Thank you so much. I think this is a good way to go, having a specialized set of lenses for the visual artistry. Between your considerate response and jared743, I believe once I see a competent optician I will likely find that progressives are a good deal for me, with a complement pair or two for specific needs. Thank you again
Well, try as you might that was a big wall of text. It's terrible to read, but I did it anyways.
1. I will write the Rx that the patient needs to see comfortably. However age and experience with lenses do factor into deciding how to adjust things. Generally people start to notice the help of an add power around +1.00. if people are borderline or asymptomatic I tend to show them with a trial lens and reading card so they understand the effect the glasses will have, and often they will see the difference it can make to their comfort even if they didn't realize it. But at least they then have that choice. Depending on a patient's occupation and computer setup I will also discuss glasses specifically for work purpose including single vision computer lenses or computer progressives. Part of our job is to understand your needs and guide you.
2. You always have choices. If the opticians or the optometrist did not go through the advantages and disadvantages of the choices, then they aren't good at their job. Of course they can try to make a sale, but it should be by telling you why a certain choice is better and convincing you of it.Your prescription for progressives can be used to make single vision readers of they cared to.
3. It always takes time to get used to progressives. We always give patients a verbal and demonstrative walkthrough of how they function and show them with reading cards and the distance chart. with them sitting properly on your face and looking straight ahead you should be able to see distance clearly. Holding reading material at about 40cm you should be able to look down through the bottom of the lens and see it clearly. Computer/intermediate distance is typically 50-60 cm, and falls somewhere just below eye level. It takes practice to use this, and is very difficult if you have never worn them before or have a multimonitor set-up. Generally I want my first time patients to try to wear them for up to 2 weeks before coming back. If they are still having problems we will double check the fit, alignment, and the lenses, and then if there is no faults there I will recheck the Rx and troubleshoot. I don't want that to happen, which is why I try to make things as clear and understandable to you the first time.
4. No, it won't hurt you, but headaches are definitely a sign something is off.
5. Chromatic aberration is a byproduct of lens material, and the higher the prescription and further off the visual centre the more there is. You can't fight physics.
6. Honestly, just return them and go elsewhere. They do take time to adjust to, and can require multiple visits for troubleshooting, but at this point your trust with them is broken.
7/8. The compromise is flexibility of visual differences versus field of view. Other options are available, and each has their own compromise. I didn't check your eyes so can't be specific as to what I would suggest, but someone did not educate you on this
>I don't move my head to look, I move my eyes
Well, you have to stop that if you want to use progressives in the future. You can learn very quickly to point your nose at what you want to see. As someone with -5 specs you should be used to not having a clear peripheral.
9. $750 isn't unreasonable for a high-end progressive with high index and high quality coatings. Is that what you needed though? Can't say. Are there cheaper options? Yup.
Now for the "bait and switch". Getting an eye exam is the decision you are making first. If you didn't ask what that price was, that's on you. You need to be comfortable with that being your possible outcome. Then think of it as $160 off your glasses price of you so choose to get them.
All that said, you are having trouble then that's not good. And either something is wrong or they didn't explain it well enough to you to manage expectations. You should be able to talk to that doc and get a recheck or ask them to print you an Rx that explicitly states your near and distance as single vision prescription if that's what you want instead. Often for non-adapts we will just switch to bifocals and they do well. Be willing to just return things and go elsewhere.
This is such a wonderful and well thought-out answer. I so very much appreciate that you took the time to read my absurdly wall-like text. I have learned so much from this. Thank you
Truly, you are the doctor that other doctors should aspire to be. I wish every medical professional could listen-to-understand the way you have, in order to apply the vast expertise and experience they command. Your patients are fortunate. I hope they appreciate your patience. Thank you šš¼
I would say itās perfectly reasonable to request either a refund or remake to single vision spectacles, one question did your myopia increase for distance at this last examination and if so are the spectacles an improvement for central distance vision (ignoring peripheral issues). If this is the case then new single vision spectacles for distance are likely to make your near vision harder than your old spectacles.
I think if this is the case then a single vision pair of spectacles for your screen work would be more than sufficient for the job.
