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By Andrew Karp,
Group Editor, Lenses and Technology

NEW YORK--Just a few years ago, the subject of digitally surfaced PALs--progressive addition lenses--would have drawn a blank look from most U.S. eye doctors and dispensers. Although Japanese and European eyeglass wearers have been wearing these technologically advanced lenses--also known as free-form or direct surfaced--for as long as a decade, few if any American eyecare professionals had direct experience with them. Lack of production and distribution as well as patent confusion had limited their availability here.

However, over the past 18 months, the situation has changed considerably. Major PAL manufacturers have expanded domestic production capacity through their own facilities as well as those of their partner labs. Additionally, manufacturers and labs have significantly boosted their sales and marketing efforts. Most offer seminars to educate ECPs about the benefits of digital PALs, and some are reaching out to consumers as well.

   
Neil Sika, OD Harry Snyder, OD
   
Donna Troutwine Doug Clark, OD
Although the U.S. market for digital PALs is growing, suppliers estimate that sales of the lenses--which retail from an estimated $400 to $700--currently comprise only 5 percent to 10 percent of the entire U.S. PAL market. Yet most suppliers predict the market will grow steadily over the next few years as excitement about digital PALs continues to build among both ECPs and eyeglass wearers.

In general, digital PALs deliver clearer vision than conventional PALs because they make more effective use of the lens surfaces. Some feature full backside designs, while others feature frontside designs or combinations of front- and backside designs. The most advanced digital PALs are customized according to individual patient measurements and, in some cases, facial form and frame style as well. Based on these selling points, digital PALs are becoming some of the hottest and most profitable products in the optical dispensary.

Top Performers
“These lenses are the future,” asserted Dr. Neil Sika, OD, a solo private practitioner in Strongsville, Ohio. “Part of the attributes of the old type of PALs was distortion and the narrowness of the corridor. With those lenses, you may not get the width of range in terms of reading in the middle. Free-form technology can get rid of most of the abberations, which makes the lens easier to adapt to. That’s a strong point.”

Because of such high-performance characteristics, digital PALs appeal most to doctors and dispensers whose patients want the latest, most technically advanced lenses. The lenses offer ECPs the opportunity to present something new and exciting to patients, while providing them with practice-building products.

“They’ve made a difference for our practice,” said Dr. Harry Snyder, OD of Northern Virginia Doctors of Optometry, in Falls Church, Va. “We have very few redos because the lenses are easier to adapt to. People say, ‘I tried progressives three or four years ago and didn’t like them,’ but I tell them it’s the same with a computer from three or four years ago. Things have improved a lot.”

As Dr. Sika noted, “These lenses give you another way of increasing your bottom line. They also separate you from the chains that might not carry them.”

While not all ECPs are sold on digital PALs, most have at least heard about them. New market research data from Jobson Research indicates that awareness of the lenses is high among ECPs. According to 20/20 magazine’s 2008 Premium Lens Study of Eyecare Practitioners, 79 percent of respondents said they are familiar with the term “digitally surfaced progressives,” versus 75 percent the previous year. Seventy five percent of respondents said they are aware of the term “free-form progressives,” compared with 70 percent in 2007, and 44 percent said they are aware of the term “direct surfaced progressives,” versus 38 percent the previous year.

Although awareness of digital PALs among ECPs is on the rise, it’s unclear to what extent ECPs understand and appreciate the benefits of the lenses. A plethora of new products has resulted in a potentially bewildering array of choices. Conflicting marketing messages from different lens suppliers, compounded by the lack of standard terminology for describing digital PALs is also confusing to many ECPs.

“Eyecare practitioners need to be more sophisticated in their understanding of progressives,” said Laurie Badone, senior manager, retail sales for Seiko Optical Products, who presents educational seminars about the Seiko Succeed Internal Free-Form and Pentax Perfas progressives, both of which feature proprietary backside designs. “There’s still a lot of confusion in the market about new technologies and what they represent.”

Bruno Salvadori, president of Signet Armorlite, which markets the Kodak Unique digital PAL, said lens suppliers need to explain to both labs and ECPs the advantages and disadvantages of various lens designs. “We need to, as an industry, come up with a glossary of terms and definitions,” he suggested.

