For Distance-Intermediate-Near Vision: One, Two, or One-and-a-Half Glasses?
Application of (+) Spherical Additional Lenses to Clip-on Monofocal and Progressive Glasses: (Combine Eyewear)—Is It Worth It for Near and Intermediate Distance or Not?
We have faced issues with near and intermediate vision for single-focus (monofocal) glasses, and intermediate clarity in progressive glasses, for many years. By attaching full near correction or low-powered (+) lenses for intermediate vision to an armless magnetic clip that is compatible with a primary eyeglass frame set, which has full-distance and near corrections, we achieved perfect clarity in near and intermediate distances. This approach is explored in the letter-article below. The application of magnetic clip-on “Combine Eyewear” is a new approach for monofocal and progressive glasses. Although progressive correction is highly effective, this concept reduces some dissatisfaction with progressive glasses.
Dear esteemed ophthalmologist colleagues and optician friends, I am a 63-year-old retired ophthalmologist. Here, I want to share a glasses study with you—an aspiration I had as an assistant approximately 35 years ago, which I could only realize after retirement when time and opportunity allowed.
As I said, during my specialization training 35 years ago, while testing optical corrections on presbyopic eyeglass patients with a 3-lens-channel universal eyeglass frame, we would prescribe two glasses: by adding a (+) spherical addition lens in the third channel for near reading to spherical and cylindrical lenses placed in two channels for distance correction. What puzzled me at the time was this: could we not, just as in examination techniques, add a second frame containing a near addition lens on top of the primary frame’s distance-corrected sphero-cylindrical lenses for presbyopes?
In the summer of 2021, I retired. This idea reignited once again. Magnetic clip-on glasses, which started to become widespread in the eyewear market, inspired me (I’m writing this not for optician friends who are already familiar but for ophthalmologist colleagues who might not have noticed: these glasses consist of a main frame with arms and one or more stemless frames (clips) attached to it via magnets in front of the main frame. The clips typically come pre-equipped, for purposes such as sun or polarized filters. Attaching and detaching the clip is simple and practical). Around the beginning of 2022, these glasses sparked a new idea in me. I decided to perform my first trial with these frames. I bought a plastic clip-on pair of frames, not meticulously. I fitted my sphero-cylindrical single-focus (monofocal) lenses (-4,0 sph for the right eye and -4,5 sph for the left eye) on the main frame with arms, and I added (+2.50 for full near vision correction) lenses to the clip. Since the clip, which is an arm-less frame, was designed for thin filters, it was also thin and flexible. Thankfully, my optician carefully mounted the spherical near addition lens onto the delicate and thin clip. My distance glasses worked perfectly; I was seeing 10/10. Excitedly, I attached the clip with near vision value on top of it, and I obtained an excellent result in my opinion for near vision as well. Because, when looking straight through the center of the lens, downward, and in 360-degree near vision for reading, there was no issue. With my monofocal (single-focus) distance glasses, I could even comfortably watch TV while lying down, looking up through the lower portion of the lenses—which wasn’t possible with progressive glasses unless I kept my head upright. Later, I replaced the clip’s near addition lens with a thinner one, which, of course, made it lighter.
The only issue was that the clip was slightly bent, making it impractical and difficult to attach and detach from the main frame. I realized that I had not selected a clip-on frame suitable for my purpose. In response to the issues with this frame, I designed clips that were slightly thicker and provided easier attachment and detachment features. I did not experience much bending with other clip-on frames. While we achieved excellent results with monofocal lenses, my curiosity shifted toward progressive lenses. For many years, I had been using progressive glasses, but I faced difficulties using progressive glasses designed for distance and near vision for tasks like working with devices such as computers and manual phoropters in the workplace, as well as reading market labels. Upon the suggestion of an optician friend, I acquired a second pair of progressive glasses, referred to as office glasses, designed for intermediate and near vision. To avoid forgetting my glasses here and there, I inconveniently wore both pairs around my neck with a string.
I have done numerous trials with monofocal, progressive, office, and pilot glasses. In the first trial, I used plastic clip-on glasses. I equipped the main frame with wide-corridor progressive lenses for full-distance and near vision correction. While distance vision was good with these glasses, reading required looking from a very low position, which was challenging for me. The lens manufacturer expected me to look at the computer screen through the middle section of the corridor, but this approach wasn’t very efficient either.
