PROGRESSIVE LENS FITTING AND DISPENSING GUIDEVARILUX

FITTING GUIDE STEPS FOR FITTING VARILUX LENSES

1. FRAME SELECTION

2. PRE-ADJUST FRAME

3. MARK PUPIL CENTRE AND MEASURE MONOCULAR PUPILLARY DISTANCES (PD) AND FITTING HEIGHT (FH)

For best vision select a frame appropriate for the wearer’s face: it should be stable on the nose and offer sufficient height between the pupil & the lower rim of the frame. The eyes should also be well centered.

Always adjust the frame on the wearer before taking any measurements!

Ensure that:

• The vertex distance is approximately 12 to 14 mm without touching eyelashes or skin

• The pantoscopic angle is around 8 to 12 degrees

These 2 parameters are critical for a proper fitting of progressive lenses. You can measure them manually or automatically, using digital device such as Vscope (recommended for a more accurate dispensing).

• Manually

With the wearer looking straight at far distance, shine a pen torch below the eye and dot each lens at the center of pupil. Draw a line horizontally across the mark and check that the lines are crossing the center of each pupil.

Measure monocular FH on the di-test card or with a ruler: this is the vertical distance between the deepest point of the frame and the mark.

For an easy measurement, you can use the HMS (Height measuring system): adjust the white lines to cross the corneal reflect and read the FH at the tangent to the bottom of the frame.

Measure the monocular PD on the wearer, using a pupillometer or a PD ruler, to ensure exact centering of the eyes behind the lens.

VARILUXPROGRESSIVELENSFitting and Dispensing Guide

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PART I

PD FH

VARILUX PROGRESSIVE LENS - Fitting and Dispensing Guide

• Digitally

Adapt the clip on the frame and take the measurements with the Vscope. Ensure the pointer is placed over the corneal reflex and that the markers for the frame size are properly positioned.

For patients wishing superior visual performance with personalized parameters, Varilux Comfort f360, Varilux Physio f360, Varilux Ipseo and some Varilux S Series will need these additional measurements. As for PD and FH, you can proceed manually using the 360 ruler or digitally using the Vscope. Always measure on a pre-adjusted frame!

• Manually

Pantoscopic Tilt

With the wearer looking straight ahead, place the vertical edge of the tool against the temporal front surface of the frame. Once the air bubble is stabilized, you can read the pantoscopic tilt of the frame.

Check lens cut out

• To ensure proper lens cut out, place the lens marking in alignment with the layout chart cross, aligning the pupil center dot over the fitting cross.

• Frame size is adequate if the full areas of the distance vision and the reading circles fall within the frame.

• If the lens does not fit consider choosing another frame.

Back Vertex Distance

With the patient standing up in profile, place the edge of 360 Ruler tool along the frame temple with the “0” at the lens plane, and measure the distance in millimeters from the back of the lens to the front of the eyes.

Wrap Angle

Using the 360 Ruler tool, place the frame top down on the tool aligning bridge center and lens as shown. Measure the frame wrap angle from the base of the tool to the right lens angle.

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4. PERSONALIZATION PARAMETERS

Adameapoinandpro

VARILUX PROGRESSIVE LENS - Fitting and Dispensing Guide

Measuring Tools for Personalization Parameters:

DISPENSING GUIDE STEPS FOR FOR DISPENSING VARILUX LENSES

1. CONFIRM MEASUREMENTS, POWER AND LOCATE ENGRAVINGS

Use a good light source and dark background to locate the engravings. Center the frame using the centering chart:

• Confirm the monocular PD and FH

• Confirm the powers: note that because modern progressive lenses are optically compensated to optimize wearer perception, measured powers (sphere, cylinder, axis, add, prism) might differ from prescribed powers. Please check on the lens label what should be the measured power and ask your customer service if in doubt.

- distance power can be checked through the center of the distance checking circle, 3mm above the fitting cross

- verify that the add power engraving under the temporal micro-circle matches the first two digits of the prescribed add (e.g. “25” signifies addition 2.50 D) and check the addition at the center of the near vision circle

- confirm prism at prism reference point (PRP)

• Design identification ensures that you are getting a quality branded Varilux lens. It’s shown as an engraving located under the nasal micro-circle that’s unique to each Varilux lens design.

Technological devices:

To prescribe sophisticated lenses, high technology measurement devices have been developed. The Visioffice allows to measure 15 parameters in a few minutes, including the Eye Rotation Center position and the Head/Eye behavior for totally personalized lenses.

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PD Ruler 360 Ruler Pupillometer Vscope Visioffice

• PDs• FH • VD• WRAP

• PANTO• DEYE• WD• H/E

• PDs• FH • VD• WRAP

• PDs • PANTO• DEYE• WD

• PDs• FH • VD

• PDs• FH • VD

• WRAP• PANTO

1.67 1.74

Airwear 1.53

1.601.56

• Material codes appears to the right of the design identification.

