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Pupillary Distance (PD)
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| Right Eye | Left Eye | |
| SPH | Please select a value | Please select a value |
| CYL | Please select a value Combined SPH and CYL cannot exceed -6 | Please select a value Combined SPH and CYL cannot exceed -6 |
| AXIS | Please select a value | Please select a value |
| ADD | Please select a value | Please select a value |
| Pupillary Distance (PD) | ||
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| Near Pupillary Distance | ||
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OC Heights
Right Eye
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Left Eye
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Optional Upload
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| Right Eye | Left Eye | |
| Horizontal | Please select a value | Please select a value |
| Horizontal (base direction) |
Please select a value | Please select a value |
| Vertical | Please select a value | Please select a value |
| Vertical (base direction) |
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