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December 5, 2023
Following EssilorLuxottica’s introduction of its newest eyeglass lens, Varilux XR, and the announcement that it was designed using behavioral artificial intelligence, Review of Presbyopia and the Aging Eye reached out to get the opinions of both an optometrist and an optician. ROP Editor-in-Chief John Sailer interviewed Ryan Parker, OD, Sr. Director of Professional Development, EssilorLuxottica, and Pete Hanlin, VP, Professional Services, EssilorLuxottica, to find out how this new lens matches today’s presbyope’s lifestyle and how it was developed with thousands of data points from real world measurements. Read or listen to the conversation here:
John Sailer, Editor-in-Chief, Review of Presbyopia and the Aging Eye: Hello and welcome to the Review of Presbyopia and the Aging Eye interview series. I am John Sailer, Editor-in-Chief of Review of Presbyopia and the Aging Eye, and we are here with optometrist, Dr. Ryan Parker and optician Pete Hanlin. We have the opportunity to bring together this optician and this optometrist to get the perspective of these two Os about the latest spectacle lens technology, Varilux XR. Thank you both for being here.
Ryan Parker, OD, Sr. Director of Professional Development, EssilorLuxottica: Hey, John, it is absolutely my pleasure. Anytime I get a chance to talk with you about some of the latest technology, it’s always an honor.
Pete Hanlin, VP, Professional Services, EssilorLuxottica: My pleasure. Thanks for the opportunity.
ROP/Sailer: So, let’s get right into it. This is really exciting new technology. It’s a lens design based on artificial intelligence. So, what do optometrists and opticians need to know that’s different about Varilux XR from each of your perspectives?
EssilorLuxottica/Dr. Parker: Alright, John, I’ll think I’ll take that one first. I’ll give Pete a little time to formulate an even better answer. There’s so much. I don’t know how long we want this podcast to be. We could get like three days’ worth, but I’m sure your listeners would appreciate something a little bit more succinct.
There’s a lot of things that are new. The one thing that I like to talk to my optometrist colleagues about is just level setting on how lens technology and R&D work. As you know, we launched Varilux X around 2017, but the R&D leading up to that lens was five years prior. So that lens was designed with ideas and visual usage back in 2012/2013. As we all know, the way that we use our eyes today is vastly different. And the way I like to describe this lens for them is it is designed for how their patients use their eyes today, because, as we know, it’s vastly different today than it was even five and definitely 10 years ago. I also want to make sure that they understand that this lens should give them the confidence to open up that presbyopia conversation sooner than they have historically.
EssilorLuxottica/Hanlin: I get to listen to a lot of opticians in market research, and a recurring theme that I hear as well is that all progressives are pretty much the same. If they don’t say it out loud, you can tell they kind of believe that in the back of their mind. I would emphasize that all progressive lenses are not the same. When you do the research, and when you really start looking into human vision, progressive lenses are apt to cause so many different side effects. We hear those as opticians all the time: “I have to move my head all the time.” or “The stairs are wonky.” In the course of solving for near and far vision and everywhere in between, there are a lot of things that progressives do that annoy our patients. And you can actually get rid of those side effects if you just study them and come up with technologies that get rid of them.
ROP/Sailer: Okay, great. That’s very exciting. So, Dr. Parker, elaborating on the optometrists’ perspective, what changes were occurring among patients, their environment, and their lifestyles that resulted in the need for developing Varilux XR?
EssilorLuxottica/Dr. Parker: I think we could sum it up with we are hyper connected. We have multiple devices, and it seems like we’re on the go more than we ever have been. There’s a lot of data out there, and we have more than 100,000 eye movements per day. Our eyes are moving all over the place to be able to take in all the information that we have. Think about my workstation. I’ve got the phone. I’ve got my computer. I’ve got another screen over here. My watch is on as well. And that’s just at the workstation. As I’m transitioning to my Jeep and I’m moving around I have the phone there, the GPS is now up, the watch is there. Not that I would ever check my phone, of course, while I’m driving in traffic in the Dallas-Fort Worth area. But eye movements are a big thing, and when we’re moving our eyes and we’re moving around so much, it’s difficult to maintain sharpness while we’re in motion. That’s one of the things with the Varilux XR series; it’s the first eye-responsive progressive lens that gives that instant sharpness while we’re in motion. It comes down to the fact that we’re more digitally connected than ever. There’s a lot of eye movements throughout the day. You know as well as I do, we’re getting 80 plus notifications on our devices during a normal day. All those things add up. We’re on the go, we’re moving around. Being able to deliver that sharp vision that our consumers expect while we’re on the go is a very big challenge. Until, of course, we introduced Varilux XR series.
ROP/Sailer: Okay, and for opticians, Pete Hanlin, how would you describe the technology behind Varilux XR that opticians can use when communicating with their patients?
