Despite ever improving progressive spectacle lens designs – with easier adaption, less distortion, wider fields of vision and a broad range of designs and coatings – there are still many patients that benefit from prescription vocational lenses, be they in spectacle or contact lens form.
The perfect candidates for prescription vocational lenses are early presbyopes or low hyperopes. These people do not usually require full-time spectacles but have trouble seeing ‘up close’ and suffer from resultant asthenopia. They may have already tried standard or ready-made reading glasses but found the range of vision limited, their distance acuity too blurry, or reported they disliked the ageing effect of half eyes. Yet you know that it’s still too early to push them into full progressives – doing so may cause difficulty adapting, distortion or a narrow field of view.
I encourage you to take time to discuss vision needs with every patient
For these patients, a ‘simple’ degressive style vocational or occupational lens will work wonders. For many, the increased range provided by mildly progressive ‘office-style’ lenses may also be of benefit.
Other patients who are ideal for vocational lenses are computer users; especially those with three, four or six large screens, spread laterally and vertically. For these patients, a full progressive lens is likely to cause frustration, neck problems and a lot of head movement as they try to find the sweet spot for each screen. Instead, a vocational design with a low shift and resultant wide field that covers their required near range of vision – sometimes in the 35 to 80cm range but more typically in the 40cm to 70cm range – will be ideal. Cases like these may also benefit from a little bit of extra plus in the top section of the lens to enhance viewing of a superior row of display monitors, which usually have a slightly longer viewing distance than normally positioned screens. Tweaking the distance and near prescriptions to suit posture, working distance and environmental requirements can be a game changer. A mild compromise in distance acuity is rarely an issue.
Similarly, we can use contact lenses to fine-tune reading in print or on screens, via simultaneous-vision blended multifocals, concentric rings and extended depth of focus (EDOF) designs. Typical multifocal contact lenses are concentric in design, which means that head movements are not required to find the sweet spot for near vision. Some are specifically designed to relieve asthenopia by easing the accommodative burden via ‘digital zone optics’.
With contact lenses we can also use monovision/blended vision to set up one eye to cover the reading/computer range.
Single-vision contact lenses can also be useful for some professions. Consider for instance, microscope users who prefer the wider field of vision provided with contact lenses, as opposed to using spectacles for microscopy.
Office workers requiring general purpose progressive lenses for distance and near will usually benefit from a customised second pair of vocational lenses to maximise computer vision and minimise issues such as cervicalgia, which results from unnecessarily lifting the chin to see at near.
Those who work from home may also benefit from vocational lenses that help them cope with a range of visual needs, from Zoom meetings, to webinars, spreadsheets, email etc., all of course, while watching TV. An ‘office’ type lens, covering 40cm to 3m will usually do the trick.
TIPS FOR SUCCESS
Knowing what to prescribe and for who is part of the art and science of optometry. These skills come with experience but there are many tips and tricks that can ease the decision making process and improve outcomes. Like many aspects of our profession, communication is a critical cornerstone in the pathway to prescribing the ideal lens design. A thorough case history is a starting point, including questions about hobbies, vocational needs and limitations, asthenopia, postural issues, lighting and so on. Beyond this, are discussions between the practitioner and dispenser at hand over, and when walking the patient through their options. Having a great rapport with key lens suppliers is also essential as they can offer guidance on the best vocational lens design to meet specific requirements.
Work with your suppliers and arrange hands on staff training, or use Zoom sessions, tutorials, product documentation and videos to get your staff on board with understanding and prescribing the best design for the job at hand.
HOW LONG IS A PIECE OF STRING?
A surgeon in theatre might need to see monitors at varying heights and distances, as well as fine detail at the site of the surgery. A stockbroker may be constantly checking six monitors in one plane. Electricians, nurses, teachers and hairdressers etc., also demand carefully considered prescribing and specific lens designs.
To help determine the best lens for your patient, ask them to estimate the distance they hold their phone or a book to read – and measure it with a tape measure. You will usually get reasonably accurate measurements of working distances to aid your lens choice. When practising, I used a retractable tape measure to determine and record the working distances of every patient. That said, such estimates are less reliable when the object of regard is not hand held. Patients can, for instance, make significant errors in estimating the distance of a computer monitor. To that end you can ask patients to attend a consultation having used a tape measure to measure these distances. Or, simply get them to use a piece of string. Holding one end at their nose bridge, get them to tie knots at the positions of their screen, document, keyboard and other things they need to see within their workspace.
