SNOOKER Order
NAME
ADDRESS
POST CODE TELEPHONE
EMAIL
Prescription detail
SPHERE CYL AXIS
RIGHT EYE SELECT -6.00 -5.75 -5.50 -5.25 -5.00 -4.75 -4.50 -4.25 -4.00 -3.75 -3.50 -3.25 -3.00 -2.75 -2.50 -2.25 -2.00 -1.75 -1.50 -1.25 -1.00 -0.75 -0.50 -0.25 0.00 +0.25 +0.50 +.075 +1.00 +1.25 +1.50 +1.75 +2.00 +2.25 +2.50 +3.00 +3.25 +3.50 +3.75 +4.00 +4.25 +4.50 +5.00 +5.25 +5.50 +5.75 -5.00 +6.00 SELECT NOT USED +2.00 +1.75 +1.50 +1.25 +1.00 +0.75 +0.50 +0.25 0.00 -0.25 -0.50 -0.75 -1.00 -1.25 -1.50 -1.75 -2.00 SELECT NOT USED 180 175 170 165 160 155 150 145 140 135 130 125 120 115 110 105 100 95 90 85 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5
LEFT EYE SELECT -6.00 -5.75 -5.50 -5.25 -5.00 -4.75 -4.50 -4.25 -4.00 -3.75 -3.50 -3.25 -3.00 -2.75 -2.50 -2.25 -2.00 -1.75 -1.50 -1.25 -1.00 -0.75 -0.50 -0.25 0.00 +0.25 +0.50 +.075 +1.00 +1.25 +1.50 +1.75 +2.00 +2.25 +2.50 +3.00 +3.25 +3.50 +3.75 +4.00 +4.25 +4.50 +5.00 +5.25 +5.50 +5.75 -5.00 +6.00 SELECT NOT USED +2.00 +1.75 +1.50 +1.25 +1.00 +0.75 +0.50 +0.25 0.00 -0.25 -0.50 -0.75 -1.00 -1.25 -1.50 -1.75 -2.00 SELECT NOT USED 180 175 170 165 160 155 150 145 140 135 130 125 120 115 110 105 100 95 90 85 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5
WE CAN ONLY SUPPLY PRESCRIPTIONS WHICH CAN BE COVERED BY DETAILS IN THE SELECTION TABLES.
ANTI REFLECTIVE COATING NOT REQUIRED PLEASE COAT MY LENSES ........£20.00
PLEASE POST A CHEQUE FOR £80 (£100 IF COATING IS REQUIRED).
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