EssilorLuxottica/Hanlin: It’s important to have the optician let the patient know that as much as opticians tend to believe that all progressives are the same, patients don’t have that perspective because patients generally believe there’s only one type of progressive. I hear all the time from consumers that there are lined multifocals, there are readers, and there are no-line progressives. They think that they’re all the same thing, and the truth is that they’re not. The progressive lens is going to enable you to see up close again. That’s what you’ve lost as you’ve gotten a little bit older. But in the process of doing that, it can cause things like magnification, which is what causes what people call swim. It can cause other problems with your visual system that you might not be thinking about because wearing a progressive lens is much different than wearing a single vision lens. So, the technology that I would emphasize is just the fact that it’s possible to have a set of matched lenses that are designed to work together because most progressive lenses are not designed necessarily to work together. The right lens is calculated, the left lens is calculated. Hopefully you put them in the right place. But Varilux XR series lenses are calculated as a matched pair of lenses, and that is dramatically different than most of the progressive lenses that we see on the market today.
ROP/Sailer: Okay, that’s a big difference to share with the patients. So, Dr. Parker, of course, the optometrist must also discuss the new Varilux spectacle lens technology with patients. What advice do you have for optometrists who want to prescribe this new lens for their patients?
EssilorLuxottica/Dr. Parker: I think one of the things that optometrists will probably hear is, “This is another lens?” Just like Pete said, they don’t understand that there’s more than one progressive lens out there, and when we start talking about yet a different lens, they may be confused about why. The thing to understand is technology has evolved. As far as EssilorLuxottica’s standpoint, they have studied over 6,500 consumers to really understand and predict how a presbyope is going to move their eyes based on their prescription. We’re talking tons and tons of data points that we’ve compiled together to predict how the consumer will move their eyes.
As Pete talked about earlier, this really becomes an issue when you’re moving your eyes around the lens because once we get off the optical center of the lens, in theory, the designs can be different enough to where it can challenge binocularity.
That creates some issues while the patient is in motion. So, by understanding and predicting how the patient is going to move their eyes, we can get a more customized design for that. The technology and lens design are keeping up with the way that our patients are using your eyes. So those data points have been used for a breakthrough behavioral monitoring system that’s going to predict how their patients are going to be able to move their eyes and look around the lenses. What this means and what the optometrist needs to be talking about to the patient is for every single prescription that’s out there that visual behavior profile is predicted, and the design will be customized that respects those natural eye movements. At the end of the day, that means better vision while in motion, better vision with our connected lifestyle, and most importantly, it’s the vision that they expect to have because that’s the same type of vision they have before they’re presbyopic. That’s what’s really exciting. If they get asked the why, it’s just because technology has evolved, and all these data points that EssilorLuxottica has taken for years, in store with different measurements, with consumer wear tests, with R&D testing, they’ve compiled together and created an amazing predictive behavior on how the consumers are going use their eyes.
ROP/Sailer: Okay. So then after the doctor prescribes this new lens technology for their patients, it’s time for the optician to begin the dispensing process. So, what would you say, Pete Hanlin, is everything the optician needs to know about Varilux XR in order to successfully fit their patients with this new technology?
EssilorLuxottica/Hanlin: Well, I’m actually going to back the train up a bit and say that the first thing that the optician needs to know is that the proper place to put that fitting cross is right in the center of the pupil. I say that because I get called in on hundreds and thousands of troubleshoots, and as an optician, it just pains me to say it, but over 85% of progressive non-adapts don’t occur because the prescription is screwed up. They don’t occur because of the design. They occur because the fitting reference point, the fitting cross, was not placed right in the center of the pupil. Now, for this design especially, it’s important that as an optician you’re doing your job, you’re taking the binocular pupillary distances, you’re taking that accurate fitting height, and you are putting that fitting reference point right where it needs to be.
The reason is that this lens is powered by something called behavioral artificial intelligence. I say artificial intelligence, and people will think that’s just marketing. But it’s not. We interact with artificial intelligence every day of our lives in modern life. Every time you put into Google Maps where you want to go and you see that map, Google Maps is using artificial intelligence. They’re using data points gathered from thousands of drivers on the route that you’re trying to take to say what is the best route to get from point A to point B. In a very similar way, Essilor R&D was able to use over 4,500 patients. They were able to study them, and they were able to say what are the pathways that the eyes are taking going from distance to near. Because those pathways, just like traffic, are going to alter depending on what your prescription is, depending on what your pupillary distance is, depending on what the fitting height is, depending upon how tall you are, to be honest, because you taller people have longer reading distances because they don’t have tiny T-rex arms like I do. I’m kind of short. And the most crucial thing for that artificial intelligence and that predictive behavior is to start at the right starting point.