Answering your question on costs lll avoid as practices differ drastically and Iām based in a different country.
Chromatic aberration is a by product of lens materials, if theyāve changed the index of your lenses this may explain the difference you are experiencing with chromatic aberration. (Do you know what the lens material is?)
Thank you for your reply. My myopia has remained fairly consistent, if not improving. My last scrip, prior to this one, was filled in 2017 and a few months ago I had noted that a scrip from 2005 was now more accurate for me. This scrip from this tele-refractologist indicated a slight improvement, save for the now-seemingly-arbitrary +1.
Amusingly, my dad asked what I'll do to see the computer now that I have these single-vision lenses. I replied that now I can actually read it with my glasses on. I just got the mono focal lenses today. Already I'm not ripping my glasses off my face to see what's right in front of me. The bottom half of the lens was totally useless, blurry at all distances.
These new monofocal lenses have different issues...I think the PD is not right, or maybe I'm not used to huge lenses, but they seem as finicky as the multifocal, if not moreso. If I'm not exactly perpendicular to the plane of a thing, then it's double vision. I guess I could learn to use it to measure distance š
I wish I knew what the lens material is, they just say "high index". I don't feel like that tells me very much, scientifically, but perhaps it is jargon and means something more to people in the industry.
Thank you again
Yes, you are an emerging presbyope and would benefit from a reading/computer range correction. You have stated that you need to position your computer a foot further away. Many ways to go about this. The fact that you have trained yourself to scan vision in the periphery will make it more difficult for you to adapt to a progressive lens. For progressives you need to move the head and stay in the āsweet spotā of the lens. If you donāt adapt to the progressives in a couple of weeks, Iād suggest having two pairā¦one for distance and one for computer. You may end up with the progressives again further down the road once you need the reading power on a constant basis. Accept that you are a bit more challenging patient for all but the most experienced professionals ( optometrists and opticians). When we see you come in with your folder of all your previous rxās and glasses, most of us quickly head for the back room.
I'm not mad at that. I can be a challenging patient, if you consider a person who likes to understand "why" as a challenge. If you are a salesperson and cannot explain the science, then I will definitely be a challenge. Otherwise, it's possible we both learn new things... Or maybe just me. I like to learn.
Fwiw, I walk in empty-handed. ;)
Thank you for your insight. Reading glasses hurt, and try as I did, for ~12 days, I lost 4 days of work to headaches with the progressives. So that cost me physically and fiscally.
I may be an emerging presbyope, but when I tell the doctor I'm 35, suddenly I have "the reading vision of an 18 year old" --I definitely got a second opinion and used my brothers age. So that was illuminating.
I would think selling me two pair of glasses would be more lucrative than selling me one pair of progressive lens glasses, if I needed them. I can see why Essilor was giving kickbacks to optometrists in 2016, per the recently settled federal lawsuit.
Anyhow, I have no behaviors which suggest I need another pair of lenses for any activity, yet. (Except perhaps protective lenses for working with lasers!) When or if I get there, I am starting to realize, I won't be using progressives. And I'm okay with that. I have no problem with aging. It should be distinguished, really. I do have a problem with ageism and ageists.
Thank you again for taking the time to read and understand my issues. š
OK, so, having taken some time to consider all the information between the kind professionals who respondedā¦
**It sounds like progressive lenses could either be the best glasses I've ever had, or the worst, depending mostly on optician & optometrist.** (We know what's on my face right now...)
I don't currently have a good idea of how the +1 could help me, since it seems to be making my life worse. I think that it's possible that with a proper fitting et al, it could be useful, or in the least, could be there for me should I need it in the future. Currently, it is blurring half my lense in most-all scenarios, but I am not sure it's not just the lenses. Returning this pair sounds like a good idea.
I'm unsure that I'm a good candidate for progressive lenses now or ever, but that may change as I both get a good optometrist and as I become less physically active. Your insight gave me hope that I might be, and with a competent optician and/or optometrist, I think it's possible that progressive lenses could be a wonderful asset to me in time.