The company produced another pair of lenses with narrow corridors, and this time, both distance and near vision were satisfactory for a progressive lens. In this frame, attaching and detaching the clip was relatively easier due to the gap that developed between the frames at the bottom because of lens tension deformation; however, this deviated from the original frame design style. When I added a simple and economical spherical additional lens, such as (+1) or (+0.75), to the clip on top of the progressive lens, I was able to see the contents of my desktop computer screen—situated at arm’s length, at eye level—very clearly by looking straight ahead through the center and upper part of the lens without tilting my neck backward. When I looked slightly downward with the clip, without excessively directing my gaze downward, the combination of the half addition in the progressive lens corridor and the half addition of the clip nearly matched the full near vision correction value (addition amount), which made near vision satisfactory as well. Naturally, with the additional (+) spherical lens on the clip, distance vision was somewhat impaired, but moving around indoors or in an office setting was not difficult. In summary, the combined application provided 100% satisfactory visual results. For “Combine Eyewear”, whether for monofocal or progressive glasses, 100 % distance and near vision correction values should be prescribed unless there is a specific obstacle in the eye.
However, I felt the need to store the delicate clip in its case when not in use, to prevent it from getting dirty, lost, broken, or scratched. Since it lacked arms, it couldn’t be hung around the neck with a string or attached to my shirt. As a solution, I thought it would be very useful to have a glasses pouch with one or two compartments that could be hung around the neck with a single string to easily carry the most frequently used clip with a low (+) spherical lens and a second clip, such as a desired sunglass clip. This way, as there would only be one string, the problem of tangled strings from multiple glasses would be eliminated, and it would also look more stylish. Hanging glasses around the neck might not appeal to everyone. Additionally, protective belt holsters for clips could also be used. Carrying them in a shirt or jacket pocket, in a separate case, or in a bag, with or without a cover, are also options.
Secondly, I conducted another trial using a frame with a metal main frame and a plastic clip (all the clips we have seen are plastic), maintaining the same eyeglass prescription values. Similarly, I achieved what I considered excellent vision results. This frame had no claw in the middle of the clip, making it easier to attach and detach. Its structure also gave me another idea for modifying the plastic clip in frames where both the main frame and the clip are made of plastic. This would make attachment and detachment easier for completely plastic frames as well. I hope to share and collaborate on these design ideas with frame manufacturers.
I would like to point out here that if you search for “magnetic eyeglasses frames” in internet search engines, you will find hundreds of companies and products. Some offer up to five additional clips (for features such as anti-headlight, anti-glare, sun, or polarized) on a main frame with arms. In other words, this industry is already quite extensive. However, in our searches, we did not come across products with slightly thicker clips designed to prevent easy distortion and breakage or to accommodate prescription lenses. Some clips were delicate and unsuitable for prescription lenses. Others, while not as thick as we desired, served our purposes when handled by careful hands during assembly. For this reason, we named our application “Combine Eyewear” and aimed to evaluate our suggestions with all stakeholders in the industry. I believe we are dealing with an economic, aesthetic, practical, risk free and efficient solution. Most clip-on frames, which have recently become widespread in the market, are able to adequately meet the needs of our “Combine Eyewear’ concept”.
One point to highlight is that if you search the internet for terms like “magnifying eye glasses,” you’ll find numerous examples available for purchase online. These products typically have two magnifying lenses of equal (+) power for the right and left eyes. While they provide magnification, they lack refractive error correction functionality. They are somewhat bulky, and they often disregard conditions like refractive errors and anisometropia in the individual’s eyes. However, I believe that in our “Combine Eyewear” application, since the refractive errors and anisometropia of the individual are fully corrected in the main frame, it can also function as magnifying glasses when equipped with a high (+)-powered lens with thinned glass on the thick clip. This could be an economical, comfortable, and effective solution, particularly for artisans and craftspeople who want to work with both hands free. Additionally, the lenses can be easily replaced. In the market, lenses with 30–65% thinning are available.
To summarize, patients with both distance and near vision impairments, if financially able, should acquire a high-quality pair of progressive glasses. This option is ideal for those who don’t require detailed work in their daily lives. For those who especially need intermediate vision—for example, for desktop computer or some type of sewing machine use, market label reading etc—a second pair of progressive office glasses can be used. However, this poses an additional financial burden and the inconvenience of carrying two glasses. This is where the “Combine Eyewear” option we propose comes in. Specifically, patients who want progressive glasses can acquire frames with clips (especially thicker ones, if available on the market) so they can use progressive lenses for distance and near vision while attaching a clip with low (+) spherical lenses for intermediate vision to see more clearly by looking straight through the lens. For those with limited financial means, either two single-focus (monofocal) glasses for distance and near vision can be used, or the “Combine Eyewear” application we recommend can be beneficial. For example, if two clips can be acquired for the main frame—one for reading and the other with plain spherical lenses for intermediate distance—it will provide a three-function (multi-focus) solution. Since the lenses in the clips are single-focus (monofocal) simple spherical lenses, they can be updated at a relatively economical price.
