OD/Right Sphere *
OD/Right Cylinder *
OD/Right Axis *
OS/Left Sphere *
OS/Left Cylinder *
OS/Left Axis *
Bifocal/Right
Bifocal/Left
Pupil Distance Binocular – if one number is shown on your Rx
PD/Right (If two numbers are shown on your Rx)
PD/Left (If two numbers are shown on your Rx)
Laser Name Labeling – Enter your name or message. in the box below
