Advances in lens design and manufacturing processes have spurred the development of the ‘premium’ progressive lens market. It has also created endless possibilities for lens makers and eyecare professionals to satisfy any patient who walks through their door. MYLES HUME reports.
Whether it be a tailor-made suit, engagement ring or cufflinks, research suggests there is a growing appetite for personalisation among consumers.
Optical products are no exception, and there are few that can match the level of individualisation now being offered by progressive lenses.
The market’s best products, commonly referred to as ‘premium’ progressives, are at the vanguard of spectacle design.
Through a combination of precision manufacturing techniques and advanced design informed by highly personal measurements, these top-of-the-line products aim to provide a tailored eyewear solution to match a patient’s physiology and daily activities.
Today, premium progressives remain the largest revenue earner for any lens manufacturer. They also demand a superior skillset from the dispensing practitioner, presenting an ideal opportunity to create a differentiated business proposition in an increasingly crowded marketplace.
In order to appreciate premium progressive lenses, Australian optical dispensing consultant and RMIT University teacher MR LEIGH ROBINSON says it is important to understand what lens manufacturers are attempting to achieve.
He believes the best progressives will focus the light at the fovea for any gaze direction at any point on the lens.
“Nearly all ophthalmic lenses give clear sight through and around the optical centre of the lens, but peripheral vision is compromised with a variety of lens forms, and that is the Holy Grail for lens designers.
“The performance of the lens when the eye looks away from the optical axis, that’s what is driving the technology that underpins these progressive lens products. Premium progressive lenses consider the position of the lens in front of the eye and how this changes the effect of the lens on the optical system.”
Robinson says the market can be split into two distinct classes. The first is optimised progressive lenses. These use default measurements that consider how the frame might sit on the patient’s face.
In contrast, personalised lenses provide unrivalled visual outcomes by incorporating specific measurements such as facial dimensions, back vertex distance, pantoscopic tilt and facial wrap of the frames.
“This is important, it lets the lens companies know how the frame is sitting on the face so they can personalise these lenses to compensate the prescription,” he says.
“That’s an area a lot of practices find complicated to understand. The lens compensation is not changing the prescription, it’s changing the effect of the prescription by adapting the lens design and matching the prescription from its written form to the as-worn position on the face.”
According to Robinson, the use of Computer Numerical Control (CNC) technology in the manufacturing process has been the key to producing highly accurate lens designs, known as digital or freeform surfaced progressive lenses.
Traditionally, lenses were designed with the power of progression on the front of the lens, however the advent of digital and freeform surfacing has allowed this to also be done on the back.
“This has advantages of a wider field of view, and less magnification of the lens,” he says. “Some lens companies will also say that they have now got 1000 or more individual value points on a lens, which is essentially like 1000 individual tiny lenses in the one lens.”
Precision manufacturing
Digital surfacing is a key component in Essilor’s Varilux progressives, which have long been a pioneering lens of the category since first coming to market in 1959, Essilor Australia and New Zealand professional services director MR TIM THURN says.
Essilor’s Varilux range of lenses, spearheaded by the Varilux X Series, encompass more than 50 patents, with each individual lens incorporating up to 30 patents alone. A move from traditional to digital surfacing techniques lead to a renewal of these patents.
Thurn says in the traditional surfacing process, the back of the lens was cut using two curves to produce the sphere, cylinder and axis of the prescription. Once completed, the rough surface was “fined” and “polished” using a metal tool to match the two curves. Specific pads on the tools removed the roughness before making the lens transparent.
Today’s more advanced digital surfacing process, according to Thurn, allows the back of the lens to take any form, such as an aspheric design or progressive surface. Manufacturers can also use this complex surface to overcome the shortcomings of the base curve, regardless of whether it is a simple or more complex front surface.
“The surface is cut with a precision diamond tool. The design is a computer file and, in our case, is generated for each lens via complex calculation software which can take into account new parameters such as the frame tilt, wrap and back vertex distance and other information that will be added into the calculations,” he says.
“The surface is cut so finely that the only additional process is called ‘soft polishing’ – a gentle polishing that removes just enough material to make the lens transparent without impacting the complex surface that has just been cut.”
Thurn says the use of CNC to produce digitally surfaced or freeform lenses has opened endless possibilities for manufactures. However, he stresses it is merely a process, and the true performance lies within the design.
He believes three key components make digital/freeform surfacing such a remarkable process. Each component is dependent on the other to ensure the final product benefits the wearer:
• The machinery involved to manufacture highly accurate lens surfaces.
