the advice. I really appreciate all the time that folks invested in making comments. What's happened since my post: I discussed the issues again with my optician. He seemed to be a little unsure about what to do and I suggested that maybe he should ask his guy at the lab for a suggestion...just to give him an opportunity for him to get another opinion. He agreed (and seemed relieved at the suggestion)...the lab immediately suggested to him that we try a set of SolaMax progressives...that these lenses fixed most issues that the guy at the lab had had to deal with in the past. I guess time will tell, but in the 6 hours since I've had them, they are noticeably better....NV is OK (wide and tall), distance is OK, and most importantly, intermediate is great...I can see all of the computer screen without moving my head. As an engineer, I'm quite amazed at the difference between different lens designs. I know that there is an element of art in this, but nevertheless, I'm still somewhat surprised at how wide a range of differences that there are. Now, knowing this, what brand of poly polarized progressives should I get because I don't think the Solas are available in brown. (I really don't want true bifocals if I can help it). One cosmetic question...if wanted to get a mirror finish on these, will that affect the performance of them in trying to follow a golf ball? thanks again... Dave >Many thanks for all the advice. I really appreciate all the time that >folks invested in making comments. What's happened since my post: [quoted text clipped - 11 lines] >importantly, intermediate is great...I can see all of the computer >screen without moving my head. Probably because the MAX has a much shorter corridor (the distance from the far to near vision) than the TOP. >As an engineer, I'm quite amazed at the >difference between different lens designs. I know that there is an >element of art in this, but nevertheless, I'm still somewhat surprised >at how wide a range of differences that there are. About 10% art, mostly in technique and communication with the client. >Now, knowing this, what brand of poly polarized progressives should I >get because I don't think the Solas are available in brown. (I really >don't want true bifocals if I can help it). The Panamic, Ovation, Image, Illumina, Fusion2 all come in brown poly polarized. There are additional choices if other materials can be used. Consider a low set lined bifocal. >One cosmetic question...if wanted to get a mirror finish on these, will >that affect the performance of them in trying to follow a golf ball? Probably make the lens to dark. I wouldn't recommend it. An AR coating would be helpful. >thanks again... > >Dave Your welcome. Robert Martellaro ~~~~~~~~~~~~~~~~~~ Optician/Owner Roberts Optical Wauwatosa Wi. ~~~~~~~~~~~~~~~~~~ "Science is a way of trying not to fool yourself." - Richard Feynman |
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