Ashore Vision Center
Customized Lenses Form
Your Name (need match in your order)
Email Address (need match in your order)
Choose Lens Type
Select one...
Myopia (Nearsightedness)
Hyperopia (farsightedness)
Select Degree for Left Eye
Select Degree
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Select Degree for Right Eye
Select Degree
0
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75
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Pupillary Distance (PD)
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