Matt, yes the real medical loupes are pricey, like in the $1,000 range for my dental hygienist. The ones my dentist uses are quite a bit more I believe. As tlfamm said, there are much less expensive ones. They do the same magnification, just don't have the same lens quality.
John, the microscope is way too much magnification for me. Here is an interesting article and the one that got me thinking about better magnification. I don't work on watches or things as small as the author.
Tid-Bit 14 - To See or Not To See - Vienna Regulators - SNClocks - by Stephen Nelson
Pete, you have about what I've been looking at. I agree on the focal length, 550 is about 21", and I figure I would like something around 400-440. I assume you used something else before jumping up to the loupes, visor maybe? How does the magnification compare to your previous approach?
Larry, I bought a magnifying lens w/arm and a circular florescent light from MSC. It is handy, but the arm does not like to remain in position. I tend to take off 1 spring at a joint to keep it better positioned, but it still fights me.
MichaelP, that is a good unit, I've looked through them. I have the cheap plastic lens version and it's workable. I use it over reading glasses. The big problem with visors is the focal length decreases as the diopter goes up. The diopter value is not the magnification level, it's lower. A 3 or 4 diopter visor has a focal length in the 10-12" range (and is around a 2x magnification), which gets kind of close for machines. The Loupes come in several magnifications and several focal lengths from ~13" out to ~21".