So, imagine that you’re trying to go somewhere and you’re using Google Maps, why would you ever type in an address that’s not actually where you’re starting from? Because the directions are going to be screwed up. In the same way, if you don’t fit a highly complex progressive lens at the right spot, and if you’re not starting the eye where the designer assumed the eye was going to start in its journey to near, you’re not going to get the best results.
Conversely, the exciting thing is that behavioral artificial intelligence is driven by the size of the database. In artificial intelligence, the database determines how intelligent the artificial intelligence can be. The database used to create Varilux XR series is by far the largest ophthalmic database that exists out there. So, it can be very accurate and provide great vision as long as you give it the right starting point, and that would be the fitting reference point right in the center of the pupil.
ROP/Sailer: Okay. Good information and great advice. So, we’ve discussed what’s new among patients that they need the new Varilux XR technology. We’ve discussed this exciting new spectacle lens design technology that uses behavioral artificial intelligence as you just mentioned. Anything else that you’d like to add about this new development from EssilorLuxottica from both of your perspectives?
EssilorLuxottica/Dr. Parker: The one thing that we haven’t really discussed yet is how well are patients seeing in this thing? Because that’s what the optometrist and optician want. They want a happy patient running around there, and I know a lot of times in the world of presbyopia we delay the conversation. We delay it because we know that historically we’re going to prescribe a design that the patient’s going to have to work with to be able to see like they want to be able to see. We’ve all heard, “We’re going to put this lens on you. You may have to point your nose at something, move your head up and down a little bit, and give it two weeks.” When I was in practice, I did that a ton. What we’re trying to tell there is, “Mr. and Mrs. Jones, I’m going put you in a lens that’s weird because it’s not designed for how you use your eyes, and I hope in two weeks that you’re going to get accustomed to it.” Which means you’re just going to forget the shortcomings of that lens.
It’s not like that with Varilux XR anymore because like what Pete talked about with the behavioral artificial intelligence, the huge database we’re able to do amazing things with the design. We’re calculating this three-dimensional area that the wearer can see sharply from 30 centimeters to infinity, and there’s a big area with that. In fact, if, if you compare it to an amazing lens, its predecessor, Varilux X, the Varilux XR series has that instant sharpness even while in motion and 49% more volume of vision in that area that we’re talking about.
Of course, we’re not going to bring this product to market without doing some independent third-party tests because we want the optical world to be confident when they put their patients into this product, that the patient’s going be happy and tell all their friends about it.
So, in those independent third-party wearer tests, 87% of the consumers, which most of them were wearing some type of premium progressive lens, actually preferred Varilux XR to their previous lenses after trying them; 95% of the wearers adapted to their new lenses on the first day. I remember my days in practice. I don’t think I had 95% of my wearers adapted to their brand new progressive lenses on day one. That’s what I’m so excited about this, all these wonderful things we’ve talked about for our patients mean better vision, and for us it means happier patients, which means happier practices.
ROP/Sailer: That’s great. So, Pete Hamlin, anything from your optician’s perspective?
EssilorLuxottica/Hanlin: Just as consumers don’t know that there are multiple different types of progressives, you can flip that around and use it to your advantage. When you put the right progressive on a patient and fit it properly, you give them vision that they’re not going to get anywhere else. Dr. Parker mentioned that 87% of people who were already wearing and adapted to premium progressive lenses preferred Varilux XR series over their current lenses. I can tell you why because I’ve been wearing Varilux XR Track lenses now for about a month. I was a huge fan of Varilux X series. The thing that I always liked about that design and I like about the new design is I’ve tried every single major premium progressive on the market, and they’re good. They’re very good, but the one thing that I always notice is I’m always able to tell that I’m wearing a progressive because there’s always portions of my vision that get just a little bit compromised because I’ve got a lens that’s changing power across its surface.
When I put Varilux XR Track on, for the past month, I have not been able to notice a moment where I noticed that my vision was compromised. The reason comes down to four key technologies that are found in this lens. W.A.V.E. 2 Technology gets rid of aberration and gives me sharper vision even though I don’t particularly like lighting. I tend to hang out in dimly lit areas, and I need to read things, so W.A.V.E. 2 Technology allows me to do that easier than any other lens. The XR-motion, as Dr. Parker mentioned, I’m moving my eyes 100,000 times a day. Every single time you switch where you’re looking, your two eyes have to be able to see the same thing, and your brain has to turn it into crisp, clear vision. With most progressive lenses, the second you look away from the fitting reference point, your eyes are seeing slightly different images.
That doesn’t happen with my Varilux XR Track lenses. As a result, even though I didn’t realize it was a problem before, now as I just look around, it just feels very natural. I never notice an instance where I have to take that extra second to be able to figure out what I’m trying to see. Then Nanoptix basically uses a very simple geometrical principle to get rid of magnification in the near zones. So, when I come up the stairways, I don’t have to grab the hand rail, the stairs look perfectly normal. Yes, I’m now a 2.25 add because I’m getting kind of old, so if I look through the very bottom of the lens, I can get the stairs to be a little blurry because they’re a little far away, but they’re not curved and they’re not moving around. That’s the only progressive lens that I’ve ever worn that completely gets rid of that off balance feeling when I’m running up and down the steps.
