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Ophthalmic Lenses: How Doctors Rate the PAL Class of 2000 Rich Kirkner, Editor-in-Chief Sidebar: A Peek at the Class of 2001 Tilt your head up to see far away, tilt it down to see near, and turn your entire head to look left and right. Point your nose at where you’re looking. It’s the mantra your opticians use when fitting progressive addition lenses on a first-time wearer. Of course, these head movements and nose points are one of the tradeoffs presbyopes make in order to get “those no-line bifocals.” However, the newest designs from the progressive addition lens class of 2000 have three things in common, manufacturers claim: wider viewing zones, smoother transitions between zones and less peripheral astigmatism. The idea is to give your presbyopic patient’s neck and head a rest. Here’s a look at the newest PALs and what doctors have to say about how they use the lenses. Rodenstock Progressiv life 2 What the manufacturer says: This lens has less peripheral astigmatism and a progressive zone that’s 15-30% wider than previous designs. It fits frames as small as 18mm with a variable reading inset.  What
the doctor says: Kathy Shamblin, O.D., of Shelbyville, Tenn., has had very
few non-adapts and re-makes with this lens. Much of that has to do with the
fitting and patient expectations. “When we’re telling patients how to
adapt, one of the things we’ll tell them is to point their nose to what
they want to see. I’ll ask the patient to walk in the new glasses. The
purpose of that is to recalibrate the brain to match the visual picture with
the input from the feet.” This helps the patient adapt to the outside
distortion and movement.” Special patient needs it’s best suited for: Just about anyone, but there are some patients on whom she won’t fit life 2. “If someone is an accountant and used to wearing an executive, I don’t go there,” Dr. Shamblin says. “I use this lens for small frames with a minimum seg height of 18mm; anything lower is when I use a different lens.” Kodak Concise What the manufacturer says: Signet Armorlite designed this lens for small fashion frames, and claims it has the shortest corridor of 30 PALs against which it was measured. Kodak Concise has a wide corridor with soft near zone boundaries, “generous” reading area, wide and clear distance zone and minimal peripheral distortion.  What the doctor says: Optometrist Paul DiFiore, who has
three offices in southern New Jersey, has made the Kodak Concise his workhorse
lens for small frames. He likes it for a quality the manufacturer doesn’t
boast: a generous intermediate zone. “I feel that some other products
don’t give the range of viewing pleasure that Concise does,” he says.
“Typically, they have adequate reading and distance zones, but
they’re lacking a significant amount of intermediate. My experience with
Concise is that it has given people the mid-range that’s most
critical.” Special patient needs it’s best suited for: Dr. DiFiore finds that Kodak Concise works well with early presbyopes because it minimizes distortion. “With our patient selection being early presbyopes, that helps because we’re not dealing with +2.50D add but with a +1.50D add.” Computer users who want smaller frames also like the lens’ generous intermediate zone. Varilux Panamic What the manufacturer says: Varilux Panamic strives to give the user enlarged fields of vision, allowing more natural head movement and posture vs. traditional PALs. Its “Global Design Management” manufacturing method allows for an asymmetric multi-design, a regular power profile in the periphery, low astigmatism and high near vision with short progression length. Varilux uses an automated manufacturing process. What the doctor says: Dave Ziegler, O.D., of suburban Milwaukee has made Varilux Panamic his lens of choice. In fact, he wears it himself. “There are two things in this lens design: First, they made the reading and intermediate zones wider,” Dr. Ziegler says. “You usually have to tell the patient to point his head right where he wants to see. With this lens, you don’t have to do that as much. It has a wider lateral field of vision, which means less side-to-side head movement. ” Special patient needs it’s best suited for: People who move around a lot at work. “The second area of design improvement is the peripheral vision through the lower half of the lens,” Dr. Ziegler says. With traditional progressives, the wearer gets a “swimming” effect when he or she looks down; not with Panamic. “This is a lot easier for people who are more mobile in their jobs, those who look down and to the side a lot and won’t experience ‘swimming’ or distortion.” Varilux Panamic also works well for low myopes who become presbyopic. “These are patients who are more accustomed to a wide field of view because of their myopia. They really appreciate the wider field of view this lens gives,” he says. SOLA SOLAMAX What the manufacturer says: This lens provides a near zone that’s up to 33% larger than conventional PALs when fit in small frames, and up to 22% larger in large frames. It has a minimum fitting height of 18mm. Proprietary “Design by Prescription” technology allows for variable design in the prescription and add power. SOLA says the lens is ideal for patients who are unhappy with the near area in their current lenses. SOLAMAX is available in either Spectralite or polycarbonate. What the doctor says: In the eight months since its release, James P. Summers, O.D., of Hot Springs, Ark., has made SOLAMAX his PAL of choice. “Patients seem to like it better than other progressives because they get a wider reading area, and the lenses are thinner and lighter, which is a benefit also.” SOLAMAX also provides crisp near, intermediate and distance vision. “There seems to be less swim effect, and patients have better peripheral vision than they do with others.” Special patient needs it’s best suited for: Dr. Summers can’t think of any. “Basically anybody in a progressive would benefit from the lens.” New or existing presbyopes—it doesn’t matter. “One lady said it just opened up the world; she’d been in an old progressive, and she said this lens had much wider viewing areas,” he says. He also fits it in the smaller fashion frames, too. u
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It provides an expanded “Active Viewing Zone” in the
periphery and a large central zone. Says Debby Corriveau, AO’s director of
marketing: “There is minimal skew distortion and reduced oblique
astigmatism with this PAL.”