Shamir DUO, Good Looks Comes to Flat Tops

By Mark Mattison-Shupnick, ABOM

Introducing Shamir DUO (Bifocal), an application of freeform technology that delivers the cosmetics of progressives for the presbyope that prefers bifocals. Using new free-form design algorithms, and single point diamond turning technology, an invisible bifocal, analogous to a flat top can be added to a lens’ back surface. This process incorporates the add power, the prescription, fitting measurements and frame details all in a unique application of the technology.

Shamir DUO is an invisible digital bifocal lens solution for the loyal flat top bifocal wearer. This product allows every office an upgrade for a portion of the 15 million patients that purchase flat top bifocals every year. It allows the optician to deliver to patients, a multifocal, invisible to everyone but the wearer. Unlike older seamless bifocals, unique to this lens is a no jump segment. The segment is continuous with the lens’ distance portion. This helps with easy adaptation and patients will appreciate the size and invisibility of the segment.

PUSHING THE TECHNOLOGY

In this advanced application of single point diamond turning, a cutting file for a flat top like segment, combining prescription, add power and fitting requirements, is assembled. In the most modern of labs, the result produces a lens where the top center of the

segment is continuous with the distance lens portion so that there is no segment line (invisible) and the eye’s passage from far to near has no prismatic jump. The cutting algorithm creates the rest of the segment with soft borders of small blur.

Here’s what we mean. Figure 1 illustrates the major differences between traditional flat tops and Shamir Duo. In traditional lenses, the segment is visible to the wearer and those that see the wearer. Also, since the optical center of traditional flat top segments is about 5mm below the segment line, there is prism jump or displacement, as the wearer’s eyes look downward from far vision to near. This results in a small blur spot over the top of the segment line and a blind spot created as the image jumps upwards, a product of the add power and resulting base down prism created.

When using digital cutting technologies, a mathematical description of the surface and machine file controls the precision of a single diamond cutting tool. Figure 2 is an illustration of free-form cutting technology. (1) A lens rotates at high rpm while (2) the cutting tool moves from edge towards center and (3), the cutting tool moves rapidly in and out to cut different surface heights. This 3-dimensional topography is described by the cutting file and produce the curves needed for the far prescription and near prescription as well as the shape of the invisible segment.

The photo in Figure 3 shows the result. Notice the how the blue centerline is unbroken and the size of the print is larger in the lower portion as a result of the add power, here +2.50D. The distance prescription is about -2.00D (image is minified) and is the author’s Duo Rx lens. Of special note is the lack of prism jump. This can be seen if you look at the even spacing of the lines of print, as we cross from far to near vision (red circle).

This represents a major improvement over traditional flat top lenses. It creates a continuity of vision from far to near without breaks and delivers reading, importantly, where the FT wearer would expect it.

LARGE MARKET

Why an invisible flat top? This author suggests that the flat top or bifocal market will continue for some time. After all, some patients just won’t purchase progressives; others have tried them and while they tolerate them, they would actually consider an alternative. More importantly, there are an estimated 19% percent of all lens purchases (Fig 4) that are primarily lined bifocals. That’s a large market of about 15 million pair of traditional lined multifocals sold annually. That also equates to 39% of all multifocals.

How big is your potential market? Depends on your attitude towards the opportunity for these lens types as well as the demographic of your office. I would suggest that there are many flat top patients interested in hearing about an improvement and upgrade to their current flat tops, while progressives would not be of interest.

According to the Best Practices, Spectacle Lens Management (MBA, Jobson 2014), 2/3^rds of presbyopes in an average independent optometric office purchase progressives. That means that the balance purchase lined multifocals. What lens should you consider for a third of presbyopes? In fact, some offices use more than a third and that means that they also are typically interested in how technology might have improved their chosen lens designs.

New technologies also increase the opportunity to improve average sell price and capture rate, the number of patients that become purchasers after their comprehensive eye exam. Seems that this technology is worth a close look and some trial since it’s a potential practice builder.

BETTER COSMETICS AND MATERIAL AVAILABILITY

There’s a reason that progressives are most commonly referred to as no-line lenses. The absence of the line, and good looks, is a driving factor in the sale of progressives regardless of the availability of all distance vision. After all, the low add wearer has enough reserve of accommodation to still use the distance portion of the lens for mid-range and read even when in the middle of the corridor. However, as stated, some wearers would prefer the cosmetics without the other effects of progressive lens design. Shamir Duo meets the cosmetic requirement of no line and invisible segment yet is not a progressive.

