Progressive Rejection Rate?

Discussion in 'Optometry Archives' started by Greg Beaulieu, Jul 18, 2003.

  1. For the first time in my life (I'm 46) I needed correction to help me
    read. I've been wearing glasses for distance vision since I was a
    teenager. Based on the recommednation of everyone I talked to I bought
    progressive lenses, supposedly state of the art, from an independent and
    highly recommended optician. They were quite expensive (lenses alone were
    $300 Cdn, plus frames at close to the same amount).

    I've only had them for a couple of days now, but so far I absolutely hate
    the things. If you look straight ahead through the appropriate part you
    get the proper correction, but it seems you seldom do that naturally. So
    most of the time everything is distorted to some extent. I've not yet been
    able to figure out what the middle portion of the lenses are supposed to
    be doing, because I never had any problem with seeing beyond 18-24 inches
    with my old glasses. As near as I can tell the outer portions of the
    lenses don't correct properly either (they warned me about that) and the
    distortion out there is quite severe. The only safe way to do things like
    walk down stairs is to plant your chin on your chest so you can hope to
    see your feet. So I'm wearing my new high-buck glasses to work where I
    need them to read, but the minute I get home I go to my old single-vision
    glasses. Not what I expecteded, to say the least.

    Do people who have these things eventually get used to them? I'm going to
    give them a few more days but right now I'm tempted to go back next week,
    bite the bullet, and get different lenses made up. For those in the trade,
    what sort of rejection rates do you get with progressives? I find it hard
    to understand what advantage they are supposed to have other than the lack
    of a line, and the trade-offs of distorted off-center vision and constant
    over/under correction seems quite severe. But never having worn any kind
    of "regular" bifocal I don't know what that experience would be like by
    comparison. Am I nuts?
     
    Greg Beaulieu, Jul 18, 2003
    #1
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  2. Greg Beaulieu

    Mark A Guest

    I don't know what the rejection rate is, but the accommodation rate after a
    few days is ZERO.You need to wear them for at least 2-3 weeks straight
    without going back to your old pair if want to accommodate.

    You did not tell us your Rx or the brand AND model AND material of the
    lenses, which makes it a little harder to predict how difficult your
    accommodation will be.

    The advantage of progressives is that they offer continuous power
    progression from the near to the far, not just near and far like bi-focals.
    The part of the lens that can be used for intermediate vision is small, but
    it is there.

    You will have "swimming" effect in which things seem distorted and your
    balance is not that good. Also, only certain parts of the lens can ever be
    used for clear vision, which is shaped like an hour glass, although the
    upper part is wider than the lower part. Ask your optician to show you a
    graphic that explains this, or have them draw one by hand if they don't have
    graphic.

    However, even though accommodation after a few days is completely
    unrealistic, it is possible that the glasses were not fitted properly, which
    is a common problem. Proper fitting includes how the lens is placed in the
    frame, the L/R pupil distance, how the frame sits on your face, and other
    factors, which are much more critical for progressives than most single
    vision lenses. You also need to take care in choosing a suitable frame that
    sits on your face properly, preferably close to your face. Some very small
    frames do not work well with progressives, despite what they tell you.

    Generally, there is an accommodation warranty offered by the manufacturer
    that is good for 30-90 days depending on your brand, so contact your
    optician and find out what your warranty period, and then mark that date on
    a calendar. Leave a few days to before then to take them back if not happy.
     
    Mark A, Jul 19, 2003
    #2
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  3. Greg Beaulieu

    Terry Horton Guest

    <snip>

    My own situation could hardly be closer to yours. Early this year my
    first try at progressives was the Zeiss Gradal Top, a generally well
    regarded lens. The blurriness was similar to what you described. I
    hated them.

    So I tried another lens, the Hoya SummitECP. I love it! Not sure why
    the peripheral vision is so clear relative to the Zeiss, but the
    difference is profound. Downside is cost - the SummitECP is quite
    expensive.