• The process, including the operating procedures, software system, calculation engine, consumables, experience and quality control.
• The design, capturing the latest innovation in the science of sight, the source of the optical benefits to the wearer.
Asked what constitutes a premium progressive lens, Thurn says one should consider the technology and research invested, rather than its price point.
“A lot more goes into it and it’s backed with good solid proof as well. I know one of our Varilux products was worn by approximately 4500 people around the world in clinical trials before it went to market.”
Reducing swim effects and broadening the field of vision are the most common issues optical engineers have been attempting to overcome
for decades.
Thurn says while today’s best products work to address those issues, they also go much further to consider other factors such as depth of field.
“In Varilux X, the big change produced by our optical engineers is that the lens surface lets me sit here with my phone in front of me, take it away and without moving my head I look at my computer screen and it’s clear,”
he says.
“I don’t have to move my eyes or my head. Then if there’s an object beyond that, it would also be in focus. This very clever overlapping of those different depths of field means you have this continuous, seamless vision that is not only wide, but deep as well – that’s the real revolution.”
Essilor elevates its premium progressives, such as its top of the range Varilux Xclusiv, to the level of personalisation with the use of an iPad app that simulates the way people read without using text.
It involves the patient tracking a blue dot across the screen, while the iPad camera measures the down gaze, offset from centre and the reading distance.
It also factors in the patient’s visual behaviour. At one extreme keeping their eyes still and tracking with their head or, at the other, keeping their head still and tracking with their eyes – and all the combinations in between.
From this personal data the design of the lens is modified to shift their volume of vision to exactly match their parameters.
Other designs factor in whether the patient is right or left-handed. Optical company OSA, which is part of the Essilor group, does this with its Intuitiv lens.
Unprecedented patient interest
Rodenstock Australia national sales and professional services manager MS NICOLA PEAPER believes two aspects have greatly improved progressive lens comfortability and usability.
The incorporation of frame parameters to reduce the effect of aberrations and calculating compensations for the way an eye moves across the lens – giving a larger usable area – have made a difference in Rodenstock’s lenses.
Peaper says the company is now the only manufacturer that can build a different distance and near cylinder power and axis into a progressive lens design. “The value to the patient is near vision will be incredibly sharp and the full corridor width usable.”
In addition to its lens designs, Rodenstock has developed the DNEye Scanner 2 device, which itself is indicative of how far lens companies are prepared to invest in progressive lens technology.
“Lens manufacturers have been looking for ways to compensate for higher order aberrations (HOA) for some time and different solutions have been offered,” Peaper says. “Rodenstock can measure the HOAs of the individual patient and are the first to incorporate this in a lens that is also calculated using eye length,” she says.
The DNEye Scanner 2 offers topography, pachymetry, aberrometry, tonometry and pupil size readings. The measurements can then be incorporated into Rodenstock’s Multigressiv and Impression level lens designs.
Reports produced by the device can show patients the effect of HOAs that haven’t been compensated for, and how compensation will improve their vision. This also gives the practitioner the advantage of visual demonstrations to show why lenses may be superior to competing products.
“This is the first time I, personally, have seen patient interest in what they are experiencing. Patients have called the laboratory to find out where they can access this technology,” Peaper adds.
“We hear from our customers that they have patients travelling 400 to 500km to purchase a pair of spectacles, and it is commonplace for all family members to come in for a pair.”
Rising above the corporates
Hoya Lens Australia national training and development manager MR ULLI HENTSCHEL lays patient satisfaction is one of the most important qualities premium lenses can bring to a practice.
It’s no secret the technology built into premium progressives has made the lenses far more capable. But what use would it be if eyecare professionals couldn’t translate this into positive outcomes?
“This segment is one area that the independent practitioners can really have to their own, because a premium, really high-end progressive lens takes more time and skill to dispense,” Hentschel explains.
“This demonstrates to the patient that they have a much deeper understanding of lenses and the patient’s lifestyle needs which, in turn, positions them in a league above their corporate counterparts.
“We find practices that get on board with these high-end products have such great feedback from patients and get much better word-of-mouth referrals. It is one of the most important segments of the independent lens business, and it’s one of the most profitable as well.”
Hoya’s top premium product is the MyStyle V+. Aside from incorporating the full range of parameters, the lens design factors in the patient’s lifestyle and even their experience with previous lenses.