If the patient has cataracts and will undergo surgery, trifocal lens implantation is also a current surgical option. For patients without cataracts or who are hesitant to undergo surgery, “Combine Eyewear” can be a risk-free alternative to surgery. Our recommendation is a simple solution that does not require new or advanced technology. Clip-on eyeglass frames are already widely manufactured in the industry and are practically used by a broad audience for purposes such as sun protection. We believe they would also gain popularity for optical purposes among those in need (currently not in use). Lens manufacturing technology is now capable of producing lenses that are 30–65% thinner, both for progressive and monofocal lenses, which significantly facilitates our approach. Additionally, most of lenses on the market today are aspheric, which reduces curvature and, thanks to thinning, also decreases the likelihood of friction between the lenses. Currently, clip-on sunglasses have an elegant structure, and if the slightly thickened, more durable, and easily attachable/detachable clips we propose are reasonably designed and produced by professional designers (as the visual outcomes, while satisfying, are not fully compatible with the concept), we hope our concept will gain acceptance and find widespread use in the future. Even if I don’t live to see those days, I believe our children will. Thin clips will remain stylish for purposes like sunglasses and should maintain their elegance in our application as well. In the market, we found the possibility to fit spherical lenses up to (+3) on existing clips.
Dear friends, personally, I don’t want to, as the Turkish idiom goes, “celebrate the wedding by myself” in this matter. Although I find the concept efficient and economical, I desire to evaluate and discuss it together with expert colleagues in the field.
Here, we are not reinventing America, nor are we abandoning progressive glasses. We are simply taking them a step further. Even our grandmothers stacked one pair of glasses for distance and another for near vision, and with a very simple, contemporary innovation, we embark on a journey. Not one, not two, but one-and-a-half pairs of glasses achieve clear vision across three distances. If there is an error in progressive glasses, correcting the spherical component with a clip is straightforward.
When we ordered our progressive lenses, optical companies consistently recommended dual glasses (regular progressive + office glasses) to achieve full clarity across all distances.
My expectation from you is this: optician friends with distance and near vision problems could potentially replicate my approach during their first eyeglass transitions using the easiest-to-attach-and-detach clip-on eyeglass frames available that can accommodate lenses. That is, both with monofocal and progressive lenses. Since they can be used either as spare glasses or according to current needs, I don’t anticipate this to be overly burdensome. Many people who are satisfied with their unaided distance vision often have minor refractive errors that, when corrected with glasses, noticeably enhance visual quality. Trials can be conducted on such distance glasses as well. After a good eyewear examination, if monofocal is to be tested on the main frame and there are two clips available, one can be fitted with full addition (for near reading), and the second clip can be fitted with low (+) lenses suitable for intermediate distance. For reading, I’ve enjoyed using (+) 2.5 lenses both on clips for monofocal glasses and clips for progressive glasses (for reading through the center of the lens) and (+) 0.75D lenses for intermediate distances. The application poses no risks apart from the cost of the trial. I also expect the same from my fellow ophthalmologists when changing their glasses. In the worst-case scenario, you’ll have a backup pair of glasses. Using your phoropter, you can determine full near and intermediate distance (+) lens values (addition amount) or use different (+) spherical lenses from your classic eyeglass trial lens set, placing them in front of your existing progressive glasses for selection. Patient selection and determining the exact (+) lens value for the clip according to its purpose is critical. Please read the easy method of testing the Combine Eyewear concept without cost at the menus.
Even though we gained confidence during our first experience, we conducted trials with various monofocal and progressive lenses over three and half years. If a single pair of progressive glasses could meet all our needs, we wouldn’t have ordered so many progressive glasses or spent so much effort. Progressive lenses are indispensable as the primary glasses. Combine applications for single-focus (monofocal) glasses are for those with limited financial means.
Our concept can become popular both in developed and developing countries. Because, I believe we are facing a simple, economical, ergonomic, aesthetic, practical, risk-free, effective, and efficient solution for seeing the intermediate distance clearly and comfortably with progressive and monofocal distance glasses. It is not just a product idea but also a perspective. It can be integrated into all types of progressive or distance-near monofocal prescriptions. It relies on a simple application, not new technology. It can be tested with the clip-on frames currently available to opticians. The need for office glasses can be effectively met without the burden of carrying an additional pair and without high costs. With the joint evaluation of opticians and ophthalmologists, patient selection can be improved. Clips are easy to carry, and both the clips and the lenses can be replaced when needed, providing flexibility to the user. Thanks to this approach, the burden of carrying multiple pairs of glasses is eliminated; both economic and ergonomic benefits are achieved. Just as clip-on glasses became widely used for protection from the sun and harmful rays, I believe they will also be used for better vision.