    The only bifocal I've ever owned is my scrip dive mask. :) But with
    the Hoyas the power seems to naturally optimize for the distance, so
    that in most situations I can hardly tell I'm not wearing my SV
    glasses - except I can see up close.:)


    So
     
    Terry Horton, Jul 19, 2003
    #3
  4. Greg Beaulieu

    Mark A Guest

    Do you know your Rx and what material the lens was made from? The choice of
    material is sometimes as important as the lens design.
     
    Mark A, Jul 19, 2003
    #4
  5. Mark A () wrote:
    : I don't know what the rejection rate is, but the accommodation rate after a
    : few days is ZERO.You need to wear them for at least 2-3 weeks straight
    : without going back to your old pair if want to accommodate.

    I cannot comfortably wear them outside of the office environment. Watching
    TV, for instance, is impossible unless I sit on the floor. I can make you
    a good deal on my recliner because I can't use it any more. If I play golf
    this weekend I definitely will not be wearing them because I cannot see a
    golf ball at address. Not to be crude, but even going to the bathroom
    (standing, that is) is, shall we say, a hit-or-miss proposition. I find
    the distorted peripheral vision especially annoying; I guess I never
    realized how much I used that. Headaches and straining after I got home
    last night made me take them off immediately. I understand the need for
    accommodation and adaptation, but frankly wearing no glasses is almost
    preferable to these right now.

    : You did not tell us your Rx or the brand AND model AND material of the
    : lenses, which makes it a little harder to predict how difficult your
    : accommodation will be.

    All I know is that the invoice says they are polycarbonate, which was
    recommended for strength because I selected Movado drill-thru frames
    (MV130). The lens shape is basically rectangular and is approx. 30mm high
    by approx. 50 mm wide. I was not told what brand/model the lenses are and
    all the invoice says is Rx lenses. I'll try to find out tomorrow. My Rx is
    hard to read due to being handwritten but tell me if this makes any sense:

    Sphere Cylnd. Axis
    R -1.25 -1.25 75
    L -1.75 -0.75 105
    Add R +1.50
    Add L +1.50

    There are columns for prism and base that have nothing in them.

    My main complaints are the peripheral vision (which was explained to me,
    but which I did not appreciate until now) and more importantly, the fact
    that about 50% of the time it feels like I'm looking through the wrong
    part of the lens, regardless of what I'm doing.

    Is there such an animal as a no-line bifocal that does away with the
    intermediate portion of the correction (which I don't think I need) yet
    doesn't have the peripheral distance distortion these things have? It
    seems to me that these are a good idea that technically hasn't been
    perfected yet, but has been heavily promoted, perhaps overpromoted. I am
    curious what other users have found.
     
    Greg Beaulieu, Jul 19, 2003
    #5
  6. Greg Beaulieu

    Mark A Guest

    Polycarbonate has the worst optical quality of just about any lens material,
    but is usually not a big problem for a moderate strength Rx like yours. It
    was chosen by your optician because of its tensile strength which makes it
    easier to make drilled frames.

    30mm total frame height "may be" a bit shallow for progressives, but the
    important dimension is from the "fitting height" down to the bottom of the
    frame. The fitting height may not be in the center. Usually the absolute
    minimum is 16-20mm depending on the lens design (brand and model), but
    progressives work much better if you stay away from the absolute minimum and
    select a frame with more depth.

    It is impossible from here (on the internet) to know whether your lenses can
    be improved or if you have a fitting problem. But you can try moving your
    frames around to see if it makes a difference. If so, discuss this with your
    optician. Exact positioning of the lens is extremely important with
    progressives. Poor positioning could be a lens mounting problem or a frame
    adjustment problem, or it could be the frame is just not appropriate for
    progressives on your face. If you dealing with a sales clerk who is less
    than 30 years old, you may have problems. Ask for the most experienced
    person in the store to help you.