Coating cosmetics has been a tolerated factor in lined multifocals. When photochromic, the varying thickness of the coating along the segment line and surrounding the segment can cause varying darkening and white lines when activated, less in low add power lenses, worse in high powers. A digital back surface bifocal avoids any issues from irregular coating application around and along the segment. This is especially important since the average presbyope in the US is 63 years old and the average add power, is +2.25 to +2.50D, where segment cosmetics issues are more pronounced.

There are other factors that affect lens choice and final lens sales. In the past, lined multifocals were hostage to material availability i.e., because of the molded front surface lens design, an inventory of semi-finished lenses in each base and add were necessary for each index material, photochromic and polarized lens. As a result, that required significant investment in molds and lens inventories. For example, for a long time, there was no photochromic flat top in polycarbonate. So, if a customer was wearing a plastic photochromic in an acetate frame and switched to a rimless frame, they were out of luck.

The advantage of free-form production of the Duo lens is that lenses are produced starting with a SF SV lens blank. As a result, any material and any treatment available in a SF SV lens blank allows the production of Duo. Next, like all digital lenses, to maximize vision, add AR so that Duo AR lenses produce the best vision possible for the wearer. Starting with a SV front lens surface rather than a lined multifocal makes for the best AR cosmetics and durability because of continuity of surface.

COMMUNICATING SHAMIR DUO

No line, no jump, continuous surface, better suited for AR… is an easy way to remember these lenses. Whenever a customer prefers bifocals or expresses their dissatisfaction with previous progressive lenses, ‘think’ Duo as an opportunity.

Shamir Duo can open new doors since it provides a new technology alternative for the bifocal wearer. We might often think that the bifocal wearer is just OK with repeating their lens style and not interested in change. Not so! Many of my bifocal wearers have been made more successful with upgrades like AR and/or for those with cylinder Rx’s over -1.00D, the use of atoric lens designs. Now, recommend changing to a lens without lines (not a progressive), that’s steeped in technology, that’s an opportunity.

The older adult is one of the fastest growing groups online; the major portion of their searches is for information about healthcare. They’ve also have adopted tablets as the chosen mobile device in parallel with TV for entertainment and information gathering. Therefore, technology is of interest however since the 2008-9 financial crisis, this consumer is critical of anything new unless its value can be demonstrated.

Like other new products using new technologies, with a clear list of added values helps justify its cost. For example, Smartphones aren’t cheap but they do have increased value in the way that we use them every day. When and where was Sandra Bullock or Ulysses

S. Grant born? I think I made the wrong turn at the light. Let me see what it says about this new refrigerator, restaurant, spa, gym… before I buy, eat, use, join. Get it; the smartphone has become an irreplaceable tool for information. The value of technology is that it makes many things in life more convenient. For example, guys like me don’t need to ask directions and actually get lost less because of the phones GPS while we can also become better informed about any decision. New lenses like Duo add this kind of convenience since there is less to learn to use when ‘prism jump’ and a line is removed from a multifocal. That has value.

When To Discuss Shamir Duo

To know when to use Shamir Duo, ask the right questions. Start with, “If there was anything I could do to improve your current bifocal experience, tell me what that might be?”

The customer’s response for removing the line or interruptions in vision means that an improved appearance and the elimination of the visible dividing line between far and near vision zones helps to improve visual performance and visual continuity between far and near. Fig 5 shows the difference between a visible flat top and Shamir Duo.

Production via free-from technique makes these lenses suitable for sunglasses in either tinted, photochromic and/or polarized form in a wide variety of materials including high index for thinner, lighter and better looking lenses. New lab technique can then add the best of the best AR.

Don’t forget that there are some progressive lens wearers that tolerate progressives but would prefer an alternative. Yet they haven’t wanted to sacrifice the invisibility of the multifocal.

Enhanced Identity

Headed to the Apple store just to see the new watch? Technology tickles just about everyone today. That’s your hook to be known as an expert on the newest lens technologies. I’ve said this before. Understanding and knowing what’s new, enhances your professional identity and, the identity of everyone in the office. Will everyone that you describe Duo to order it? Of course not, however, reviewing options in a clear and informative way provides patients confidence that their needs are understood. That means that the other things that you’ll describe will be heard with increased trust. Technology sells, use it!