TAKE THE CHALLENGE
Some of my most challenging spectacle patients included newly-presbyopic, highly irritated surgeons, lawyers, engineers and stockbrokers, who’d been prescribed full progressives that drove them mad. Putting them into the ideal vocational lens design turned them into happy, loyal patients, who provided valuable repeat business and became great sources of referral.
I encourage you to take time to discuss vision needs with every patient, and when appropriate, recommend vocational lenses. You’ll probably be happy with how many conversions you make. Your patients, in turn, will be delighted with the benefits of reduced asthenopia, greater flexibility and improved vision. Referrals will follow.
Check out the multitude of vocational lens options in the following product section. There’s something for everyone.
Wishing you a prosperous and safe 2021.
I’m sure we’re all happy to have closed the door on 2020.
Spectacle Lenses for Professionals
Surfacing offers two office lens designs in the Perfection Series. The Task and Device lenses are perfect for today’s busy work environments and are specifically created for maximum field of view for near and intermediate distances.
Task lenses are optimised for up to four meters distance, making them an excellent companion in office and boardroom environments. Device lenses have a working distance up to two meters, giving an even wider field of view for working on digital devices or multiple screens.
According to CR Surfacing, these lenses incorporate the most advanced freeform design, state-of-the-art technologies and latest equipment to provide unparalleled visual performance.
Contact: CR Surfacing (AUS) 03 8795 9111
Research shows that 43% of employees use screens for prolonged periods during the work day.1 This demands more from our near and mid-distance vision.
OSA EasyWork lenses offer a choice of styles that give convenience and visual comfort for all working conditions. They are available in two distance options; EasyWork Mid and EasyWork Long.
Contact: OSA Account Manager
1. DigitalEyezed Study by Vision Source.
Varilux Digitime’s modern ergonomic design precisely focuses near and intermediate task distances. Simply provide Essilor with your patient’s working distance and Varilux Digitime’s power shift is calculated to place the correct intermediate power right in front of the patient’s pupil.
Choose from three options:
- Digitime Near is ideal for smartphones,near and computer use,
- Digitime Mid is designed for computeruse, around the desk and near, and
- Digitime Room is designed for tasks outto two metres, the computer and near.
Available with Essilor’s blue filter technologies; Smart Blue filter and Crizal Prevencia coating.
Contact: Essilor Account Manager
Essilor Interview provides the freedom of seamless near and intermediate vision with a natural posture, and in some cases, offers clear vision up to two metres – enough to cover most intermediate tasks.
Designed to meet the needs of young presbyopes and patients in readers, Essilor Interview is available in two shifts: 0.80D and 1.30D; three materials: 1.5, 1.59 and 1.6; and with all Crizal coatings, including Crizal Prevencia for patients wanting the added contrast of a blue filter.
Contact: Essilor Account Manager
Sync III is designed with a near boost in the lower portion of the lens to relieve symptoms of digital eye strain among children and young adults through to pre-presbyopes.
These lenses incorporate Hoya’s advanced patented Binocular Eye model, and offer the option for individual fitting parameters, three boost zone options, and a wide range of materials including polarised.
Worsktyle V+ for presbyopes, with iD Workstyle V + Space, Screen and Close can be customised to meet each patient’s working conditions.
This lens design uses Hoya’s patented Binocular Hamonization Technology to perform individual calculations, ensuring the correction is appropriate at each point of the lens and exactly measured according to the needs of each eye. Even people with mild cases of anisometropia can benefit from binocular harmonisation due to so much near demand on the visual system in today’s screen-based society.
Hoya’s new Sensity 2 Light Reactive and Diamond Finish Bluecontrol coatings, combined with these advanced lens designs, provide a solution for all age groups to reduce digital eyestrain and mitigate the effects of blue light.
Contact: Hoya Account Manager
Opticare’s ClearPro Office is designed for patients who need customised glasses for use in office environments.