Raanan Naftalovich, president of Shamir Insight, offers this definition of “Freeform,” a term which Shamir not only uses to market its Autograph line of progressives but has trademarked as well.

“The meaning of Freeform is you are starting every lens you do from scratch. You’re saying OK, here is my patient, here is his Rx, here is his frame, let’s see what I can do to give him the best optical solution. Everything is Freeform.

It’s like jazz. You don’t know how it’s going to end. If you choose two different frames and one is round the other is wrap-around, we’ll give you two different designs.”

A basic misunderstanding among ECPs concerns the difference between a digitally designed progressive and a digitally surfaced progressive.

“Some people assume that a lens is better if there’s a digital design behind it,” said Daniel Monaco, vice president of market innovation and retail marketing for Essilor of America. “But it’s really got to be a combination of the design and the calculation system behind it to optimize the design for the end user.”

Jean Marc Leroy, Essilor’s director of product management, PALs, added, “Design drives optical performance, and the technology will deliver it. It’s like with television. You can buy an HDTV tomorrow, but if you see an old black and white movie on it, it’s not going to be any better.”

The Three Tiers of PALs
Because marketing terminology varies from one manufacturer to another, comparing digital PALs can be difficult. However, most can be grouped into three distinct tiers based on performance characteristics, degree of personalization, and price.

At one end of the spectrum are lenses that are completely customized. These are typically the most expensive digital PALs, and currently account for the smallest share of market.

“When a personalized PAL is ordered, the dispenser provides the lab with much more information than is typically provided,” explained Mark Mattison-Shupnick, director of continuing education for the Jobson Optical Group. “That information consists of patient measurements that may come from an instrument, or it may be specific to the exact way it’s worn, the way the patient’s eyewear fits for distance, tilt and face form. This contrasts with the way the Rx was created in the exam room.” Examples of fully customized lenses include Varilux Ipseo, Zeiss Individual, Shamir Autograph, Indo Eyemade and Rodenstock Impression.

“Hoya iD Lifestyle, which has a standardized vertical front and a customized horizontal back, is also a personalized lens, although it’s somewhat in its own category,” Mattison-Shupnick added.

The middle tier of the digital PAL market consists of lenses that are modified or optimized to improve the Rx using a combination of back surface and/or front surface design.

“The back surface is modified to consider any unwanted front surface errors inherent in the design as well as the prescription, fitting characteristics and add power,” said Mattison-Shupnick. “The curves may be aspheric, atoric or a complex surface based on a variety of assumed patient characteristics, so the lens is not completely personalized.” Examples of this type include Varilux Physio 360º, Varilux Comfort 360º, Varilux Ellipse 360º, Definity, Definity Short, SOLA HDV, Pentax Perfas, Seiko Succeed, Shamir Autograph DLT, Hoyalux iD lifestyle, Signet Armorlite Kodak Unique and Rodenstock Multigressiv MyView.

At the opposite end of the spectrum are lenses that are delivered in a more traditional manner, such as semi-finished PALs with traditional sphere and cylinder backs and toric prescriptions.

“This category really has two parts,” noted Mattison-Shupnick. “It consists of new designs that are delivered from molds that have been created using the newest of digital technologies in design and the actual cutting of the surfaces.” Among the examples are Varilux Physio, Varilux Ellipse, SOLAOne, Zeiss GT2, Seiko Proceed and Shamir Creation.

“The other category is the library of lenses that have been on the market for years, made traditionally and have a good following among patients,” he continued. “Dispensers who recommend these lenses may have patients that are risk-adverse to switching to other PALs.” Examples include Varilux Comfort, SOLAMax, Shamir Genesis, Shamir Piccolo and Younger Image.

Dispensing Options
The increasing variety of lens designs and brands allows ECPs a wide range of options when prescribing and dispensing digital PALs, just as it does with conventional progressives. Clear preferences are developing among ODs and dispensers.

“We go with Varilux Physio and Physio 360º lenses,” said Dr. Snyder, noting that 40 percent of his patients wear progressives. “We’re big on the wavefront technology issue, so we explain to patients about higher order abberations. It’s kind of complicated, so we show them pictures of what the distortion looks like through an older lens compared to a digital lens.

“Patients tell me they see well with these lenses,” he added. “They have no issues with them. That saves a lot of chair time.”

