Should I Wear Progressives? Where Should I Buy Them
Posted , 6 users are following.
Hi Everyone
I had cataract surgery a few months ago and it went well. I had Tecnis 1 monfocal in both eyes and I see distance 20/20 minus a few letters. However, my vision is sometimes blurry for a few second until my eyes focus and my cataract surgeon said that was due to my residual astigmatism. My intermediate is good enough to read the computer. My near vision is not good enough for sustained reading or small print. I told my cataract surgeon to to give me a prescription to sharpen up my distance vision and another for prescription readers. And they do really prove my near vision and improve my distance vision. However, when I wear either pair, my intermediate vision suffers. I can't wear either pair and see the computer well. I end up just looking the computer with no eyeglasses at all.
I may be taking a new job where I will have to read books and be on the computer a lot , plus move around a large office, I wonder if I should ask my cataract surgeon for a prescription for progressives or just juggle around with my two pairs of eyeglasses and take them off to use the computer? I got my glasses made at a nationwide optical chain and they didn't cost me that much. They said progressives would be around $175. What do you all think I should do?
0 likes, 18 replies
RonAKA thomas72521
Posted
Before cataracts I had worn progressive glasses for many years. I was using HD Progressives from Costco made by Essilor, for all around use including the computer. They worked ok, but you do have to move your head up and down some to get a sharp image from the top to the bottom of the screen. Costco also sell a multi-function lens that has a much larger intermediate vision section for computer use, compared to the standard progressive lenses. It looks interesting if one is willing to buy a set of glasses just for computer use. I have never tried them.
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After cataracts I went with mini-monovision so I don't use glasses at all for computer work. My near eye provides all the vision. I like it better than my earlier days with progressives, as it pretty much eliminates the the need for up and down head movement.
RebDovid thomas72521
Posted
Unlike IOLs, where "premium" denotes the cost of the lens but not necessarily its optical quality or suitability, when it comes to progressive lenses more money generally can buy better lenses. The question is whether one needs, and can afford, the better quality. Having worn progressive lenses for c. 30 years, and only recently begun exploring IOLs, I'm suspicious of the quality of $175 progressive lenses.
That said, a lot depends on your needs and priorities. If your emphasis is on reading books, being on a computer, and moving about an office, then I suggest strongly considering Shamir Workspace lenses, which I've worn quite happily for the past few years. (Since last year, Shamir is 100% owned by Essilor, the Varilux company.) For an even stronger emphasis on nearer vision, the Shamir Computer lenses are worth considering.
Apart from the developing impact of my cataracts, I've found that the Workspace lenses allowed me to shift easily from reading a book, magazine, or hand-held device to working on a desktop computer to moving about an office, my home etc. Indeed, for me, there's been enough distance vision at the top of the lenses that I sometimes forgot to switch to my regular progressive lenses before getting in the car to drive.
RebDovid thomas72521
Posted
I also should address your where-to-buy question. I've always bought my progressive lenses from an independent optician's office. Correct measurements and fitting are even more important with progressives than with single vision glasses. Also, as I recall from the last time I filled a prescription, chains often tend to sell proprietary lenses, about which it's more difficult to find information. Were I less myopic, however, I'd also consider Costco, whose optical department has, or at least used to have, a good reputation.
soks RebDovid
Posted
what are your thoughts on the varilux xtend?
RonAKA soks
Posted
No experience with the Varilux X series lenses but I did find this article which provides some "technical" information on what it is about. I put technical in quotes as I am not sure if this is really accurate information or just technical mumbo jumbo trying to pitch something that is much less significant than what they want you to believe.
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If there was anything I got out of it, it is that they have apparently expanded a progression zone that they define as being set for arms length vision (ALV). It goes from 60% add (+1.5 D or so) to 85% add (+2.0 D), based on a 2.5 D total add at 100%. See figure 5 in the article. This has been identified as the best add compromise for today's intermediate distance vision.
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This validates to some degree the use of -1.5 D as the optimum for the near eye in mini-monovision.
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So is this a real breakthrough or just marketing hype? Not sure. Here is a description of the article (which is authored by Essilor). I see the article is dated July 2017, so not really a new technology in 2023. The one bit of a flag for those with IOLs that I noticed in the article is that they have apparently assumed some degree of accommodation remaining in the eye. With IOL implants there will be no accommodation. Not sure if that impacts anything. Perhaps the next major "breakthrough" will be a progressive lens that is optimized for those that have had cataract surgery and IOLs with no accommodation!