    Millions of people (including myself) wear progressives and are happy with
    them compared to the alternatives. This is not just a cosmetic issue
    (no-line) but it allows infinite range of vision power from near to far. But
    they are not easy to adjust to, and the physics of progressive lens design
    means they will never be perfect.

    Will await the info on lens make and model.
     
    Mark A, Jul 19, 2003
    #6
  7. Greg Beaulieu

    Mark A Guest

    Polycarbonate has the worst optical quality of just about any lens
    material,
    Check out this site for information about fitting progressives. I don't know
    how current the material is.
    http://www.bruneni.com/articles.htm
     
    Mark A, Jul 19, 2003
    #7
  8. Mark A () wrote:
    : Will await the info on lens make and model.

    Mark, I failed to mention that I appreciate the info you are providing
    here. Thank you.

    I went back to the optician today and asked what I have, I did not let on
    that I was dissatisfied other than to say I was challenged by them and
    that I would be back in a week or so.

    I was told that I have Essilor Ovation Airwear progressives. The optician
    who fitted me said that she picked those because they have (I forget her
    exact words) something special about them for computer users. I remember
    her asking me if I used a computer at work and I answered yes. Of course
    that's not all I do - maybe she should have asked me if I walk around
    there too. :)

    I put them on this AM and within 15 minutes I had a headache in an unusual
    spot for me, sort of behind my right ear. Still have it, along with an
    ache in my right eye. As I sit here in front of the keyboard about 12
    inches away from it, if I center myself to look at the letter "T" the "W"
    and the "I" are both blurry. Moving away from it makes no difference.
    Driving to her office this morning I also discovered that the outside
    mirrors on my car are now useless because I cannot make out anything
    clearly. And I tried watching the British Open on TV this morning and made
    an interesting discovery - the top half of the TV screen was fairly clear,
    but the scoring "crawl" on the bottom was unreadable.

    Once I found out what I have I went and did some web research and was
    dismayed to find that these seem to have been sold to me at a very
    inflated price. From what I understand they are not the top-line, state of
    the art product I was led to believe I was getting. I am starting to
    believe I have been sold a bill of goods.
     
    Greg Beaulieu, Jul 19, 2003
    #8
  9. Greg Beaulieu

    Terry Horton Guest

    Zeiss Gradal Top 1.6 w/ Foundation AR.
    Hoya SummitECP 1.7 w/ SuperHiVision AR.
    Frame is a Silhouette SPX rimless, 50mm eye, 33mm "B" (Sorry, don't
    know fitting ht).

    OD -2.25-2.75x003 OS -3.25-2.75x002 +1.5 add

    I went with the Zeiss originally because it was what the optician
    recommended, and who wouldn't be happy in Zeiss lenses? :) Before
    choosing the Hoya I did a little research, but still figuring it was
    hit or miss. I liked Hoya 1.7's 36 abbe, the tensile strength/2-year
    drill-mt. breakage warranty, 12.4 Bayer abrasion rating on the
    SuperHiVision, and of course the thinness at my prescription. The
    Hoya looked like it had everything, if only I could see through them.
    :)

    I could see well from the start. None of the "swimming", the
    peripheral distortion, the feeling I had to look directly at something
    to see it (looking hard I can see some peripheral distortion at the
    lens edge but it's farther out and much less than with the Zeiss). I
    remember telling the optician I was now an "instant adapt" with the
    Hoyas. My SV Vizios are now pretty much relegated to TV watching in
    bed.

    I'd like to understand what made such a difference between the two
    lenses. And is there something to look for in a future lens in case
    the SummitECP was no longer an option...
     
    Terry Horton, Jul 19, 2003
    #9
  10. Greg Beaulieu

    Mark A Guest

    Do you know your Rx and what material the lens was made from? The choice
    of
    SummitECP is a fairly new design and should be around for awhile. Hoya is a
    Japanese company that has been involved in optics for quite awhile. But
    there are other premium designs for progressives and the market for them is
    getting larger.

