Lens Order Form

ACCOUNT INFORMATION

PLEASE SUPPLY NOCTURNAL DESIGN LENS FOR PATIENT DATA BELOW:

SE Rx Input SE Rx (Best Vision Sphere).

HVID Lens diameter 11.0 for HVID >11.20, 10.5 if below

Optic Diameter Standard optic diameters will provide optimum vision quality. Smaller diameters can be used to increase spherical aberration desirable in myopia management or presbyopia. Specify Standard or desired diameter in 0.5mm

RXStandardMinimum
< -5.006.504.50
-5.00 to -6.006.004.50
>6.005.504.50
Maximum upload size: 33.55MB

IF YOU CANNOT UPLOAD A TOPOLOGY FILE PLEASE FILL IN THE FIELDS BELOW

Attach Topography Attach exported file from Medmont, Keratron, Oculus, Topcon, CSO topographer. If topographer not listed input Ks and e data.

K Flat K Steep* (needed if NO topography attached) Input Ks from topographer.

Eccentricity (if e>0.45) Input the average e value from the flat and steep axis from topography or use 0.45 which is population average. To design meridian specific lenses with eccentricity input e in e Flat and e Steep boxes