For years bifocal and trifocal lenses were worn by the majority of
presbyopic spectacle lens wearers. Yet they were not able to satisfy all the
visual needs for every wearing situation. As a result, a number of segmented specialty
lenses developed.
Even though progressive
lenses are clearly overtaking segmented multifocals, it is also unrealistic to
think that general purpose progressives are able to fulfill everyone’s specialized
needs any more than segmented lenses could. If a progressive lens is truly for
specialized tasks and will not be used for full-time wear, the lens may be
called an occupational progressive lens and may be abbreviated OPL.
Progressive addition lenses as a general category are often abbreviated as PALs.
SHORT
CORRIDOR PROGRESSIVE LENSES
The short corridor category of specialty progressives is really
a subcategory of general purpose progressives. The thing that makes this lens
unique is that it is designed to allow a progressive addition lens to be worn
in a frame with a small vertical dimension. Regular progressive lens corridors
are too long. Too much of the near portion of a regular progressive lens is cut
off when the lens is edged for frames with narrow B dimensions.
The short corridor progressive has a faster transition between the
distance and near portions of the lens. This means that the wearer is quickly
into the near portion when looking downward. Because the transition is short, near
vision is suitable. Yet it is only logical that there will be some sacrifice of
the otherwise larger intermediate portion. When choosing a short corridor
progressive, be certain that the minimum fitting height is suitable for the
frame. Even short corridor progressives can come up short on near viewing if
the frame is exceedingly narrow. Some examples of short corridor progressives
are shown in the table below. Short corridor progressives are fitted in the
same manner as regular progressive lenses. Monocular PDs are needed, and the fitting
cross is placed in the center of the pupil.
NEAR
VARIABLE FOCUS LENSES
Near variable focus lenses started
out as a replacement for single vision reading glasses. This lens also goes by
other names, including, small room environment progressives, reader
replacements, or simply OPLs. Over time the lens has become the lens
of choice for someone working in a small office where intermediate and near
vision are the primary viewing needs. To get an idea of how the lenses are
constructed, take the example of a prescription that has no power in the distance
and a +2.00 D add. The normal progressive addition lens would have powers as
shown in figure with no power in the upper (distance) portion. Power gradually
increases until it reaches the prescribed +2.00 D add power in the lower near
portion.
*These are only a small number of short corridor lenses available. It is not meant to be an inclusive list, nor it will be a current list.
Drawing of a simplified progressive lens with plano distance and +2.00 add. "Power range" of this lens is full two diopters.
When a prescription with plano distance power and a +2.00 D add is placed in near a variable focus lens having a 1.00 D power range, the power difference between upper and lower portions is less. The progressive zone is also lengthened. This makes the progressive zone wider and reduces the intensity of peripheral distortion. This simplified drawing of the lens structure, based on the same prescription, can be compared with the standard progressive in above figure.
This
is usually not the case with most near variable focus lenses. The farthest
distance that people who work in small office environments need to see clearly
might be the distance of someone sitting across the desk from them. They also
need a clear view of a computer monitor placed at an intermediate viewing
distance and at the normal 40-cm near-working distance for reading. With this
in mind, our example lens could be designed with a moderate amount of plus
power in the distance. If we use +1.00 D of power in the upper portion of the
lens, we can gradually increase plus power until a total of +2.00 D is achieved
for near. This would appear as shown in figure. Note that the progressive zone for
this type of lens is longer and wider than the normal progressive corridor
found in a general wear progressive lens. This works well, and for this type of
working environment, these OPLs give excellent intermediate and near vision
with less peripheral distortion.
Here is why:
· A longer progressive zone will result in less peripheral
distortion.
· In a near variable focus lens, the difference
between the powers in the upper and lower halves of the lens are usually
smaller. In the example, instead of having a difference of +2.00 D, this lens
has a difference of only +1.00 D. In reality this is a +1.00 D add instead of a
+2.00 D add. The smaller the add power, the smaller will the unwanted cylinder
be.
· When wearing a near variable focus lens, more visual
work will be done with midlevel and downward viewing than with a standard
progressive where clear distance vision is important. The designer has the
option of moving a larger proportion of the peripheral distortion inherent in progressive
lenses into the upper periphery of the lens. Increasing the area of distortion
decreases its intensity.
Power
Ranges
With regular progressives we think of beginning with the distance
power in the upper portion and increasing plus power as we go downward. With
near variable focus lenses, we begin with the near power. The reference power
is the near power instead of the distance power. We start with the near power
in the lower portion and decrease plus power moving up to the distance portion.
This is no longer an addition, but a decrease in power. This decrease in power
is called a degression. Manufacturers often call this the power range
of the lens.
This means that near variable focus lenses do not come in regular
add powers like general purpose progressives. They instead come with one or
more power ranges. Again the power range is the difference in power between
the lower and upper areas of the near variable focus lens.