    Other top brands (besides Hoya and Zeiss) include Rodenstock, Varilux,
    Pentax, Sola, and Seiko. But some of these companies have various models,
    and they may have different features.

    Progressives are a sometimes a hit and miss situation and no single design
    is best for all people. But a large part of the problem may be the fitting.
    Even if the same person helps you at the optician, the lens may have been
    processed differently in the lab, or they may have made a fitting adjustment
    the second time around (intentionally or unintentionally).
     
    Mark A, Jul 19, 2003
    #10
  11. Greg Beaulieu

    Mark A Guest

    Essilor Ovation is a short corridor lens designed for shorter frames. The
    absolute minimum fitting height is 17mm (not from the top of the frame, but
    from the fitting height), but it is always better to be comfortably above
    the minimum (as is the case in many products, marketing claims are sometimes
    exaggerated for competitive purposes). Short corridor lenses usually have a
    shorter intermediate channel for viewing. The Ovation has a corridor length
    of 11mm, good for short frames, but one of the shorter ones on the market
    http://www.visioncareproducts.com/11/progressive_corridors.html.

    Essilor owns Varilux and they share some products just with different names,
    but my understanding is that the Varilux Panamic (the premium lens in their
    line) is not available as an Essilor equivalent.

    As mentioned before, you should try to move the frames around (up/down,
    right/left) to see if you get better results.This can be especially critical
    for a short corridor lens and a small frame. It may be the lens is
    positioned wrong in the frame, or the frame needs to be adjusted on your
    face. But since you have drilled frames, it may be more difficult to move
    them around than ordinary frames.

    My first progressives 10 years ago had this problem (the fitting height was
    too high) and they had to be remade. I have found that most women
    chronically position the fitting height too high with me, because they are
    not eye level with me (6' 2") even when we are both sitting down. Based on
    your TV viewing description, this may be your problem.

    Besides the fact that you probably don't have a premium lens (but not
    necessarily a bad lens), other suspicious factors for your situation
    (besides the fitting) is that your frame may be too small for optimum use of
    progressives, and the polycarb material is not as good optically as other
    materials (but is good for drilling and usually not a big problem for a
    moderate Rx).
     
    Mark A, Jul 19, 2003
    #11
  12. Mark A () wrote:
    : Essilor Ovation is a short corridor lens designed for shorter frames. The
    : absolute minimum fitting height is 17mm (not from the top of the frame, but
    : from the fitting height), but it is always better to be comfortably above
    : the minimum (as is the case in many products, marketing claims are sometimes
    : exaggerated for competitive purposes). Short corridor lenses usually have a
    : shorter intermediate channel for viewing. The Ovation has a corridor length
    : of 11mm, good for short frames, but one of the shorter ones on the market
    : http://www.visioncareproducts.com/11/progressive_corridors.html.

    An odd thing - I asked more then once when I was trying frames whether the
    size of any particular set made a difference because I needed bifocals or
    progressives, and in every case was told "no". The set I ended up with is
    nowhere near as small as some of the others - in fact, I specifically
    picked it over another model because the lenses were bigger top to bottom.
    It's not as if I insisted on a particular style and they had to force-fit
    the lenses. I'm afraid I don't understand the fitting height/corridor
    length issue you discussed.

    : As mentioned before, you should try to move the frames around (up/down,
    : right/left) to see if you get better results.This can be especially critical
    : for a short corridor lens and a small frame. It may be the lens is
    : positioned wrong in the frame, or the frame needs to be adjusted on your
    : face. But since you have drilled frames, it may be more difficult to move
    : them around than ordinary frames.

    I've tried this, with not much change. If I slide them down on my nose
    like a pair of reading glasses I can see the entire TV screen fairly well,
    but anything above eye level is outside the lenses and hence invisible.
    Pushing them closer so they almost touch my face does nothing except fog
    the edges. I can't really adjust sideways. And the peripheral distortion
    and blur is severe in any incarnation.

