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