EngravingRegular

EngravingShort

Digital Digital

Varilux Liberty

ClassicalEngravingRegular

360°

India

EngravingShort

360°

360

360°

Azio

360°

Azio 360°

India

f-360°f360

360360°

Kan

Kan

Varilux Physio

EngravingRegular

EngravingShort

Classical Digital360°

Azio 360

360°

Digital 360°Azio 360

360°

India 360°

India 360°

Kan

Kan

Varilux Comfort

Design

DesignShort

Digital

+ SDigital

CustomizedDesign

+ FFit

3D

+4D4D

Azio

360°

Azio 360°

India360°

India

Kan

Kan

360°

+ 3D

Varilux S series

20Lens Engraving NasalTemporal

20

Physio

20

15

10

ABCD*

R L

Add Power

Design Identification

Distance Power

Prism Reference Point

PART II

PD – Pupillary Distance; FH – Fitting Height; VD – Vertex Distance; Wrap – Wrap Angle; Panto – Pantoscopic Tilt;

Deye – Dominant Eye; WD – Working Distance; H/E – Head Eye

3. DEMONSTRATE VIEWING AREAS

2. CONFIRM FIT ON PATIENT WITH THE FOLLOWING STEPS:

a. Verify lenses: lenses should have their ink markings and frame should be adjusted. If ink markings are missing, retrace them from the micro-circles using the appropriate di-test card.

• the fitting cross should be at pupil center when eyeglasses are on the wearer.

• adjust the frames to raise or lower the fit if necessary

b. Recheck frame adjustments

• Pantoscopic Tilt, Face Form Angle, Back Vertex Distance

c. Educate wearers how to use lenses: explain

• The extent of the visual fields

• The transition between distance, intermediate and near zones

• Side-to-side head movement for peripheral viewing

d) Periphery

Demonstrate the decrease in power at the periphery by having the wearer hold his or her head still while moving the reading card from side to side.

c) Intermediate

Repeat the demonstration. This time, ask the patient to look at an object at arm’s-length distance.

a) Distance

Demonstrate the distance prescription by having the patient look at an object at least 6m away.

b) Near

Demonstrate the near reading area by having the wearer read the Varilux Lens Reading Card.

d. Provide Assurance to the wearer

• Deliver the Certificate of Authenticity

• Inform patient about adaptation period

• Provide wearing guide

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6m40cm

60cm

VARILUX PROGRESSIVE LENS - Fitting and Dispensing Guide

1) Understand the precise complaint

Type of problem encountered, frequency and symptoms of problem, distances concerned, expedient solutions found, etc. Discuss with the wearer to clarify the issue.

2) Remark the lenses

Locate the lens engravings and remark the fitting cross for distance vision and near vision circles. Look also for coating issues (crazing, scratches, resisting smudges…) that can affect vision.

3) Recheck lens prescription

Power of distance vision, near addition, pupil distances and fitting heights.

TROUBLESHOOTINGHOW TO SOLVE ADAPTATION PROBLEMS

FOLLOW UP CARE

It is important to follow a precise sequence in order to determine the cause of the issue.

SYMPTOM SOLUTION

Wearer has narrow reading area

Peripheral vision blurs and moves

Wearer lifts head or glassesto read

Wearer lowers head or glasses to look at a distance

Wearer moves reading material off to side for better focus

Distance vision is slightly blurry

Wearer sees light sources doubled

• Verify fitting height and PD Measurements• Verify ADD Power• Add pantoscopic tilt and decrease vertex distance

• Adjust frame to decrease vertex distance and to increase facial wrap

Lenses are fitted too low:• Adjust the frame to sit higher• Raise frame by adding nosepads• If necessary, re-fit lenses

Lenses are fitted too high:• Adjust the frame to sit lower• Lower frame by adjusting nosepads• If necessary, re-fit lenses

PD is off:• Verify monocular PD measurements• Have lenses re-made with correct PD measurements

For central vision, increase pantoscopic tilt, or slightly decrease fitting height

• Verify astigmatism• If necessary, re-fit lenses with new Anti-reflective coating

Essilor International is the world leader in the design, manufacture and customization of ophtalmic lenses. Active on five continents, Essilor offers a wide range of lenses under the flagship Varilux®, Crizal®, and Essilor® brands to correct myopia, hyperopia, presbyopia and astigmatism.

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4) Check the centration of the lenses

Confirm the proper fitting of the frame. Then with the wearer looking at distance, recheck the centration of the lenses. Adjust the pantoscopic tilt and wrap angle if necessary.

5) Validate the wearer’s prescription

If the earlier steps did not reveal any inconsistency, measure the acuity at distance and near.

• Confirm the value of the addition as related to the age. • A refraction is necessary if the acuity falls below expectation.

VARILUX PROGRESSIVE LENS - Fitting and Dispensing Guide

PART III

PART IV