Literatur Review

PROGRESSIVE LENS

MEIRONI WAIMIR

Refraction, Contact Lens and Low Vision Sub Division

Department of Ophthalmology
Medical Faculty of Andalas University/ DR. M. Djamil Hospital
Padang
2019
 INTRODUCTION
Progressive Addition Lens /PAL

A corrective lens used in eyeglasses to correct

presbyopia and other disorders of accommodation

 Characterized by a gradient of increasing the lens power

 added to the glasses.
 Power gradually increasing from the distance zone, through a
progressive zone to the near zone.
 INTRODUCTION
1953
Bernard
Maitenaz,
patented Varilux
and introduced
1983
in 1959 by
Essilor Carl Zeiss AG
developed free-form
1972 technology and has
1907
Maitenaz created a been patented
first
truly aspherical
patented by
design and
Owen Aves
1922 manufacturing
Duke Elder process (Varilux 2)
developed the
world's first
commercially
PAL
 DESIGN AND CHARACTERISTICS OF
PROGRESSIVE LENS

 Progressive lens  a type of multifocal lens that has a

surface with a continuous smooth increase in addition (plus)
power.
 Gradual increase in power  intermediate zone
 DESIGN AND CHARACTERISTICS OF
PROGRESSIVE LENS

Gradual increase in
curvature

Produces a corridor
that progressively
increasing plus power

Variable focus
intermediate zone

All three zones are enclosed on both sides by blending regions and
geometric distortions
 DESIGN AND CHARACTERISTICS OF
PROGRESSIVE LENS
• Bifocal Lens
Has two fixed focus vision zones, separated by visible
discontinuity  image jump
Intermediate vision is often limited

• Progressive Lens
Provide the desired add power without any breaks, ledges or
lines by blending the transition between the distance and near
zones.
The transition  very smooth enough to prevent sudden
changes in image jump.
 EARLY PROGRESSIVE LENS DESIGN

• Owen Aves (1907)  dual surface progressive lens design

section of a cone on one side and elliptic cylinder on the other.
• The progressive region of the surface can be represented by
circular cross section that gradually decrease in diameter,
thereby increasing in curvature  Elephant’s trunk.
Progressive Lens Structure
 CHARACTERIZING PROGRESSIVE LENS

• In the blending region there is a contour plot that shows the optical
quantity levels of the lens.
• Progressive lenses have an astigmat plot like finger print  useful
for evaluating the strength distribution of additions.
 CHARACTERIZING PROGRESSIVE LENS

Minkwitz’s Theorem

The rate of change in cylinder power away from the progressive

corridor increases as the length of the progressive corridor
decreases

The rate of change in cylinder power away from the progressive

corridor increases as the Add power of the lens increases
 DISTRIBUTION OF SURFACE OPTICS

Wide distance and reading zones Reduced distance and reading zones
Narrow intermediate zones Wider intermediate zone
Close spacing of contour lines Wide spacing of contour lines
 ADVANTAGES OF PROGRESSIVE LENS

• Progressive lenses provide the correction that presbyopia

patients need to see clearly at all viewing distances.
 ADVANTAGES OF PROGRESSIVE LENS

• Comfortable intermediate vision

Using the distance vision Using the near vision Using the intermediate
portion of a bifocal segment of a bifocal portion of a progressive
 ADVANTAGES OF PROGRESSIVE LENS

• Progressive lens avoid discontinuities (image jumps) that are

found with bifocal and trifocal lenses.

In PAL, an uninterrupted curves links distance vision, intermediate

vision, and near vision with no visible separation

• More cosmetically attractive  no line of damarcation

DISADVANTAGES OF PROGRESSIVE LENS

Fitting

Peripheral
Cost
Distortion

Disadvantages PAL
The Best Candidates for PAL are :
• Patients with early presbyopia who have not previously worn
bifocal lenses.
• Patients who do not require wide near-vision fields.
• Highly motivated patients.

Patients who change from conventional multifocal lenses to PAL

should be advised that distortion will be present and adaptation will
be necessary.
 PROGRESSIVE LENS FITTING

• Lens manufacturers now offer PAL  more compact, smaller,

more fashionable frames and still get the full effect from the
lens.
• The main difference between lenses is the width of the central
corridor.

• Wider intermediate area  the patient who works on the

computer.
• Wider reading area  the patient who spends a significant
amount of time reading.
 PROGRESSIVE LENS FITTING

Additional information that will assist in selecting progressive lens

that will provide the best possible vision, including:
 Patient’s prescription
 Patient's occupation
 Leisure time activities

All information collected will help in choosing the right design.

 PROGRESSIVE LENS FITTING

Step 1. Frame Selection

• Frames accomodate the lenses, fit comfortably, suit the patient’s face
shape, and be stylist.
• Check the frame before taking any measurements.
• Vertex distance (12-14 mm), face form, and pantoscopic tilt 8-12
degrees.
 PROGRESSIVE LENS FITTING

Step 2. Frame Measurements

• Place properly adjusted frame on patient

• Mark each lens at the pupil center with a
felt-tip marker.
• Draw a horizontal line on each lens
• Check to see that the lines are at the center
of each pupil.
• Measure fitting height from the deepest
point of the lenses to the pupil center.
 PROGRESSIVE LENS FITTING

Step 3. Pupillary Distance (PD) Measurement

• Take monocular PD measurements.
• Use a corneal reflex pupillometer to ensure exact measurement
of center pupil.
• Take PD measurement for infinity and near and record the
measurement
 PROGRESSIVE LENS FITTING

Step 4. Check Lens Cut Out

• Use the card provided by the progressive manufacture to check
lenses.
• Use the patient’s fitting height and distance PD measurements.
• Place lens cross over the layout chart to verify the lens will fit in
the frame.
• If it does not fit, select another frame.
 PROGRESSIVE LENS FITTING

Patient Education - Adaptation

• Always wear progressive glasses during activities.

• To see an object on the side, turn your head, don't glance
because it will cause visual distortion.
• Do not look at the edges of the lens because these are
distortion areas on the progressive lens.
• If you cannot adapt yet, it is not recommended to ride
using progressive glasses.
• Move the eyes when looking at objects or text above and
below.
 CONCLUSION

Progressive lenses are eyeglass lenses that ideal for presbyopia

because providing a continuous increase in the plus power focus
to compensate lack of accommodation. The progressive lens
allows clear vision for distance, intermediate and near zone
where dioptric power gradually increases along the lens surface
from the top to the bottom.
 CONCLUSION

Progressive lens provides comfortable intermediate vision,

avoid image jumps, and more cosmetically attractive. The
disadvantages of progressive lens are there is peripheral
distortion, requires fitting, and more expensive than other
multifocal lenses.

Progressive lens fittings is important to get the best vision and

patient comfort in using progressive lens glasses.
Thank You