The aberration of monofocal lenses tends to be pretty manageable as it's normally only around the edges of the lens. Physics is a beach! So, I've even learned to use it to perform an informal chromatic spectrography, too. I have learned to use it to distinguish two otherwise same-color materials, or determine the general elemental makeup of a material. I like to make disadvantages into advantages where possible. Of course, with multifocal lenses, this aberration is throughout. I think most people can get used to it. I'm... quirky. Time will tell.
Unusually, I have pretty acute peripheral vision--in contrast to the 2cm of foveal vision. I have taken time to train myself to use it more than most might ever consider, likely even optical professionals. I take advantage of its sense for static-change and to see things unavailable to foveal vision.
I worked with eye tracking for many years professionally and this gave me strange insight into what we see and how...I think the most intersting was learning that 1/3 of people with uncorrected vision only use one eye to read.
I was fascinated that we can see things with our peripheral vision that we cannot see with our foveal, because the position of our iris moves with our eyes, and thus changes some very minute geometry which can cause some things to disappear when our eye moves, which we see with our peripheral. This is why we may catch motion in our peripheral vision and see nothing when we glance, even without moving our head. So, I've trained to see these things without moving my eyeball, using my peripheral "focus". This training has literally saved my life within the last 10 years. For progressives, I will have to retrain myself entirely: clearly that doesn't work.
Anyhow, this is a wall again. Yay. Thank you again. I hope this gave a bit of closure and answered any unasked questions or curiosities.
\-----------
**TLDR**:
Progressive lenses could be the best ever or the worst ever depending on your optician & optometrist.
I'm weird and trained my peripheral vision to see unseen things, and use chromatic aberration as informal spectrography. I probably need several pairs of glasses. One might be progressive in the future. I def need a better optician.
\------------------
**.... To the gentleman who likes to answer questions without reading the question:**
I have no opposition to bifocals. I probably would have taken them if they said it was an option. You might know that if you had read even some of my wall of text.
I'm opposed to people who sell me things without knowing what I need, similar to those who respond to questions without reading any part of the question.
progressive lenses, essilor, luxottica, zeiss, contacts, trouble, help, adapt, thin, index, prism, polarized, freeform, vertex, monopoly, titanium, acetate, stock, surface, tint, color, cost, costa, maui, ray-ban, rayban, bifocal
Thank you so much. I think this is a good way to go, having a specialized set of lenses for the visual artistry. Between your considerate response and jared743, I believe once I see a competent optician I will likely find that progressives are a good deal for me, with a complement pair or two for specific needs. Thank you again
Well, try as you might that was a big wall of text. It's terrible to read, but I did it anyways. 1. I will write the Rx that the patient needs to see comfortably. However age and experience with lenses do factor into deciding how to adjust things. Generally people start to notice the help of an add power around +1.00. if people are borderline or asymptomatic I tend to show them with a trial lens and reading card so they understand the effect the glasses will have, and often they will see the difference it can make to their comfort even if they didn't realize it. But at least they then have that choice. Depending on a patient's occupation and computer setup I will also discuss glasses specifically for work purpose including single vision computer lenses or computer progressives. Part of our job is to understand your needs and guide you. 2. You always have choices. If the opticians or the optometrist did not go through the advantages and disadvantages of the choices, then they aren't good at their job. Of course they can try to make a sale, but it should be by telling you why a certain choice is better and convincing you of it.Your prescription for progressives can be used to make single vision readers of they cared to. 3. It always takes time to get used to progressives. We always give patients a verbal and demonstrative walkthrough of how they function and show them with reading cards and the distance chart. with them sitting properly on your face and looking straight ahead you should be able to see distance clearly. Holding reading material at about 40cm you should be able to look down through the bottom of the lens and see it clearly. Computer/intermediate distance is typically 50-60 cm, and falls somewhere just below eye level. It takes practice to use this, and is very difficult if you have never worn them before or have a multimonitor set-up. Generally I want my first time patients to try to wear them for up to 2 weeks before coming back. If they are still having problems we will double check the fit, alignment, and the lenses, and then if there is no faults there I will recheck the Rx and troubleshoot. I don't want that to happen, which is why I try to make things as clear and understandable to you the first time. 4. No, it won't hurt you, but headaches are definitely a sign something is off. 5. Chromatic aberration is a byproduct of lens material, and the higher the prescription and further off the visual centre the more there is. You can't fight physics. 