PALs
PAL Problems? Ask Your Lab
This OLA-sponsored feature addresses how to work with your labs to make sure you�re using the appropriate PAL for each individual patient�s needs
By Alex Yoho, ABOM

In the past few years our industry has finally begun to realize that progressive addition lenses are indeed the way of the future. When the economy wavers, and managed care squeezes another drop of profit, things can get pretty tight. As one version of the old saying goes, �The best defense is a good offense,� and a proactive approach to progressive addition lens sales is about as good a hedge as you will find these days to cushion the rough times.

The best part is that our customers are generally accepting the idea of progressive addition lenses as the popular solution to presbyopia. They are depending upon you to select the best design for their needs, so of course you�re expected to be the resident expert on all the more than 100 progressives currently on the market. Can you do that? Only if you�re superhuman!

So how do you gear up to provide the very best for your patients? As is often the case, your lab can really shine in this area. Start by asking your lab to supply you with the latest literature from the lens manufacturers that they handle.  Most manufacturers have great point-of-purchase displays that can help you convey the benefits of a particular progressive to the patient. Your lab more than likely has this and other literature to make this daunting task easier than ever. You�ll need availability charts, since many progressives can be ordered in different materials and colors. Often the lab�s price list will indicate availability of a particular brand of progressive with the correct options for your patient.

Selecting a PAL

With so many progressives available, a lab�s sales often break down into somewhere around 10 top sellers and maybe a few specialty-type progressives. So when you ask an individual at the lab which one to use, you are asking for an answer from experience.

A popular method for choosing the right progressive at your lab�s disposal is knowing the current best selling lens in any given category. As labs move into the realm of remote ordering software, their accounts are offered drop-down menus of progressives to choose from that change according to the lab�s sales at any given time. That can be of value, but there are some aspects of this method that might preclude using an alternative that could be a good choice for this patient.

Nonetheless, this method of lens selection is probably a good starting place if you are just beginning. But pay very close attention to how your patients respond. And make sure you review the material describing the design benefits of the several bestsellers. It�s always wise to have options.

An old proverb states �Those who do not learn from the mistakes of history are doomed to repeat them.�  This is perhaps the greatest wealth of information a lab has available. Even though progressive addition lenses have fewer and fewer failures, the lab sees them all. This puts the lab in a very unique position to help you troubleshoot frustrating problems.

Three Categories of PALs

There are, generally speaking, three categories of progressives on the market today. General-use progressives would be the vast majority, while the newer short-corridor types are very popular with small frame styles. Lenses designed specifically for the workplace are also gaining in recognition. All have their advantages, but offering them without considering their unique design traits can be problematic, to say the least.

For example, an account had been having great success with the relatively new short-corridor progressives and was using them quite regularly. Recently, the dispenser encountered a patient who was fit with a second pair using exactly the same lens style, but the frame was considerably larger. The patient was very frustrated by the performance, but upon analysis everything checked out exactly like the first pair. At the lab�s recommendation, the second pair of lenses was re-edged to fit a smaller frame, and the patient was very satisfied.

The lab looked at previous jobs and learned that this situation had occurred several times, and took steps to alleviate the problem in future orders. Labs, in partnership with the lens manufacturer, often offer opportunities to make the best of difficult situations.

Progressive remake policies have been established to assist dispensers in trying lenses for different patient needs. These current policies can turn the situation around as well as provide a tremendous learning opportunity. It�s not just the disappointments that are valuable, though. Lab customer service people are also apprised of success stories. You can benefit from this collection of positive experiences by simply asking what others have done in a particular situation.

For example, if you had a patient who was doing well with their current progressive style, with the exception of the times when they spent long hours doing something like pouring over blueprints and correcting them on a computer screen, what would you do? Common sense, as well as a recommendation from your lab, would suggest that you present the patient one of the intermediate intensive progressive styles designed especially for the unique demands of office space.

	PROPS COURTESY OF HILCO AND WESTERN OPTICAL SUPPLY

Converting Bifocal Wearers 

So what would you do if you had a patient who had worn an executive bifocal for years, and every time the prescription changed he or she had problems with base curve sensitivity or optical center height and was now insisting that you fit them with a progressive lens? If you�re a little uncomfortable with a scenario like this, you might want to give the lab a call just to be sure you have every advantage.  I recently encountered this situation, and we decided to use one of the power-compensated designs that takes into account how the lenses are positioned before the eye. At first blush this seemed like it could be pretty risky since the base curves would certainly be different and, of course, he might miss his executive, but it worked out fine.

One time while doing my daily troubleshooting at the lab, I made a call to an account that had ordered a short corridor-type progressive and the frame was much too large to allow it to cut out the lens shape. As we were discussing the dilemma, they told me they were having such good success with the lens that they had been recommending it all the time. I explained that this lens was designed for small frames that would take advantage of the shorter corridor and consequently there was no need for the factory to offer it in a large blank size. Since the patient�s goal was just an everyday pair of eyewear, we decided to use a design that has a relatively standard corridor length. The patient had several task-specific pairs and wanted to save a little money, so we opted for one that had been available for a long time and was tried and true.

Another service your lab offers is puzzle solving. Perhaps you have experienced the frustration of designing the ultimate pair of eyewear for your patient and suddenly realized that the progressive addition lens you selected is not made in a 1.66 index photochromic.  A quick call to the lab will help you bring as many of the desired features together as possible to help avoid embarrassing call-backs.

With all the progressive addition lenses on the market, and all the configurations for each of those styles, your lab is the most valuable resource at your service.  Bringing all those pieces of the puzzle together is one of the things your lab does best.  They are excited about progressives and the business building opportunities PALs provide. So �which progressive addition lens is the best?� It�s the one that brings together the best features you have to offer, and with your lab as a partner, the possibilities for patient satisfaction and business growth are enormous.