    : My first progressives 10 years ago had this problem (the fitting height was
    : too high) and they had to be remade. I have found that most women
    : chronically position the fitting height too high with me, because they are
    : not eye level with me (6' 2") even when we are both sitting down. Based on
    : your TV viewing description, this may be your problem.

    This is interesting. When I was fitted the optician originally marked the
    display lenses using a Sharpie at one level, then made a comment that I
    might prefer them differently and remarked the point slightly higher. That
    may be part of the problem and would explain the split-screen TV.

    : Besides the fact that you probably don't have a premium lens (but not
    : necessarily a bad lens), other suspicious factors for your situation
    : (besides the fitting) is that your frame may be too small for optimum use of
    : progressives, and the polycarb material is not as good optically as other
    : materials (but is good for drilling and usually not a big problem for a
    : moderate Rx).

    Again, at the time I knew nothing about anything and just accepted their
    recommendation and took what they told me was a top-line, state-of-the-art
    lens. I've learned a lot in a few days. If I knew the issues around
    polycarb I might not have picked a rimless. I really don't think the lens
    size can be an issue because they aren't *that* small compared to a lot of
    others I've seen. I am very dubious of the Ovations due to the bad
    peripheral distortion and blur I'm seeing in the distance part - I don't
    think that could all be a fitting issue. Knowing what I know now I'd just
    get new single-visions and take off my glasses when I need to read.
    Actually, since my distance Rx didn't change I didn't even need new
    glasses except for aesthetics. I feel like I just threw $600 down the
    drain.

    Can I ask a dumb question? If I can get a SV ground so I can see perfectly
    around the edges of the lens, why is it that adding the near correction
    just to the bottom part of the lens throws that off so badly? I just don't
    get why progressives force you to accept such compromised peripheral
    vision.
     
    Greg Beaulieu, Jul 20, 2003
    #12
  13. Greg Beaulieu

    Mark A Guest

    Many people who work at optician offices and serve customers are
    incompetent. This is especially true of chain stores, and especially true
    when talking about progressives. The only chain store that has good
    opticians in my experience is Wal-Mart, although some of the other chains
    "may" have one decent person in the store if you can find them. Ask for the
    most experienced person.

    The fashion these days is for very small frames, especially short frames
    (top to bottom dimension). Sales clerks are very fashion oriented, but very
    few know much about progressives. Remember that only people over 40-45 wear
    progressives.

    While the total height of the lens is important, more important for
    progressives is the fitting height measurement. The fitting height is the
    point they mark with the sharpie, down to the bottom of the frame. It is
    usually above the center point of the frame. But on a 30mm frame height,
    where the fitting height is 2 mm above center, that leaves 17mm fitting
    height. That is OK according to the manufacturer specs for your lens, but
    realistically is not optimal for a progressive lens.
    Moving the lenses down your nose won't work well, because that is not a
    natural position. As I mentioned, drilled frames may not be able to be
    adjusted much, because they are already close the eyes. You may need to see
    if you can adjust you nose pads to lower the frames. But I suspect that you
    fitting height is too high.
    I assume that is $600 Canadian. Ovations may be the best that store carries.
    Many chains do not carry premium brands, although some can special order
    them. Hoya ESP. is available in a lens with Phoenix material (which is
    Hoya's brand name for Trivex). Trivex has similar strength to polycarbonate,
    but much better vision (but a little thicker lens). I am not an expert on
    drilling, but I think many people drill non-polycarb lens such as 1.60
    plastic.
    Has to do with the physics of the progressive lens. That is, not just near
    and far, but a progression between the two. The clear viewing area (not
    including peripheral vision) is an hour glass shape, and is probably only
    50% of the total area of the lens. This include the far vision at the top,
    the near vision at the bottom, and the narrow progressive channel
    in-between. The near vision area is only about 1/3 the width of your lens
    (if you get lucky). The far vision is better, but many times not completely
    as wide as the lens width. If you can invent a better solution, you will be
    a billionaire.