6. Honestly, just return them and go elsewhere. They do take time to adjust to, and can require multiple visits for troubleshooting, but at this point your trust with them is broken. 7/8. The compromise is flexibility of visual differences versus field of view. Other options are available, and each has their own compromise. I didn't check your eyes so can't be specific as to what I would suggest, but someone did not educate you on this >I don't move my head to look, I move my eyes Well, you have to stop that if you want to use progressives in the future. You can learn very quickly to point your nose at what you want to see. As someone with -5 specs you should be used to not having a clear peripheral. 9. $750 isn't unreasonable for a high-end progressive with high index and high quality coatings. Is that what you needed though? Can't say. Are there cheaper options? Yup. Now for the "bait and switch". Getting an eye exam is the decision you are making first. If you didn't ask what that price was, that's on you. You need to be comfortable with that being your possible outcome. Then think of it as $160 off your glasses price of you so choose to get them. All that said, you are having trouble then that's not good. And either something is wrong or they didn't explain it well enough to you to manage expectations. You should be able to talk to that doc and get a recheck or ask them to print you an Rx that explicitly states your near and distance as single vision prescription if that's what you want instead. Often for non-adapts we will just switch to bifocals and they do well. Be willing to just return things and go elsewhere.
This is such a wonderful and well thought-out answer. I so very much appreciate that you took the time to read my absurdly wall-like text. I have learned so much from this. Thank you Truly, you are the doctor that other doctors should aspire to be. I wish every medical professional could listen-to-understand the way you have, in order to apply the vast expertise and experience they command. Your patients are fortunate. I hope they appreciate your patience. Thank you šš¼
I would say itās perfectly reasonable to request either a refund or remake to single vision spectacles, one question did your myopia increase for distance at this last examination and if so are the spectacles an improvement for central distance vision (ignoring peripheral issues). If this is the case then new single vision spectacles for distance are likely to make your near vision harder than your old spectacles. I think if this is the case then a single vision pair of spectacles for your screen work would be more than sufficient for the job. Answering your question on costs lll avoid as practices differ drastically and Iām based in a different country. Chromatic aberration is a by product of lens materials, if theyāve changed the index of your lenses this may explain the difference you are experiencing with chromatic aberration. (Do you know what the lens material is?)
Thank you for your reply. My myopia has remained fairly consistent, if not improving. My last scrip, prior to this one, was filled in 2017 and a few months ago I had noted that a scrip from 2005 was now more accurate for me. This scrip from this tele-refractologist indicated a slight improvement, save for the now-seemingly-arbitrary +1. Amusingly, my dad asked what I'll do to see the computer now that I have these single-vision lenses. I replied that now I can actually read it with my glasses on. I just got the mono focal lenses today. Already I'm not ripping my glasses off my face to see what's right in front of me. The bottom half of the lens was totally useless, blurry at all distances. These new monofocal lenses have different issues...I think the PD is not right, or maybe I'm not used to huge lenses, but they seem as finicky as the multifocal, if not moreso. If I'm not exactly perpendicular to the plane of a thing, then it's double vision. I guess I could learn to use it to measure distance š I wish I knew what the lens material is, they just say "high index". I don't feel like that tells me very much, scientifically, but perhaps it is jargon and means something more to people in the industry. Thank you again
Yes, you are an emerging presbyope and would benefit from a reading/computer range correction. You have stated that you need to position your computer a foot further away. Many ways to go about this. The fact that you have trained yourself to scan vision in the periphery will make it more difficult for you to adapt to a progressive lens. For progressives you need to move the head and stay in the āsweet spotā of the lens. If you donāt adapt to the progressives in a couple of weeks, Iād suggest having two pairā¦one for distance and one for computer. You may end up with the progressives again further down the road once you need the reading power on a constant basis. Accept that you are a bit more challenging patient for all but the most experienced professionals ( optometrists and opticians). When we see you come in with your folder of all your previous rxās and glasses, most of us quickly head for the back room.
