Seg Way
Discover the merits of forgotten segs and atypical bifocal applications
By Karlen McLean, ABOC, NCLC

Some progressive practices sell upwards of 75 to 90 percent PALs, while others have a virtual PAL-only policy. PALs are perceived as the greater-good multifocal solution.

But, there are still some consumers who can't, or won't, adapt to PALs. Combine that with certain workplace tasks, recreational requirements, hobby needs, and other unique situations where a PAL won't fit the bill, and standard bifocals or trifocals still fulfill some patient eyewear needs.

Polish your bifocal knowledge by revisiting three key bifocals selected by EB readers as their primary picks for use beyond PALs.

FLAT TOP 28

Flat top 28 bifocals (FT28s), also known as D28s, are considered the industry's workhorse bifocal. They're recommended for almost every presbyopic situation, including everyday applications, plus uses with specific tasks, hobbies, and occupations. FT28s are also the typical fallback bifocal for those who can't adapt to a PAL, and for bifocal wearers who simply won't covert.

Bifocal and trifocal lenses have some qualities that are similar to those of progressives and can appeal to hobbyists and crafters

Some flat top solutions call for the prescribing doctor to examine patients not just for an everyday vision correction, but to examine and write an Rx for task-specific lenses. Some examples of FT28 applications follow.

Driving. For those not requiring arm's length correction, to see distance and read a map.

Needlework. To see distance, such as someone entering the room, as well as to sew or do other needlework up close.

Artists. Set the distance portion at arm's length (or have the artist measure distance from eyes to work area and set it there) and the near portion at near for preparing media.

Shaving. Set distance portion at mirror's length with the near vision seg for up-close.

TV viewing. When watching TV, many viewers lean back in bed or in lounge chairs, tipping the near vision bifocal into the distance viewing area. Offer them a reversed near vision seg at the top and distance viewing below.

Fishermen. For distance, and for working lines, fly-tying, and other close work.

Scuba or snorkel. Lenses can be ground on a flat base and applied to the inside front of a dive mask so that wearers can clearly see in the distance and at near to read gauges.

Occupational. Applicable for working presbyopes who need distance and near vision, or working/
intermediate distance with the segment at near.

Hobbies. A good general-purpose lens for hobbies requiring distance and near vision, or distance at the hobby workstation length with the segment portion at near.

	Double-D flat top bifocals combine distance, intermediate, and near vision corrections

FLAT TOP 35

Many ECPs value flat top 35s, otherwise known as D35s, for their clear, wide near vision area, especially good for those who do a lot of desk work. Many prefer FT35s to executive segments, since executives have a pronounced ledge that adds weight, causes distracting reflections, and appeals less cosmetically.

With today's smaller frames, FT35s often reach from one frame edge to the other, or nearly, without the downside of executives. Some practical applications for FT35 bifocals include the following.

Kids. In the past, doctors prescribed executive bifocal lenses for children's vision therapy. Today, most recommend a FT35 to keep down lens weight and ledge appearance.

Clerical. Some presbyopic patients prefer the wide near-vision viewing for their close-up work that a FT35 delivers. It is a good choice for those who do a lot of desk work and need to see distance and near.

Lenses can also be prescribed for intermediate in the top and near in the seg as workstation-only eyewear.

Computer-users. Place an intermediate Rx for computer-use in the top distance portion of the lens, with near vision in the seg for wide-angle reading and deskwork.

Macular degeneration. FT35s are good for patients who require magnification as well as a wider reading area.

Drivers. Those who work behind the wheel can take advantage of the ability to see clearly in the distance and peripherally, plus read a map or other materials, with the FT35s' wide near segment. Some heavy-duty drivers who can benefit from FT35s include taxi drivers, salespeople, and delivery drivers.

ROUND SEGMENT (22, 25, 28)

Now that round segments come in polycarbonate and photochromic, the category has grabbed industry and consumer attention again.

Round segments are an alternative for those patients who can't convert to blended segments or PALs but still want a no-line appearance. They feature a softer transition from distance to near than a flat top, and are less likely to have a reflection and image jump than flat tops. Applications for round segments include the following.

Flat top and round segment bifocal details

Walking safety. Offset temporally, patients can look through the distance portion of the lens when viewing straight down.

Those using a cane or walker to get up or down stairs or curbs can negotiate obstacles more easily and safely, while having the secondary ability to see at near.

Aesthetics. Since round segments have virtually no visible line, they are an alternative choice for those who can't adjust to PALs but still want the no-line appearance.

Golfing. Round segment bifocal lenses with the segment set temporally either high or low allows golfers to look down to putt the ball. It also allows users to have a larger distance view while still being able to check scorecards and read the clubhouse menu après golf.

Some ECPs fit a round seg to the temporal edge of one lens only, typically to the same side as the patient's dominant hand.

Photochromic and polycarbonate round segments can protect eyes from impact and UV rays while offering visual comfort in all playing environments, from misty mornings to full-sun afternoons.

Rimless. The standard goal of rimless eyewear is to minimize the appearance of the eyewear while wearing it.

Combine rimless with round segment bifocals, and both the frame and the lenses virtually disappear. Poly round segments add strength, durability, and protection, and make for easy processing.