If you decide to try, note that since you will be using existing clip-on glasses in the market, ensure the clips are suitable for fitting prescription lenses and are easy to attach and detach. I recommend having high-prescription lenses thinned as much as possible (up to 65 %). I am particularly curious about the results for high hypermetropic presbyopes. As I am myopic, I tested accordingly. However, I must emphasize that since I don’t have a sponsor, all eyewear costs for these experiments will be entirely your responsibility with your consent. I don’t think you’ll lose much. Those who wish may try or listen to the feedback of others who have. Trials conducted by ophthalmologists and opticians will provide the most reliable evaluations. Please read the easy method of testing the Combine Eyewear concept without cost at the menus.
Since the primary frame corrects the full refractive error, including anisometropia and cylindrical errors, the clip will have lenses of equal (+) power. Determination by examination is appropriate. Concerns about street-market glasses won’t be an issue here.
I would like to publish the experiences, results, and feedback of friends who accept the trials. I await responses via email. We will also keep you updated on developments. In fact, I would prefer to compile an academic publication in collaboration with one or several academic colleagues. I am open to proposals. I have been testing the concept for over three years and am satisfied with the results. If we can conduct a multi-participant evaluation and the results are generally positive—as we have been experiencing this for a long time—then by increasing the number of trials, we could guide frame manufacturers to produce ideal combine frames. Offering the clips in different colors or shades would be useful in distinguishing the lens prescription values they carry. To put it briefly, in this concept, the only issue is the frame, the frame, and the frame. There is no need for new technology. It is sufficient for the clip to be slightly thicker, more durable, and easy to attach and detach. Some companies’ clip frames are so thin that fitting prescription lenses onto them is neither suitable nor feasible, so attention is required. However, through careful selection, we found and used suitable clip-on frames.
Although the existing frames in our combine application are sufficient, if the frame company offers multiple thick clips, even two different intermediate distances could be achieved with addition values in both monofocal and progressive lenses. Using “Combine Eyewear”, despite everything, requires slightly careful handling and a reasonable sociocultural level. I would like to reiterate that currently, clips suitable for fitting (+) lenses for experimentation are available in the market.
Progressive glasses users who do not experience difficulty looking at intermediate distances through the lower zone of the lens can continue as they are. However, those who prefer to look straight through the center will be very satisfied with the “Combine Eyewear” application. Those who need the combine clip in the office but don’t want to carry it, can leave the clip at the office.
In our concept, it is impossible for patients to find a clip suitable for their distance glasses frame in street markets. In reality, for “Combine Eyewear”, the examination must be performed by an eye doctor, and the service must be provided by an optician. This is an advantage for our physicians and opticians in terms of patient satisfaction.
Post-production measurements of progressive lenses may not always match the exact values prescribed. The spherical deficiencies here can also be corrected with clips.
To prevent misuse of my proposal, an utility model application for a new frame design was submitted to the Turkish Patent Institute for protection, and a “Utility Model Certificate” was obtained. I have no serious financial expectations; being a pioneer is sufficient for me. Any ophthalmologist and optician who wants can freely use the concept, I wouldn’t even know. Perhaps some among you have thought of similar ideas but haven’t been able to realize them. At this stage, I wish to name and pioneer the concept. Like the famous Turkish thinker Nasrettin Hoca who “spread yeast into the lake,” thinking “what if it works,” I am taking the initial steps for this innovation. Despite all my searches, I have not come across an actively implemented version of this application to date. Due to the lack of demand, this concept is not yet part of our professional lives. If there is supply and guidance, I believe demand will start. Even if there are just a few hundred requests and satisfactions over the years, it would bring me happiness.
Clip-on “Combine Eyewear” is a new approach for both monofocal and progressive glasses. No matter how good progressive correction is, this concept reduces certain dissatisfactions. I believe the success I achieved with clips that were not targeted to my purpose would be even better with purpose-built frame clips. For this reason, I want to collaborate with eyewear frame and lens manufacturers.
One final point: To make computer use more comfortable with a single progressive lens, I had thought of incorporating a suitable (+) spherical value for intermediate distance into the upper part of classic progressive glasses lenses. I even conducted a primitive experiment for this. I shared this idea with an international company specializing in progressive lens software, and they informed me that they already had flying pilot glasses of that type. Who thought of it first, I don’t know. A company in Türkiye made me one regular pair, one office pair, and one pilot pair of glasses; however, while the first two were suitable, near vision through the lower part of the pilot glasses was not possible. They indicated that my prescription was incorrect, and I couldn’t argue.