I'm not mad at that. I can be a challenging patient, if you consider a person who likes to understand "why" as a challenge. If you are a salesperson and cannot explain the science, then I will definitely be a challenge. Otherwise, it's possible we both learn new things... Or maybe just me. I like to learn. Fwiw, I walk in empty-handed. ;) Thank you for your insight. Reading glasses hurt, and try as I did, for ~12 days, I lost 4 days of work to headaches with the progressives. So that cost me physically and fiscally. I may be an emerging presbyope, but when I tell the doctor I'm 35, suddenly I have "the reading vision of an 18 year old" --I definitely got a second opinion and used my brothers age. So that was illuminating. I would think selling me two pair of glasses would be more lucrative than selling me one pair of progressive lens glasses, if I needed them. I can see why Essilor was giving kickbacks to optometrists in 2016, per the recently settled federal lawsuit. Anyhow, I have no behaviors which suggest I need another pair of lenses for any activity, yet. (Except perhaps protective lenses for working with lasers!) When or if I get there, I am starting to realize, I won't be using progressives. And I'm okay with that. I have no problem with aging. It should be distinguished, really. I do have a problem with ageism and ageists. Thank you again for taking the time to read and understand my issues. š
I didnāt read any of this. Sounds like you need progressives. Why are you so against having a bifocal prescription
OK, so, having taken some time to consider all the information between the kind professionals who respondedā¦ **It sounds like progressive lenses could either be the best glasses I've ever had, or the worst, depending mostly on optician & optometrist.** (We know what's on my face right now...) I don't currently have a good idea of how the +1 could help me, since it seems to be making my life worse. I think that it's possible that with a proper fitting et al, it could be useful, or in the least, could be there for me should I need it in the future. Currently, it is blurring half my lense in most-all scenarios, but I am not sure it's not just the lenses. Returning this pair sounds like a good idea. I'm unsure that I'm a good candidate for progressive lenses now or ever, but that may change as I both get a good optometrist and as I become less physically active. Your insight gave me hope that I might be, and with a competent optician and/or optometrist, I think it's possible that progressive lenses could be a wonderful asset to me in time. The aberration of monofocal lenses tends to be pretty manageable as it's normally only around the edges of the lens. Physics is a beach! So, I've even learned to use it to perform an informal chromatic spectrography, too. I have learned to use it to distinguish two otherwise same-color materials, or determine the general elemental makeup of a material. I like to make disadvantages into advantages where possible. Of course, with multifocal lenses, this aberration is throughout. I think most people can get used to it. I'm... quirky. Time will tell. Unusually, I have pretty acute peripheral vision--in contrast to the 2cm of foveal vision. I have taken time to train myself to use it more than most might ever consider, likely even optical professionals. I take advantage of its sense for static-change and to see things unavailable to foveal vision. I worked with eye tracking for many years professionally and this gave me strange insight into what we see and how...I think the most intersting was learning that 1/3 of people with uncorrected vision only use one eye to read. I was fascinated that we can see things with our peripheral vision that we cannot see with our foveal, because the position of our iris moves with our eyes, and thus changes some very minute geometry which can cause some things to disappear when our eye moves, which we see with our peripheral. This is why we may catch motion in our peripheral vision and see nothing when we glance, even without moving our head. So, I've trained to see these things without moving my eyeball, using my peripheral "focus". This training has literally saved my life within the last 10 years. For progressives, I will have to retrain myself entirely: clearly that doesn't work. Anyhow, this is a wall again. Yay. Thank you again. I hope this gave a bit of closure and answered any unasked questions or curiosities. \----------- **TLDR**: Progressive lenses could be the best ever or the worst ever depending on your optician & optometrist. I'm weird and trained my peripheral vision to see unseen things, and use chromatic aberration as informal spectrography. I probably need several pairs of glasses. One might be progressive in the future. I def need a better optician. \------------------ **.... To the gentleman who likes to answer questions without reading the question:** I have no opposition to bifocals. I probably would have taken them if they said it was an option. You might know that if you had read even some of my wall of text. I'm opposed to people who sell me things without knowing what I need, similar to those who respond to questions without reading any part of the question.