At Pelham Eyecare in Pelham, Ala, the Zeiss GT2 is the digital PAL of choice for Dr. Doug Clark, OD. “Most of our patients simply say they like the lens,” said Dr. Clark, who owns the practice. “But 15 percent to 20 percent of them notice the clarity and sharpness of these higher definition lenses. They’re typically the engineers and type A’s who are very critical with their vision. The higher myopes and astigmatics will really notice a difference in their vision.”

Dr. Sika favors the Hoya iD lens, which he compared to “a custom Italian suit.” “Its front and back surfaces are customized based on your Rx,” he said.

“Some people are just happy to see a cat, but others want to see the whiskers on the cat,” said Dr. Sika. “It’s for the connoisseur who wants the best lens with the least distortion. If they’re that picky, they’ll notice the difference between iD and a normal PAL. That’s the Rolls Royce of the industry. You’re talking $700 for a pair of lenses.

“If you’re a patient that doesn’t have that ability to discern that, then you can spend $350 and get Hoya Lifestyle, and get some of the best features of iD without having to pay an additional $350.”

Hoya’s line of digital PALs utilizes what Barney Dougher, president of Hoya Vision Care North America called “trickle down technology.”

“I’ll make an analogy with race cars,” said Dougher. “As much as we’d all like to drive Ferraris, it’s not economically feasible for most of us. So why not provide some of the benefits that go with a premium, top-of-line car to some of the other products you offer?

“Race cars have brought more technology to cars in general,” he continued. “Look at Indy car racing. They’ve pioneered technology in braking, safety and fuel economy that has improved consumer cars.

“It’s the same with digital progressives,” explained Dougher. “The technology we use at the iD level, which is our Ferrari, is providing better vision all the way down to our single-vision lenses.”

Bullish on PALS
Although the market for customized, digital PALs is still small, some lens manufacturing executives are bullish about its growth potential. Steve Mitrakos, vice president of marketing, North America for Carl Zeiss Vision, sees these products as part of a broader consumer trend.

“There are a lot of signals in our culture that indicate consumers want a personalized experience,” Mitrakos pointed out. “Look at the Internet, consumer electronics and clothing. Consumers are open and receptive to that message. Eyeglass lenses are ripe for the same thing. And, if you tell the story about personalization, you move away from price points.”

Digital PAL manufacturers employ a variety of techniques to customize their lens designs to varying degrees. Typically, dispensers must supply their lab with individual patient measurements. These measurements, which may include monocular PD, vertex distance, pantoscopic tilt and frame wrap, are then fed into Rx calculation software to create a personalized lens design that is made at the lab.

For example, Rodenstock only requires the dispenser to take a monocular PD for its Multigressiv MyView digital PAL. “The calculation is optimized for that,” noted Dave Delle Donne, CEO of Optical Distribution Corp., Rodenstock’s exclusive U.S. distribution partner. Delle Donne said Rodenstock markets two digital PALs in Europe, Impression and Impression Freisign, that incorporate additional measurements.

“Impression is the next generation of Multigressiv MyView, the next level of personalization in free-form,” he explained. “Rodenstock takes four measurements for Impression: vertex, face frame angle or wrap, panto, and monocular PD. Impression FreeSign, which just launched in Europe, takes those four individual measurements, and allows the dispenser to customize the distance and near viewing zones. If someone does a lot of near reading, we can blow that out, or blow out the distance. It’s the ultimate in customization.”

Another approach to improving lenses is considering an eye’s higher order abberations, which are not corrected through a standard prescription. Digital PALs such as Varilux Physio 360º, Ophthonix iZon and Nikon W uses special backside surface designs to “include” these abberations in the final lens delivered to the patient.

The Frame Factor
One of the most interesting new approaches to customizing digital PALs takes into account the patient’s frame choice. For example, the SOLA HDV from Carl Zeiss Vision uses proprietary “Morphing Technology,” that allows the lens’ corridor to be custom-sized for the exact measurements of the patient’s chosen frame. This assures full reading performance and maximum clear viewing zones for fitting heights of 13 to 35mm, according to Zeiss. HD technology digitally optimizes the lens for the wearer’s exact combination of sphere power, cylinder power, cylinder axis, add power and frame dimensions.

