Ophthalmic Lenses

Premium PALs: Personalization Sets You Apart

By Victoria L. Dzurinko, OD, FAAO,

and Jason Moore, OD


Take presbyopic patients to a higher level of visual performance with personalized lenses. The keys to success: present premium PALs well, and personalize lens measurements to optimize performance.


SEIZE OPPORTUNITY. Progressive lenses provide a higher level of care, and each wearer generates at least $400 profit to the practice; single-vision wearers each generate about $150 in profit.

EMPHASIZE PREMIUM LENSES. Invest in high-performance digital progressive lens technology to limit remakes and enhance patient satisfaction.

HAVE LIFESTYLE CONVERSATION. Ask about daily activities and special interests to ensure the prescription closely matches the patient’s near and far needs.

Progressive eyewear featuring high-performance personalized technology is a patient-pleaser and profit-maker for your practice. The lenses not only enable seamless near, intermediate and far vision, but also allow presbyopic patients to preserve their youthful appearance by avoiding lined bifocals. However, patients can sometimes be hesitant to give progressives a try, and it may take time for their eyes to adjust.Our office succeeds with PALs, in part, because we use a computer-assisted measuring system that optimizes fit and performance Here is why premium progressives are so profitable to a practice, and how you can educate your patients about the benefits of progressives and help them adjust to their new lenses.

Note Opportunity

The majority of presbyopic patients we each see are in progressive lenses, accounting for up to 55-60 percent of the total patients of our practices’ patient base.

From what we’ve seen in our practices, the progressive lens wearer provides at least $400 profit to the practice. The single-vision lens wearer generates about $150 in profit. Premium products definitely add more value to the practice. Management & Business Academy metrics set the median retail sale for a pair of glasses at $227. A premium progressive lens with anti-reflective treatment can often generate a sale of at least twice that amount.

The added profit comes primarily from the higher price of the lenses. The lens add-ons people often get when spending money at this level is another source of profit, such as AR and photosensitive lenses. While the lenses themselves are a higher technology, and, therefore a higher price, upgrades like polycarbonate or high-index lenses also help increase the value of the sale. Per the MBA metrics, the average eyewear sale can generate $138 in gross revenues, or 2.6 x the cost of goods. This is a great benchmark to see how well your practice is doing per spectacle sale.

Don’t Charge Per Office Visit to Find Right Rx

The education on the right progressive lens is included in the refraction fee. Both the providers and the opticians should spend time educating patients on the technology. In the rare instance there is an issue as patients are adapting to the lenses, we offer a no-charge “Rx check” to address their concerns.

While a patient may occasionally need to come back to the office for a prescription adjustment, the initial presentation to the patient and refraction for progressives should not take more than a few additional minutes of chair time. Only a minute or so should be needed to determine the add power. In our experience, progressives generate no significant increase in remakes versus single-vision lenses, as long as the PAL designs are of good quality. It takes maybe a minute or two to describe the benefits of progressives and demonstrate how they work. Our optician [Dr. Dzurinko’s practice] will walk the patient through the lens design again when they are doing frame selection, as well as reiterate how to use the lens at the dispensing visit. It is a team effort that keeps the doctor’s needed chair time for progressives to a minimum.

Give patients a two-week rule: “If you are still uncomfortable in your new prescription after two weeks, I want to see you back so we can address the issue.” If they aren’t adapted within two weeks, they likely aren’t going to if we don’t change something. It could be something as simple as a frame adjustment, reassurance or re-education about what is realistic to expect in progressive lenses.

Emphasize Difference of High-Performance Lenses

We find fitting PALs that are of top quality generally produce the happiest patients. We often see people who went to a big box store and bought a low-end progressive, which, to them, feels distorted. This makes them believe that PALs just don’t work for them; and therefore, they can never wear PALs. I spend a few minutes explaining how newer, better PAL’s work and why high-performance progressive lenses are important to consider before ruling out PALs. We use the selling booklets, placemats and other point-of-sale tools that the manufacturer provides to make it a smooth and easy flowing process. Patients can clearly see the advantages and the reasons for the custom measurements we take.

We [Dr. Moore’s practice] use the MyFit system, which we bought from Essilor. The cost was approximately $2,900. It’s a small tablet computer with an attached camera. The patient sits in front of the camera wearing the frame he/she has chosen. Mounted to the frame is a small device used to measure the various points needed to custom design progressive lenses, PD’s, seg placements, vertex, pantoscopic tilt and faceform. It’s a great instrument because of the accuracy and the high-tech process. To me, when a patient buys a high-end progressive lens that retails for $750 with premium AR, as well as a $400 + priced frame, he/she needs to see that the measurements for these lenses are not taken using a ruler and a marker.

Using the best products reduces issues with non-adapts and unnecessary Rx checks. When you use the right products, prescribing a progressive lens can be as easy as prescribing single vision. Use positive phrases like “seamless vision” to describe how patients will see with their new progressives, as well as stressing that they need to “point their noses” at what they want to see in order to use the best parts of the lens.

Have Lifestyle Conversation with Patients

We always discuss visual needs to ensure the progressive prescription matches the patient’s near and far vision needs as well as possible. Do you drive long distances? Are you in an office setting? Are there mobility issues? While every progressive prescription starts with a solid refraction, we want to make sure we are matching the available designs to the patient’s lifestyle.

Related ROB Articles

Free-Form Lenses: Address the Needs of Your Patients at Work and Play

Ask Patients Detailed Lifestyle Questions…Then Select Best Lens Options

Personalized Lenses: A Measurement System Makes It Work

Victoria L. Dzurinko, OD, FAAO, is an associate at Bonds Eye Care in Downingtown, Penn. To contact: vdzurinko@gmail.com

Jason Moore, OD, is a partner with Brighton Vision in Rochester, N.Y. To contact: brighton.vision@yahoo.com

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