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Medical Forum / General / Vision / November 2007

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Help! First impressions w/New progressives...

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Marilyn - 18 Nov 2007 13:57 GMT
I am 45 years old and have always had bad distance vision. Lately, close
vision isn't so great either! I just brought home my first pair of
progressives yesterday from my eye Dr.'s office. Admittedly, they are not a
large frame. I've read all about the adjustment period and I know that it
takes time, but I fear that this lack of side and downward vision is too big
a sacrifice to adjust to. I run a home daycare and like to see what is
happening around me and right below me. While shopping, for example, I
cannot bend my head to my chin far enough to see the boxes of shoes on the
bottom rack. I'm scared that I'm losing more than I am gaining. Is this a
common complaint? And what about driving?! Should I let my brain compensate
and just get used to the head turning? I love my full view of distance
vision and I fear giving it up!
Mark A - 18 Nov 2007 14:39 GMT
>I am 45 years old and have always had bad distance vision. Lately, close
>vision isn't so great either! I just brought home my first pair of
[quoted text clipped - 8 lines]
>and just get used to the head turning? I love my full view of distance
>vision and I fear giving it up!

On a typical progressive lens, only about 1/2 of the total lens area is
useable. For the intermediate and reading areas, only about 1/4 of the total
lens area is usable. In at least some situations, you will need to learn to
move your head. This is part of the adaptation process and everyone has to
go through it.

What you gain is the ability to have distance vision, reading vision, and a
variable (but small) area of the lens that can be used to focus at any
distance in between. That is why the lens is called a progressive, because
it has more than just distance and reading powers, but the lens powers in
the intermediate (or transition) area progresses from the distance to the
reading power.

If you don't need an intermediate area, and can live with a distance area
and a reading area only, then you should consider traditional bi-focals.
With bi-focals, almost the entire lens area is useable, although only in one
of two powers (distance or reading). Distance works well from about 15 feet
to infinity, and reading area is typically optimized at about 15 inches or
so (you OD can vary this to your needs). Of course, bi-focals also have a
visible line across the middle of the lens, which is a cosmetic problem for
some people.

The above notwithstanding, there are many different progressive lens
designs, some of which work better than others. Unfortunately, the better
ones are expensive to very expensive.

In order to determine whether you might benefit from a different lens
design, it might help to post your exact Rx and the lenses you have. Please
specify manufacturer, model, and material. For example you might have a
Varilux Panamic in polycarb material (or 1.60 material , or 1.67 or
material). Ask your OD office for the specifics if you don't know. Also list
you exact frame size (should be on the frame or ask your OD office). Usually
the larger the frame, the better vision you have with progressives.

Another thing to consider is that the fitting may not have been done
correctly, and your frame or lenses need adjustment. Fitting of a
progressive lens is somewhat tricky, and often times mistakes are made,
which is one reason they offer free remakes with these type lenses (which is
built into the price you pay). Try moving the frame around on face to see if
it makes things any better, and discuss this with the person who fit your
glasses.
Marilyn - 19 Nov 2007 18:41 GMT
Thanks Mark. My frame, a Saks 5th Ave has the # SSA 193 OY76 135 on it. The
Dr's office told me the "brand" was a high index PVP. (That doesn't seem
right.) The receptionist then put my eye doctor on the phone when I asked
for the exact prescription, and he told me he "just doesn't give it out like
that."
He said this is the most natural way- give it time, etc.

> In order to determine whether you might benefit from a different lens
> design, it might help to post your exact Rx and the lenses you have.
[quoted text clipped - 12 lines]
> see if it makes things any better, and discuss this with the person who
> fit your glasses.
powrwrap - 19 Nov 2007 19:58 GMT
> The receptionist then put my eye doctor on the phone when I asked
> for the exact prescription, and he told me he "just doesn't give it out like
> that."
.
Well, then he's violating federal law:
---------------------

FEDERAL TRADE COMMISSION
PART 456--OPHTHALMIC PRACTICE RULES--

Sec. 456.2 Separation of examination and dispensing.

It is an unfair act or practice for an ophthalmologist or optometrist
to:

(a) Fail to provide to the patient one copy of the patient's
prescription immediately after the eye examination is completed.

Provided: An ophthalmologist or optometrist may refuse to give the
patient a copy of the patient's prescription until the patient has
paid for the eye examination, but only if that ophthalmologist or
optometrist would have required immediate payment from that patient
had the examination revealed that no ophthalmic goods were required;

(b) Condition the availability of an eye examination to any person on
a requirement that the patient agree to purchase any ophthalmic goods
from the ophthalmologist or optometrist;

(c) Charge the patient any fee in addition to the ophthalmologist's or
optometrist's examination fee as a condition to releasing the
prescription to the patient. Provided: An ophthalmologist or
optometrist may charge an additional fee for verifying ophthalmic
goods dispensed by another seller when the additional fee is imposed
at the time the verification is performed; or

(d) Place on the prescription, or require the patient to sign, or
deliver to the patient a form or notice waiving or disclaiming the
liability or responsibility of the ophthalmologist or optometrist for
the accuracy of the eye examination or the accuracy of the ophthalmic
goods and services dispensed by another seller.

Revised as of January 1, 1999]
From the U.S. Government Printing Office via GPO Access
[CITE: 16CFR456.2]
[Page 453]
------------------

Did he also fail to tell you the style/brand of progressive lens used?
Demand that they tell you this information. You paid them good money--
what's the secret?

> He said this is the most natural way- give it time, etc.

I'd give it a week and if you still don't like it, you might need to
go back and have them adjust the glasses to fit your face. (They
should have done this from the get-go). It took me three days to adapt
to my last pair of progressived, after adjusting the nosepads and
temple arms to fit my face better.
Neil Brooks - 19 Nov 2007 22:07 GMT
> On Nov 19, 12:41 pm, "Marilyn" <marilyn...@xxxcox.net> wrote:> The receptionist then put my eye doctor on the phone when I asked
> > for the exact prescription, and he told me he "just doesn't give it out like
> > that."
>
> .
> Well, then he's violating federal law:

Maybe he didn't want to give it verbally, over the phone ... ?

That would be relatively easy to understand.
Mark A - 20 Nov 2007 00:37 GMT
> Thanks Mark. My frame, a Saks 5th Ave has the # SSA 193 OY76 135 on it.
> The Dr's office told me the "brand" was a high index PVP. (That doesn't
> seem right.) The receptionist then put my eye doctor on the phone when I
> asked for the exact prescription, and he told me he "just doesn't give it
> out like that."
> He said this is the most natural way- give it time, etc.

Your OD is required by Federal Law to give you a written Rx upon request.
However, you may be required to go to the OD office and pick it up (you
should have this on hand in case of lost glasses when you are out of town).
You might want to mention the words "FTC" (Federal Trade Commission) and
"District Attorney" and "consumers affairs advocate at your local TV
stations" if they give you any trouble.

You need to ask for the brand (such as Sola, Essilor, Varilux, etc), the
model (such as VIP, Ovation, Panamic, etc), and the lens material (1.50,
polycarb, 1.60, 1.67 are the most common). Read this verbatim to the OD
office when you explain the information you need. Polycarb (which is widely
dispensed) is 1.59 index, but it has poor optical qualities that are
noticeable to some people.
 
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