ClearPro Choice is supported by Opticare’s Office Range Selector, a tool that will give you complete confidence when prescribing the Office Rx.
To prescribe, simply visit www.opticare. com.au and click on ‘office range selector’ on the right menu panel. Enter the patient’s ADD, then select the range the patient needs. The clear visual zone will display, and the shift will be calculated for the selected range. When you enter the patient’s distance sphere power, it then calculates the range and Rx at pupil centre, so you can use trial lenses to verify the lens with your patient before ordering.
Contact: Opticare (AUS) 1800 251 852
Rodenstock Ergo lenses
Work places are demanding on your patients’ eyes – the constant need for them to focus on monitors, desks and colleagues at different distances means a single vision lens will not suffice. Subconscious changes made to posture have to be compensated for, and often result in pain that is difficult to locate. Rodenstock Ergo computer lenses provide relief from stressed eyes, which also helps ease tense neck and shoulder muscles.
Choose from three variations:
- Ergo Book is ideal for short distancevision from 40 to 60cm, and allows upto 1m with vertical movements of gaze. Perfect for laptop computers and tablets,
- Ergo PC gives the widest area of clearvision at a medium distance up toapproximately 1.20m, and allows a monitor to be seen in total clarity and without strain with an ergonomic head and body posture, and
- Ergo Room allows for relaxed vision freefrom fatigue indoors with comfortablevision zones from the reading area up to four to five metres.
When prescribed in combination with Solitaire Protect Balance 2 coating to reduce exposure to artificial blue light, Rodenstock Ergo lenses will give your patient increased visual comfort and may balance sleep wake cycles. These lenses are now available with DNEye PRO for the clearest vision and contrast to help alleviate tired eyes.
Contact: Rodenstock Account Manager
Zeiss Office Lens Portfolio
General-purpose progressive lenses are not designed to offer optimal visual acuity in an office environment.
Zeiss Office lenses are designed to provide your patients with strain-free, clear vision when using computer screens and can be tailored to their needs. Zeiss Office lens designs are available with three ‘Maximum Intermediate Distances’ (M.I.D.):
- The Book design acts like an enhancedreader and provides clear vision to amaximum distance of 100cm,
- The Near design provides up to 200cmvision, and
- The Room design provides up to400cm vision.
For further customisation, select Zeiss Office lens Individual design.
Contact: Zeiss Account Manager
Shamir has an occupational lens that’s designed for every task.
Choose from the following four options:
Shamir Vocational Digital is the latest release in the Shamir occupational range. This affordable, fully digitised freeform enhanced reading lens is available in three degressive shifts: 0.75, 1.25 and 1.75, and a range of materials and indexes including Transitions and Blue Zero.
FULL SCOPE OCCUPATIONAL
Shamir Smart Office is a personalised digital freeform occupational lens that provides flexible focus through multiple viewing zones. When using fitting techniques available with this design, Shamir’s Smart Office lens provides excellent vision including reading, intermediate and even distance. Many potential wearers don’t like distance blur and this lens solves that problem.
The Shamir Workspace and Shamir Computer lenses derive from the Smart Office lens. Workspace provides perfect near and intermediate vision and up to three metres of distance vision. Computer lenses provide excellent vision for close tasks or mid-distance viewing, as well as up to 1.5m of distance vision.
Shamir Digital Relax is also available in three viewing shifts of 0.50, 0.65 and 0.80. Suitable for any close working environment, this lens design reduces digital eye strain and fatigue associated with prolonged intermediate and near vision tasks. This is an effective solution when combined with Shamir Blue Zero.
Contact: Shamir Account Manager
Unity Via OfficePro Lenses
Unity Via OfficePro is a workplace lens designed around the breakthrough Unity Via technology that made progressives easy to fit, customise, and dispense. This taskoriented lens is easy for you to prescribe and effortless for your patients. Unity Via OfficePro takes the guesswork out of computer lenses and ensures the monitor stays in the visual sweet spot without any extra measurements. A streamlined portfolio of two working distances (1.5m and 3m) makes it easy to match lens choice with each patient’s workplace needs.
