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    How to better fit progressive spectacle lenses

    Las Vegas—Better understanding progressive spectacle lenses (PALs) and how to troubleshoot the fit leads to happier patients who are satisfied with their vision.

    Valerie A. Manso, ABOC, FNAO, says that optometrists and opticians should forget about “one size fits all” with PALs. Manso is president of Manso Management Resources, a training and development company specializing in the ophthalmic industry.

    “Through adapting the lenses, whether design or refraction, we can make life better,” she says. 

    In an ideal world, patients put on their new eyewear and things are perfect.

    However, some patients will immediately reject the eyewear, while others will return after a period of time of struggling with the eyewear.

    Related: Top multifocal contact lens tips

    “How we handle patient complaints, troubleshoot the offending eyewear, and subsequently resolve the problems are important skills,” says Manso.

    Patients are beginning to wear multifocals earlier in their lives.

    “Multifocal use is starting now when people are in their late 20s and 30s,” Manso says.  This is change; in the past, multifocal use began in the late 40s and 50s. This is due to computer and device use. We are focusing on that distance is not natural.”

    In today’s world of digital reviews, ODs and opticians want patients to be talking about them in the right way.

    “We want them talking about our phenomenal service,” says Manso. “We are competing with outlets with no brick and mortar store. We want everyone to turn into raving fans. Yes, we do charge more because we do it well and we resolve complaints.”

    When patients present with problems look to evaluate the prescription (distance, mid-range, near) as well as the fit of the lens and frame.

    Evaluating the fit includes pupil height, pupillary distance, pantoscopic tilt, vertex, and facial wrap.

    PAL market and patient acceptance

    PALs are now a dominant mode of correction for presbyopia, comprising 75 percent of multifocal dollars in the United States. However, Manso reminded attendees that more flat-top bifocals are sold than PALs.

    PALs are the preferred modality for most presbyopes, according to Manso, especially for bifocal wearers. Patients prefer vision through progressives as compared to other presbyopic lens corrections.


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