Hentschel says Hoya has also achieved success with its MyStyle Profile range, a derivative of the MyStyle V+. Launched in 2018, MyStyle Profile comprises five pre-defined designs that are specially customised to different wearers’ common visual requirements for far, intermediate and near vision.
“It has been one of the more successful product launches we have had,” he says.
“The feedback has told us that it’s easier for eyecare professionals to grasp and explain to the consumer, while still giving that level of customisation they haven’t been able to achieve in the past. The patients are really understanding the differences between the lifestyle-based designs and that is often the most difficult aspect to overcome.”
Hentschel says both MyStyle V+ and Mystyle Profile include patented technology that considers the right and left prescription as individual components when calculating the required binocular lens design. This improves depth perception and provides comfortable binocular vision.
Visual age
Shamir’s academy training manager MR DAVID SULLIVAN says the company’s lens has been developed on the back of big data analysis that has proven a patient’s visual behaviour changes in relation to their ‘visual age’.
Shamir’s premium progressive, the Autograph Intelligence Lens, takes a different approach by looking at a patient’s ‘visual age’.
The visual age is a term referring to the physiological age of the eye (the required reading power) and is generally correlated with the patient’s chronological age. As such, it has developed 12 integrated designs (additions) for each ‘visual age. “New technologies recently developed by Shamir has allowed us to design a lens with four visual zones integrated together – driving, computer, smartphone/tablet and printed reading material,” Sullivan says.
“Visual behaviour is a new direction taken by Shamir. Research conducted by Shamir on 1300 participants looking at their prescriptions, visual habits and vision preferences, put their needs into groups and percentages, allowing us to design a customised lens for every individual lens produced.”
Shamir research also discovered wearers visually switched distances more than 300 times per day.
“All additions and patients will benefit from this technology, designed to automatically adapt to a patient’s visual need, whilst offering crystal clear vision unique to the individual.”
Going beyond for patients
Robinson, from RMIT, is frequently surprised by the advances lens companies can incorporate into their designs and associated devices. He says eyecare professionals have an obligation to themselves, as well as their patients, to harness such technology.
“Today’s shoppers want to know how you can improve their life, they don’t understand or care about the technology. Can their life be improved? Can you give them something that they can brag to their friends about?
“Unfortunately, what’s happened over the years is that a lot of professionals have developed the attitude that this patient has become used to this brand, let’s save any complications and give it to them again. So the patient walks out with a new pair of glasses with technology that is about 10 to 15-years-old, rather than advised into these newer products.
“It takes a lot more work to sell the new product, and it’s going to be more expensive, but sell the benefits of it. We have a moral obligation to offer the very best that is out there for our patients.”
To overcome this, he says individual optical dispensers and optometrists need to upskill and familiarise themselves with the available products. This could be achieved by aligning themselves with manufacturing companies and attending professional development programs built around specific products.
Companies are also working hard to ensure eyecare professionals remain on top of technological advances.
Zeiss, like other lens manufacturers, supports eyecare professionals with regular visits from its business development representatives.
Ms Elmarie Pretorius, Zeiss Australia’s clinical support and training manager, says with the average age of Australians falling within the progressive lens range, it is an important category for the company.
“Zeiss allows eyecare professionals to differentiate themselves by offering their customers a trusted branded product from the leaders in optics, and therefore they can be rest assured that their customers are getting the best optical solutions,” Pretorius says.
“This grows their reputation and revenue. Zeiss also offer state-of-the-art equipment as part of our partnership with our eyecare professionals that assists them to do the best eye examination, and gain all the information they need with digital centration so that it is easy to order their premium progressive lenses.”
The visual cortex, and more
Optical companies expect there to be increased use of the frame parameters among eyecare professionals, while increased computer power will likely lead to even more complex and accurate lenses.
While there have been great leaps in science and lens development in recent years, Rodenstock’s Australia and New Zealand general manager Mr Tim McCann believes optical industry has some way to go to before meeting every patient need.
“There is a lot involved in making great specs. The physics of light and restrictions of the materials and environment are the areas that are most often associated with lens design,” he says.
“As science develops we are now able to account in part for the physiology of the eye more than before – and then there is a visual cortex which is largely completely unknown and a huge field of future research.”
McCann says the more that can be measured in the eye, the more lens companies can do to develop highly personalised lenses now and into
the future.
“Harnessing technology to its fulness allows us to continue expanding our research and understanding of the visual system and providing solutions,” he says.
“It is exciting and important to note that we stand only at the doorway of how much there is to know about each patient and their needs