Donna Troutwine, a dispenser with Drs. Huffman and Huffman, a multidisciplinary practice in Somerset, Ky., is impressed with the performance of SOLA HDV (High Definition Vision). “I’ve sold every major progressive lens on the market,” she said. “I tell patients that regular progressives are like the little old radios from years ago. But Zeiss has turned the HDV into a high definition stereo.

“There’s not any way to describe the clarity unless you wear them yourself,” said Troutwine, who wears the lens herself. “It has the widest channel of any lens out there. They’re perfect for reading, too. When I look at my computer screen, you see the whole screen. When I pick up a book, I see the whole page.”

Essilor takes a different approach to incorporating frame measurements in its digital PAL designs. The company’s Accolade Freedom lenses employ “FrameOptimization technology” to customize the backside design using digital surfacing, based on frame dimensions. This allows patients the freedom to choose virtually any type of frame to fit their lifestyle, according to Essilor.

FrameOptimization technology takes into account the Rx of the patient, the frame size and the fitting parameters. It adapts lenses to their particular frame which maximizes the fields of vision for any frame and optimizes corridor length.

Shamir’s newly introduced “FreeFrame Technology,” which is incorporated into its expanded Autograph freeform line, takes into account the patient’s frame choice, adjusting the design of the lens by dynamically increasing or decreasing the corridor length to match the frame and fitting height.

By moving the reading zone to the exact location in relation to the patient’s selected frame, FreeFrame Technology creates wide reading areas with full add for any frame shape or structure, according to Shamir.

Signet Armorlite Kodak Unique lens is “Design Optimized for Frame Size and Shape.” The company uses proprietary production technology to automatically customize the lens design for each patient’s frame selection, ensuring the best overall visual performance for any B measurement, large or very small, down to a 13mm fitting height.

Dispensers need to provide the Signet Armorlite lab with the patient’s monocular PD, frame selection and fitting height. No special equipment or techniques are required.

Despite the many benefits offered by digital PALs, some doctors and dispensers are reluctant to recommend them to patients, particularly those that are content with their current progressives.

“With Varilux, we look at whether the ECP is using Physio or not using Physio, or are they using Comfort 360º or Comfort,” said Essilor’s Jean Marc Leroy. “If the ECP has used Varilux Comfort for more than 15 years, it’s very difficult to change their mind. We don’t want to force that. But we give them as many opportunities to upgrade as possible.”

Daniel Monaco of Essilor believes an ECP’s selection of a lens design should reflect their patient base. “We do lot of complex research behind the scenes to determine what’s best for them,” he said.

“We are hoping to get much more into that in the future. There are so many designs out there, with direct surfacing capability, we can get very segmented,” Monaco said.

For ODs, Seeing Is Believing
Although lens manufacturer sales reps sometimes struggle to get an ECP to try a new PAL design, Craig Fahan of Seiko said there are effective ways to reach them. “We’ve found ODs dispense what they wear,” he said. That’s why we’ve given out a lot of free fits.”

Laurie Badone called this approach the “try it, you’ll like it philosophy.”

“Once a doctor has the lens on their face and actually sees the differences, it means more than any amount of Powerpoints or charts,” she said. “Seeing is believing, literally.”

Narrowing Down Choices
To help ECPs and patients narrow down their choice of digital PALs, Indo has created two series of lenses. Global Designs consists of three lenses: Global 22, a soft design with a 22mm fitting height and a 17mm corridor; Global 19, a versatile design with optimized fields of vision, a minimum fitting height of 19mm and a 15mm corridor; and Global 16, which is optimized for small frames with a minimum fitting height of 16mm. The lens achieves 85 percent progressive addition at 11mm.

Indo’s Action Designs are made to be worn for certain activities. The series consists of the Office design, which is conceived for indoor working environments and created based on the focus distance at which the user usually works; Road Design, which was developed for far and intermediate distances.

The vision quality is improved in certain tasks such as backward driving or using the rear-view mirror; Outdoors Design, which was developed to improve performance when practicing outdoor activities; FreeDesign, which is based exclusively on the characteristics and parameters provided by the client, taking into account the use the design will apply to. This design will be only marketed by the lab involved in its development, according to Indo.

Looking ahead to the second half of 2008, digital PALs are poised to make further inroads into the U.S. market. As the product category continues to expand and diversify, the lenses are likely to become an increasingly attractive option for discriminating eyeglass wearers. ■