Example
Suppose a variable focus lens made by a certain manufacturer comes
in only one power range and that power range is 1.00 D. This means that there
will always be 1.00 D difference (degression) between the lower and upper
portions of the lens. If a person has a prescription of
R: plano
L: +0.25 −0.50 × 180
Add: +2.25
or
0 00
+2.
25
----------
= +2. 25
Since
the lens has a power range, or degression of 1.00 D, the upper area of the lens
will have 1.00 D less plus power than the lower area of the lens. So the upper
area of the lens has a power of
( total
near power)
-
( degression)
---------------------------
= upper
power of the lens
or
+2 25
-1 00
-----------
= +1 25
In
a lensmeter, the upper portion of the lens reads +1.25 D, and the near portion
reads +2.25 D. Same will be the pattern for the left lens.
Customizing
the Near Variable Focus Lens to the Needs of the Wearer
When someone has two specific distances at which they do most of
their work, the examiner may decide to prescribe for those distances. In this
case the type of lens should be chosen with a power range appropriate for the prescription.
Here is how it is done.
Example
Suppose a person has a regular prescription of
R: +1.25 −0.50 × 090
L: +1.25 −0.50 × 090
+2.25 add
This person does most of her near work at the conventional 40-cm
working distance, but uses a computer screen situated at an intermediate
distance. The examiner tests for the best refractive correction for this
computer screen distance.
When a near variable focus lens has a small degression (power range), the zone of optimal vision will be larger. Here are two simplifi ed drawings comparing how a lens with a small degression might compare with another with a larger degression. Which of the two would be the most appropriate lens will depend upon the intermediate and/or near tasks for
which the lenses are intended.
This
distance is found to have an intermediate add power of +1.25. If a near
variable focus lens is to be used:
A.
What would the prescription read in the lensmeter through the upper and lower
portions of the appropriate near variable focus lens? (Assume that the power of
the upper portion and mid portion of the lens will be the same.)
B.
What would the correct power range be?
C.
When choosing from the lens types, which lenses would have this power in the upper
portion of the lens?
Solution
A. Through a lensmeter the lower portion of this lens would have
the regular near power of the prescription. This would be
+1 25 - 0 50x 090
+2 25 Add
------------------------
= +3 50 - 0 50x 090
In the top part of the lens, we want to have the prescribed intermediate
power. This will be the sum of the distance power plus the intermediate add,
which is
+1 25- 0.50x 090
+1 25 Add
-----------------------
= +2.50- 0.50x 090
B. The power range, or degression, is the power decrease between
lower and upper parts of the lens—in other words, the power difference between
intermediate and near powers. This can be found by taking the
difference between +2.50 −0.50 × 090 and +3.50 −0.50 × 090, which is
+3. 50- 0.50x 090
+2. 50- 0.
50x 090
--------------------------
= +1.00
Power
range or degression may also be found by taking the difference between the
intermediate and near add powers, which would be
(+2 25)
-(+1 25)
------------
+1
00
Both
methods result in a power range of 1.00 D.
C.
In looking through the possibilities, there are several possible choices with a
1.00 D power range.
These
include the Sola Continuum, Zeiss Business, and Rodenstock Cosmolit Office.
There are many other types which are not specified here.
The
example just given assumes that the occupational progressive lens is to be used
with maximum viewing distance being the distance from the eyes to the computer screen.
If the viewing distance is to go beyond the computer viewing distance, then a
larger power degression might be chosen.
Fitting
the Near Variable Focus Lens
Near variable focus lens fitting recommendations vary widely,
depending upon the lens style. For example, the Access lens only requires a
binocular near PD and does not require any measured fitting height. It is fit
just like a single vision prescription for reading glasses. The reason it is
possible to use a binocular PD instead of monocular PDs is because the
progressive zone of the lens is much wider than in a standard progressive lens.
So if the eyes do not track down the exact center of the zones, there are not
the same problems encountered.
In contrast the Rodenstock Office lens is fit like a standard
progressive lens using monocular distance PDs and fitting cross heights
measured to the center of the pupil. The distance prescription and standard near
addition would be specified. If no power range is specifically requested, the
laboratory will use the recommended range for the add power of the
prescription.
OCCUPATIONAL
PROGRESSIVES THAT INCLUDE DISTANCE POWERS
There are occupational progressive lenses that are used for small
office environments and computer viewing, but still include a small distance
portion located at the very top of the lens. This requires that the wearer drop
the chin and look through the upper portion to see in the distance. Yet since
the lens is entirely an occupational lens, this is not necessarily a
disadvantage and may be considered an expected trade-off for intermediate viewing
enhancement.
The intermediate area of the lens is positioned in front of the
eye, as if looking through a trifocal segment straight ahead. Because the
progressive zone is longer, going almost from the top to the bottom of the
edged spectacle lens, the intermediate and near zones will still be considerably
wider than standard progressives, though not as wide as near variable focus
lenses with smaller degressions.
The lens shows a large functional intermediate zone area with a small distance area in the upper portion of the lens.
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