Contact: VSP Optics (AUS) 1800 251 025
Contact Lenses for Professionals
Contact lens wearers’ lives and eyes are constantly moving between on-screen and off-screen activities. They need innovative lenses that help their eyes feel less tired, while seamlessly shifting focus from their digital devices to their everyday activities and back.
Featuring Digital Zone Optics lens design, Biofinity Energys is ideal for:
- All existing and potential wearers ofspherical monthly and two-weekly lenses,
- Patients who are highly connected totheir smartphone, and
- Patients who spend a large part of theirday looking at a computer screen.
Contact: CooperVision Account Manager
SEED 1dayPure EDOF
SEED 1dayPure EDOF optics are primarily designed for presbyopia management, but there are other potential uses. For example, the EDOF Low design can be useful for patients who suffer from visual stress.
One benefit of this design is the reduction of vergence and thus phorias. Indeed, Gong et al1 have shown that phorias in children are pushed into the exophoric direction using multifocal contact lenses, while Kajita et al2 have shown that accommodative micro-fluctuations are reduced by wearing multifocals with a low addition.
The use of plano EDOF Low design can be useful for emmetropes suffering from accommodative stress due to excessive close work. Relaxing the vergence system can improve reading speed and reduce issues of refocusing from near to far.
Contact: SEED Contact Lens ANZ (AUS) 1300 373 718
- Gong et al. Accommodation and phoria in children wearing multifocal contact lenses. Optom. Vis. Sci. 2017;94(3):353-360. doi:10.1097/OPX.0000000000001044
- Kajita et al. Changes in accommodative micro-fluctuations after wearing contact lenses of different optical designs. Cont Lens Anterior Eye. 2020;43(5):493-496. doi:10.1016/j.clae.2020.03.003
Acuvue Oasys 1-Day
If your patients’ eyes feel tired from staring at digital devices or working in challenging environments, Acuvue Oasys 1-Day with HydraLuxe Technology daily contact lenses can help.1
Acuvue Oasys 1-Day has tear-like properties that work with the natural tear film. Wearers experience all-day comfort, vision, and easier handling thanks to J&J’s exclusive HydraLuxe Technology.2
Acuvue Oasys 1-Day has the highest level of UV protection*^ available in a daily contact lens. Also available for astigmatism.
Contact: Johnson & Johnson Account Manager
1 JJV Data on File 2020. ACUVUE OASYS Family Digital Device Claims.
2 JJV Data on File 2016. HydraLuxe Technology Definition
*Helps protect against transmission of harmful UV radiation to the cornea and into the eye.
^WARNING: UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV- absorbing goggles or sunglasses because they do not completely cover the eye and surrounding area. You should continue to use UV-absorbing eyewear as directed. NOTE: Long-term exposure to UV radiation is one of the risk factors associated with cataracts. Exposure is based on a number of factors such as environmental conditions (altitude, geography, cloud cover) and personal factors (extent and nature of outdoor activities). UV-blocking contact lenses help provide protection against harmful UV radiation. However, clinical studies have not been done to demonstrate that wearing UV-blocking contact lenses reduces the risk of developing cataracts or other eye disorders. Consult your eye care practitioner for more information.
NaturalVue Multifocal 1 Day Contact Lenses
NaturalVue Multifocal 1 Day contact lenses with innovative neurofocus optics for myopia control is a centre distance design with patented extended depth of focus (EDOF) optics.
The EDOF design works naturally with the brain to produce a continuous range of clear vision and stereopsis comparable to spectacle wear with an effective add up to +3.00DS.
Available in 0.25D steps from +4.00 to -12.25Ds, the design has a rapid, continuous and uninterrupted progression in plus power from the centre of the lens through the optic zone. This creates a virtual aperture1 with relative plus in the periphery, and is clinically proven to slow the progression of myopia.2
Contact: Contact Lens Centre Australia (AUS) 03 9543 1811
- VTI Data on file, 2015. N=59. Data assessed after 1 week of wear. Preference based on those who expressed a preference among brands tested.
- Cooper J, Oʼconnor B, Watanabe R, et al. Case Series Analysis of Myopic Progression Control with a Unique Extended Depth of Focus Multifocal Contact Lens. Eye & Contact Lens: Science & Clinical Practice. 2017;44(5): e16-e24.