    One reason progressives are so expensive, is the liberal warranty they offer
    in case of remakes or failure to adapt. Use it if you need to. It should not
    cost the retailer anything because the warranty is offered by the
    manufacturer of the lens.
     
    Mark A, Jul 20, 2003
    #13
  14. Mark A () wrote:
    : Many people who work at optician offices and serve customers are
    : incompetent. This is especially true of chain stores, and especially true
    : when talking about progressives. The only chain store that has good
    : opticians in my experience is Wal-Mart, although some of the other chains
    : "may" have one decent person in the store if you can find them. Ask for the
    : most experienced person.

    : The fashion these days is for very small frames, especially short frames
    : (top to bottom dimension). Sales clerks are very fashion oriented, but very
    : few know much about progressives. Remember that only people over 40-45 wear
    : progressives.

    Just to clarify, these were not purchased at a chain or a discount house;
    they came from a local independent optician with 3 staffers, all of whom
    appear to have been in the business for some time. The place was highly
    recommended and has been in business for nearly 20 years. I guess mistakes
    can happen even in such a place.

    : I assume that is $600 Canadian. Ovations may be the best that store carries.
    : Many chains do not carry premium brands, although some can special order
    : them. Hoya ESP. is available in a lens with Phoenix material (which is
    : Hoya's brand name for Trivex). Trivex has similar strength to polycarbonate,
    : but much better vision (but a little thicker lens). I am not an expert on
    : drilling, but I think many people drill non-polycarb lens such as 1.60
    : plastic.

    I would think that a place like mine could get most anything. They
    certainly do not appear to be low-end judging from what I saw they
    carried.

    Thanks again for all your input, Mark.
     
    Greg Beaulieu, Jul 20, 2003
    #14
  15. Greg Beaulieu

    Mark A Guest

    Independents vary greatly in terms of knowledgeable sales staff. You can
    sometimes find excellent people (if you look hard) but many of them are not
    any better than the chains. Usually there is only one really good person (if
    any) per store who is really knowledgeable about progressives (if you are
    lucky).

    Same is true with the optical shops in an OD office. Often the OD hires very
    cheap help with the idea that he/she will direct them in what to do, but the
    OD is often too busy to really do that.
    I am sure they can get anything, but sometimes getting a different product
    may mean using a different lab, which they don't always like to do unless
    pushed to do so. Also, I notice that there are a lot of contests the
    manufacturers put on for retailers to encourage them to rack up a lot of
    sales for one product, rather than using a lot of different products. I am
    not saying that happened here, but you never know.
     
    Mark A, Jul 20, 2003
    #15
  16. Greg Beaulieu

    Marc Guest

    I haven't read all of this long thread, but it seems to me that multi-focal
    contacts would fit your life style.

    You have to be patient, though. It may take a couple of weeks to get used
    to them, but I don't have any of the problems that you are talking about
    with your spectacles.

    marc
     
    Marc, Jul 21, 2003
    #16
  17. Marc () wrote:
    : I haven't read all of this long thread, but it seems to me that multi-focal
    : contacts would fit your life style.

    : You have to be patient, though. It may take a couple of weeks to get used
    : to them, but I don't have any of the problems that you are talking about
    : with your spectacles.

    I wore single-vision contacts from '92 to '99. They were like the little
    girl with the curl; when they were good they were very, very good; when
    they were bad they were horrid. And most of the time they were bad -
    uncomfortable, undependable, and poor correction. Some of that may be just
    to bad luck with ODs and bad fittings, some of it might be just me and my
    eye shape and condition. But as much as I dislike my new PALs, I disliked
    the hassle, cost and discomfort of my contacts just as much if not more.
    So I think multifocal contacts would be a huge gamble.
     
    Greg Beaulieu, Jul 23, 2003
    #17
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