As an optometrist, I knew it was inevitable that during my early to mid-forties, I would find it increasingly difficult to see small print. By way of a very brief explanation, to read or to see anything close, the crystalline lens inside of the eye must change focus. This lens becomes more powerful by getting shorter and fatter. As we get older, the muscles that enable this change no longer work so well. As a consequence, the lens cannot refocus as effectively. This means near visual tasks from reading and threading a needle to plucking one’s eyebrows and applying make up become harder. This normal change is called presbyopia, (sometimes confused with long-sightedness which is something different).
Just over a year ago, when I was 44, I wrote about getting my first pair of reading glasses. Since then, I’ve needed them more and more. This happened very quickly, just like thousands of patients over the years said. I ended up taking my reading glasses off and on countless times during every sight test. I’d peer over the top of them to see the tv if I was reading at the same time. I struggled to read a menu, but didn’t like the fact that when I looked up, my dining companion looked blurred. So in the interest of convenience, I decided to get some varifocals.
Bespoke Varifocals: Essilor Exclusive 4D
The practice I work in dispenses Essilor lenses. The top of the range varifocal is the Essilor Exclusive 4D. We refer to them as bespoke varifocals. The design uses personalised parameters, one of which is Near Vision Behaviour. Reading is unique to every individual. Knowing a patient’s body posture and visual behaviour is key to getting the best possible lens.
To do this, we recreate a familiar near vision task and use a tablet to capture four measurements. The patient wears a special frame with a parameter clip and they engage with a pseudo reading app.
The clip and the tablet camera integrate to measure eye and head movement. This ensures the patient’s own vision volume is positioned and shaped where and how they need it. The system measures the downward gaze, the distance from the screen, and the lateral offset. The fourth aspect is a measurement of how the patient reads. Do they scan with their eyes or move their head? Or a combination of both?
The next stage is to measure what Essilor call a personal Eyecode. We use a brilliant piece of kit called Visioffice. It uses cutting-edge digital dispensing technology to quickly and accurately measures physiological and behavioural parameters including eye-dominance, eye-rotation and head tilt.
My Verdict On The Essilor Exclusive 4D
The lenses take about two weeks to come through because they are a completely bespoke product. When I collected them I did expect some distortion or soft focus because that’s what most varifocal wearers report. There isn’t any. I was working in an upstairs consulting room and I had no problem with disorientation; I didn’t need to watch my step. The vision is clear at all distances and there is no need to look for a “sweet spot.” The progression is smooth from far distance (infinity), to very near. I cannot fault the Essilor Exclusive 4D varifocal and I have utter confidence when I recommend it to my patients.
Several of my colleagues have also got these lenses and report the same utmost satisfaction. I am so happy with them that I ordered another pair with Transitions Style Colours (a photochromic lens which darkens in UV light). I wore them everyday on holiday, because they were so perfect for walking around and for reading on the beach.
Essilor Exclusive 4D Varilux varifocals are available from select independent opticians including Benjamin Opticians in Skipton where I work. You can locate a practice near you by searching on the Essilor website. Thank you to my friend and colleague, dispensing optician James Brown who took both measurements and photographs. My eyewear is “Date Shake” by L.A.Eyeworks.