FITTING AND DELIVERY

Place the Shamir Duo fitting point at pupil center (Fig. 6) and when received from the lab, use the invisible markings for power and fitting verification or to renew the ink markings (just like progressive lenses).

The minimum fitting height recommended is 15mm. That ensures a full add power segment. Full add is located at 11mm below the fitting point. This is analogous with the way that flat tops are fit and used i.e., with the flat top segment line at the top of the lower lid, the eye typically travels about 10mm downwards. That places the eye and line of sight about 5mm below the segment line so vision avoids the jump and double vision that the line would create. In this case, the Duo fitting point provides the right positioning.

For PD, use monocular distance PDs. Segment inset is automatically created when the lens is produced. This is unlike traditional bifocals where the binocular near PD is used when edging for segment positioning. The advantage of monocular fitting ensures more accurate prescription centering and lens positioning.

Verify the distance lens power at the upper ink mark, about 5mm above the fitting point. Add power should be confirmed using the add power engraving. The unique music note engraving tells you that the lens is a Shamir Duo.

Selling any new product requires a plan and a process. I’ve excerpted (and shortened) this from the Opticians Handbook. Authored by Michael Karlsrud, it provides a good overview of adding new lenses like Duo to your lens library. Visit the link for the whole story. A SOLID SALES PROCESS—1, 2, 3 Selling is a process; it is teachable, repeatable, and measurable. It is a process for guiding an effective conversation in which both parties feel satisfied with the conclusion. The process begins with each party knowing up front what will happen over the next few minutes or hours. This is called setting the agenda. It may sound like "Mrs. Smith, the doctor has recommended a new prescription for your glasses. What I would like to do is first find out a little bit more about your average day, what you like to do when you relax, and finally what you do for fun. Then we'll help guide you to your best lens options that match your lifestyle. Finally, we'll match your lenses with a great frame that will complement your style and make you look great. Does this sound good to you?" The three simple steps to remember are to describe what you are about to do, why it is important and finally, checking to see that they are on board with you. Setting the agenda and getting buy-in from the patient is crucial to helping them feel in control and lowering their fears about what will happen. The second part of the sales process is to ask questions; almost like a mini-interview. Find out about their lifestyle or "if there was something about your glasses, lenses, frame that you would want to change, what would that be?" This is a crucial step that many professionals fail to do well to the peril of a looming objection down the road. Third, recommend your solution to the patient by using features and benefits of the relevant products you suggest. Keep in mind that you only suggest products and describe features that are relevant to your patient. If you describe too little you will seem like you didn't listen to a word your patient said during the "interview;" and if you say too much you will have nothing left to share should you need to reinforce your position. Finally, we ask for the order or close the sale. Have you noticed that with every stage of the sales process we have concluded by asking a question to check back with the patient? This important step is critical to sharing control of the conversation, reducing fear, and making sure that you and the patient are together on the solution throughout the process. Asking for the order is a natural part of the process, providing the process is executed well.

 

EXPECTATIONS

What should your expectations and those of patients be when dispensing Duo lenses? In each case, the patient will experience a new way of seeing and there is usually some learning required.

They’ll notice that there’s no line and vision is continuous rather than the jump and blind spot when crossing the segment line. This is quickly appreciated. The lack of a sharp border on the sides of the segment may be noticed but that also, like the peripheral blur for many progressive wearers is ignored quickly.

When dispensing, point out the absence of the segment and line for others while only they can see it. Describe how it’s used just like their previous lenses and perhaps have them get up from the dispensing table, walk around the office with you while you hand them a reading card so they see how convenient reading has become.

AVAILABILITY

To reiterate the advantage of new free-from processing, it allows a complete library of lens materials and treatments. That means that materials from 1.5 to 1.74 indices, in photochromic, polarized and blue light attenuating materials are possible, each with a variety of hard and AR coatings.

CONCLUSION

It’s easy to become overwhelmed by the number of new progressive and occupational lenses available in the variety of materials and treatments.

However, there are few, if any, alternatives for the traditional flat top wearer. This course recommends discussing the newest AR and atoric flat tops as well as the option of an invisible flat top. Good looks come to flat tops because Duo delivers continuous unbroken vision from far to near using a unique technology to create a flat top that’s invisible to everyone but the wearer.