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pointsdevue Varilux X series: the progressive lens with an expanded field of near vision Online publication 07/2017
RebDovid RonAKA
Posted
I suggest perusing the progressive forum at Optiboard. It's for professionals only, so we're merely onlookers. I found a recent comment suggesting Varilux's claims are "mumbo-jumbo". YMMV
RebDovid soks
Posted
check out the progressive forum at Optiboard.
RonAKA RebDovid
Edited
I think there is a much more basic way of ensuring a progressive lens actually works well. It is by avoiding frames that have a narrow height profile. The current progressive lenses I have are 40 mm in height. Some frames have much less than this.
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I have to admit that progressives are a very low priority for me. I virtually never wear them. My only real need for them is when driving at night in the country. I worry about critters like moose and deer coming up out of the dark ditch unexpectedly with nasty consequences for both them and me.
Bookwoman RonAKA
Posted
Yes, this. Fortunately larger glasses are now fashionable once again, although I hope we don't go back to the excesses of the '80s!
RebDovid RonAKA
Posted
Respectfully, I disagree. Adequate height to accommodate a decent intermediate zone of vision is necessary but not sufficient to provide good across-the-board vision.
RonAKA RebDovid
Posted
As an engineer I look at the physics of the matter. The top of a progressive has to have the power (curvature) required to correct distance vision. The bottom has to have the full add power overlaid on the distance correction. The curvature has to progress from the top to the bottom of the lens. The smaller the height of the lens the less physical distance there is to make this transition of curvature. That is why responsible opticians will have minimum lens height requirements for a progressive lens. But, it is not a binary good-bad issue. It is progressive. The less height there is the more difficult it is going to be to get a good result. With a compressed spacing the vision is going to be very sensitive to where you look through the lens.
RebDovid RonAKA
Posted
But the optics almost must be considered. That's why adequate height is necessary but not sufficient. Consider that lens designers don't control our choice of frames. Consider, too, that, the hype of the latest and greatest notwithstanding, there have been substantial advances in lens design. Putting different lens designs in the same frame well may produce different results.
RonAKA RebDovid
Posted
I agree that the size of the lens is not the only consideration. The other consideration is the allocation of area to the range of defocus diopters. The basic strategy of the Varilux X seems to be the allocation of the amount of area and the location of the ALV (Arms Length Vision) sections from -1.5 D to -2.0 D.
RebDovid RonAKA
Posted
It's rather more complicated. For starters, I suggest searching on an article published in Review of Optometry on June 15, 2021, by Barry Santini, Van Y. Rue, and Brent McCardle entitled Understanding Today's Progressives.
RonAKA RebDovid
Edited
Now with mini-monovision and virtually eyeglasses free I have lost all my interest in eyeglass technology. I used to follow it closely and participated in a forum which included professionals - perhaps the one you suggested. My conclusions were that the whole business is very sleazy. Wild claims are made with very little real science behind it. Companies like Essilor make products intended for small private optical dispensaries, while at the same time they supply the same product to big companies like Costco for a fraction of the cost and potential mark up. They just put a different name on it so the small shops can pretend they are selling something different and better. My conclusion at the time was that the Essilor Varilux was the same product as the Freedom Accolade that Costco sells. Now I see they are both at the same 4.0 HD level. I see the latest claims are that they are designed differently depending on whether you are right handed or left handed??? I wonder what they do with people like me who are right handed but left eye dominant??? It is stuff like this that makes me think this eyeglass lens business is 95% hype and 5% science. That said I also have no doubt there are some very inferior lenses like Zenni on the market that are not up to the top standards.
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Each time I get a new prescription I have to endure a sales pitch from my optometrist that wants me to buy the Varilux version of the lens and his overpriced frames for $1,000+ when I know I can get the same thing at Costco for 1/3 the price. I just tell him that I need a written copy of the prescription so I can shop around.
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Thankfully those times are behind me now and I hope it stays that way. With my last pair of glasses I potentially downgraded from the Freedom Accolade level to the Kirkland Signature HD level. I can't say I notice any difference, but then I almost never wear them so if there was it would not be a benefit to me anyway.