varilux progressive lens fitting and dispensing guide

VARILUX
PROGRESSIVE LENS FITTING AND DISPENSING GUIDE
01
VARILUX
PROGRESSIVE
LENS
Fitting and Dispensing Guide
PART I
FITTING GUIDE
STEPS FOR FITTING VARILUX LENSES
1. FRAME SELECTION
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.
2. PRE-ADJUST FRAME
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
3. MARK PUPIL CENTRE AND MEASURE MONOCULAR PUPILLARY DISTANCES (PD) AND FITTING HEIGHT (FH)
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.
PD
FH
VARILUX PROGRESSIVE LENS - Fitting and Dispensing Guide
02
• Digitally
Ada
Adapt the clip on the frame and take the
mea
measurements with the Vscope. Ensure the
poin
pointer is placed over the corneal reflex
and that the markers for the frame size are
pro
properly positioned.
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.
4. PERSONALIZATION PARAMETERS
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.
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.
03
VARILUX PROGRESSIVE LENS - Fitting and Dispensing Guide
Measuring Tools for Personalization Parameters:
PD Ruler
360 Ruler
Pupillometer
Vscope
Technological devices:
Visioffice
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.
• PDs
• FH
• VD
• PDs
• FH
• VD
• WRAP
• PANTO
• PDs
•
•
•
•
PDs
FH
VD
WRAP
• PANTO
• DEYE
• WD
•
•
•
•
PDs
FH
VD
WRAP
•
•
•
•
PANTO
DEYE
WD
H/E
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
PART II
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.
Varilux Liberty
Engraving
Regular
Varilux Physio
Engraving
Short
Digital
Engraving
Regular
Digital
Classical
360°
Engraving
Short
Varilux Comfort
Engraving
Regular
Engraving
Short
Classical
360°
360°
360°
Azio
360
India
360°
India
Azio
360
Kan
360°
f-360°
Varilux S series
Digital
Digital
360°
360°
360°
360
Azio
360°
360
Azio
360°
India
360°
India
Kan
Design
Kan
Design
Short
Digital
Digital
360°
India
360°
India
Azio
+S
Azio
360°
360°
Kan
Kan
Customized
Design
Fit
+F
3D
+ 3D
4D
• Material codes appears to the right of the design identification.
Add Power
Airwear
20
1.53
15
10
Physio
Design Identification
1.56
ABCD*
1.60
R
1.67
f360
Kan
1.74
L
20
Distance Power
Prism Reference Point
Lens Engraving
Temporal
20
Nasal
+4D
VARILUX PROGRESSIVE LENS - Fitting and Dispensing Guide
04
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. Provide Assurance to the wearer
• Deliver the Certificate of Authenticity
• Inform patient about adaptation period
• Provide wearing guide
3. DEMONSTRATE VIEWING AREAS
40cm
6m
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.
60cm
c) Intermediate
Repeat the demonstration. This time, ask the patient
to look at an object at arm’s-length distance.
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.
VARILUX PROGRESSIVE LENS - Fitting and Dispensing Guide
PART III
05
TROUBLESHOOTING
HOW TO SOLVE ADAPTATION PROBLEMS
It is important to follow a precise sequence in order to determine the cause of the issue.
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.
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.
PART IV
FOLLOW UP CARE
SYMPTOM
SOLUTION
Wearer has narrow reading area
• Verify fitting height and PD Measurements
• Verify ADD Power
• Add pantoscopic tilt and decrease vertex distance
Peripheral vision blurs and moves
• Adjust frame to decrease vertex distance and to increase facial wrap
Wearer lifts head or glasses
to read
Lenses are fitted too low:
• Adjust the frame to sit higher
• Raise frame by adding nosepads
• If necessary, re-fit lenses
Wearer lowers head or glasses to
look at a distance
Lenses are fitted too high:
• Adjust the frame to sit lower
• Lower frame by adjusting nosepads
• If necessary, re-fit lenses
Wearer moves reading material
off to side for better focus
PD is off:
• Verify monocular PD measurements
• Have lenses re-made with correct PD measurements
Distance vision is slightly blurry
For central vision, increase pantoscopic tilt, or slightly decrease fitting height
Wearer sees light sources doubled
• 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.