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Lenses are becoming increasingly specialised
Lenses

Digital lenses: a new hope

04/06/2018
By Steven Daras
Patients rarely insist on the same level of specialisation when choosing lenses as they do for other aspects of their lives. STEVE DARAS explains why this needs to change, especially in the digital age.

Recently I was researching information for my presentation at the Australian Vision Congress (AVC) in Brisbane and found that I was having trouble with my vision when using my laptop at home.

OK, time for a little disclosure – my amplitude of accommodation is now only +1.25 D (where did the years and dioptres go?). I found that my distance vision deteriorated after using my progressive powered lenses (PPL) on my laptop at home. My distance vision often became blurred after researching articles online for an hour or more, which was due to my accommodative process being in spasm.

In other words, my PPL didn’t help me to see what I wanted to see (laptop) whilst sitting comfortably.

My laptop sat on my dining room table and I was sitting on a normal dining room chair – neither of which have adjustable heights. My viewing angle and height wasn’t allowing me to access the correct part of my progressive corridor to see the screen and keyboard clearly. This meant that I had to supply extra accommodation to see the screen through my lenses (to be fair the PPL was not designed for this specific task), so I was using my accommodation to prop-up the PPL. As time went on my ciliary processes had locked-up.

"These specific lenses have been my salvation and I currently have three different types of occupational degressive lenses."

When it came time to stop viewing the screen, I could not see clearly into the distance as my crystalline lens was not at rest, and the distance portion of my PPL couldn’t help me until my eyes returned to normal (at rest with no accommodation) about 20–30 minutes later.

Objects around were blurry and I couldn’t see any of their finer details. Meanwhile, on the road I was still able to drive as I could see all vehicles, but I wasn’t able to read registration plates or street signs (and no, I wasn’t driving by braille!).

What does this have to do with dispensing? More than you’d think.

In recent eye examinations my optometrist and optical dispenser didn’t specifically ask me if I used computers, laptops or other digital devices; they just assumed I was happy with what I was wearing. This experience is backed up by a recent report by the American Vision Council suggests that 90% of patients don’t discuss their digital usage with their eyecare practitioner, while most also don’t know that there are alternatives to PPL for computer, tablet and smart phone use.

This doesn’t appear to be restricted to the US. Locally, nobody in private practice or a retail outlet has ever offered me lenses for multiple digital devices, instead I was only given a PPL for my general visual needs. Not once did they mention degressive lenses or extended focus lenses for computer use etc.

PPL by their very design cannot offer wide or long progressive channels for near and intermediate use. Only by removing the distance component can the near and intermediate lengthen and widen to offer unparalleled computer use. Maybe the people who served me thought that if I wanted them I’d ask for them, which led me to wonder whether they treat all people this way.

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I would hope not, as these specific lenses have been my salvation and I currently have three different types of occupational degressive lenses (ODL).

For my laptop I use a conventional near/intermediate degressive design (usually called Book, Close or Near) that allows between 40 cm and 90 cm of clear vision. These live next to my laptop, and not only is the screen clear but my keyboard never looked so clear! I also have useful, limited view of objects around my laptop.

At my workstation, where I have two desktop computer screens, I use a near with longer intermediate from 40 cm to over 1 m (usually called PC, Mid or Screen). This allows me to view the large width that two screens demand with minimal head movement, while also allowing me to see everything on my large desk area.

For the office, I have an intra-office ODL that allows vision from near at 40 cm to a few metres, with a very small limited distance portion (usually called Room or Space). This is good for use in meetings and small work presentations.

It also allows me similar vision at my desk, although my two screens require more head movement. The culprit is the small distance portion, which has narrowed and shortened the degressive corridor. This lens allows me to see around the open planned office without too much bother – there is a little blurring as I try to see further and wider than I’m supposed to.

I’m still learning to use these properly, however, I no longer suffer from accommodative spasm as I use the right lens option for my visual needs.

I wonder how many others like me could benefit from any of these ODLs? If I was in private practice, I’d be asking plenty of questions and generating useful extra pair sales.

Finally, while I’m too old to benefit, optometrists and dispensers should consider educating younger people (below 40 years) about the availability of Digital Assistance Lenses (DAL). These have been specifically designed for pre-presbyopic people to use while viewing more than one digital device, and are referred to as Digital lenses or Anti-fatigue lenses.

They have a small addition (up to +0.80 D) that allows the younger user to view TV, computer etc., while also accessing their smartphone at the same time. The DAL reduces the strain on their accommodation when looking from one device to the other (or from distance to near) by supplying a very small addition.

Please note these are not ‘training wheels’ for progressive lenses as they don’t have a progressive channel or intermediate area. In fact, they’re closer to a seamless round segment bifocal than a progressive.

Regardless, we now have a vast array of lenses that have specific designs. Much like shoes where we have specific footwear for specific needs (sport, work, recreation, safety etc.), we now also have specific lenses for specific visual tasks.

It’s about time that we started to pamper our eyes the same as we pamper our feet, so plant the seed next time you’re discussing eyewear options at work.

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