Year of Prescription ( Optional ):
Pupillary Distance (P.D.) :
|
Sphere |
Cylinder |
Axis |
Prism |
|
Add |
| Right(OD) |
|
|
|
|
|
|
| Left(OS) |
|
|
|
|
|
|
* Additional $ 59 USD will be charged if your cylinder lower than -2.75 or higher than +2.75
* Additional $ 3 USD will be charged for each degree of prism correction on each lens .