So, I would just say that if you want to be a hero to your patients, even if they’re wearing something else that’s a really good progressive lens, all you have to do is fit this lens properly, and it will make you look like an optical genius, an optical god. Your patient will have vision that’s not compromised, that’s very much like the vision that they had before they lost the ability to see up close. I can’t tell you how liberating that is. So, I’m really looking forward to this lens being on the market and people getting more and more experienced with it with their patients because I think the proof is going to be in the pudding, and you’re going to hear some very ecstatically rave reviews from your patients with this lens.
EssilorLuxottica/Dr. Parker: Hey John, one thing I want to add, if you don’t mind. Pete said something that I want to make sure and expound because we’ve been talking about Varilux XR design, and Pete did mention Varilux XR Track. Some of your listeners may be going, “Hey, what’s going on here?” It’s actually two different versions, if you will. So XR design is kind of the base design, if you will. It uses that predictive visual behavior. You don’t have to take any additional measurements. Of course, if you want to give position-of-wear measurements that will help be able to make sure the design is more closely matched to the standards that the lab uses. The way I describe them is XR design is kind of customized based on the patient’s prescription and what we know from all that predictive modeling.
But if you really want to personalize it, the cherry on the sundae, that’s where XR Track is. XR track uses a device called the Eye-Ruler 2 that measures how your patients read in your office, and what we’re able to do based on four parameters – reading distance, gaze lowering, if we’re an eye mover or head mover, and lateral offset. These are four things that all go into how we read. And if you think that we all read the same, next time you’re out at dinner, check how everyone’s holding their iPhones when we’re waiting on the food. It’s all different. So, what we’re able to do with the Eye-Ruler 2 is we’re able to see that Pete has this type of reading posture, Ryan has this type of reading posture, and the design’s going to be different based on how they use their eyes.
I am also wearing XR Track, and I’m a little opposite on the spectrum here as far as Pete goes. I’m not saying this because Pete’s had just a couple more birthdays than I, not many, but he said he was a 2.25 add, and I am only a +.75 ad. As you know, John, I’ve lectured about getting presbyopes into progressive lenses earlier because it’s much better for the visual system. You and I have talked about that many times when we’re out at meetings, so, of course, I listened and 18 months ago got myself into my first progressive lens. Yes, I was spoiled, and I was in Varilux X, which is an amazing lens. Then we started talking about XR and XR design and XR track, and I got my first pair of Track. I put them on and went, “Wow, I can see really well,” but the difference wasn’t quite clicking yet because they’re both amazing lenses.
Then Pete and I were talking prior to one meeting at some point in time, and I kind of brought this up to Pete, “Hey, are you noticing the difference?” Pete went on and on about all this, and then he said something to me that was interesting. I said, “I’m seeing the difference, but it’s not as profound as what you’re talking about.” Then Pete asked me, “Isn’t that your pair of XR track?” And I’m like, “Yeah, it absolutely is.” And he says, “Well, it’s funny. I’ve known you for a number of years, and I’ve never been able to see you wear your glasses all day long.” I’m the worst patient ever. I’m a slight hyperope with a little bit of astigmatism. So, I run around uncorrected, and Varilux X was an awesome lens, but I just wore it at my desk, and I could see beautifully well. I’ve noticed with the XR Track, subconsciously, I can get up and walk around with this thing. I’ve even gone downstairs, got to the car, started driving, and I’m like, “Wait a minute. I don’t have my sunglasses on. I still have my progressive lenses on.” Before I would’ve noticed that, just like Pete talked about, there’s some awareness of that. With XR track, there’s not. I forget that I even have a lens on that gives me clear vision throughout because it just occurs naturally because it’s exactly how I use my eyes. And so that was my aha moment, and I actually needed someone way smarter than me, which Pete is, to point out like, “Hey dude, that’s the only glasses, and we’ve known each other for a number of years, that I’ve ever seen you able to wear throughout the day.”
ROP/Sailer: Alright, that’s some really good background information based on your own personal experience. Great to hear it. Thank you, Dr. Ryan Parker.
EssilorLuxottica/Dr. Parker: Oh, it was our pleasure. Always appreciate the opportunity, John.
ROP/Sailer: And Pete Hanlin, thank you also for such excellent background information. Thank you both for being here and sharing all this information about Varilux XR from both the perspective of the optometrist and the optician. And thank you all for listening to this interview in the series from Review of Presbyopia and the Aging Eye about the new lens, Varilux XR.
