Comparison of physiognomy and frame angle parameters using different devices to prescribe progressive addition lenses.

Clinical relevance: Accurate measurement of several physiognomy parameters (interpupillary, nasopupillary and fitting height distances) and frame angles (pantoscopic and frame wrap angles) is essential for prescribing progressive addition lenses for presbyopic patients.Background: Few reports have described the repeatability of different devices commonly used to conduct essential measurements for prescribing progressive addition lenses.Methods: Interpupillary, nasopupillary (at far and near distances) and fitting point heights were measured three consecutive times in 21 healthy volunteers with four devices (traditional frame ruler, PD-5 interpupilometer, OptiCenter, and VisiOffice). Pantoscopic and wrap frame angles were also measured three times with Essilor standard pantoscopic ruler, Opticenter and VisiOffice.Results: The frame ruler, PD-5 and Opticenter showed better repeatability for interpupillary and nasopupillary distance (co-efficient of variation close to 1%, within-subject standard deviation or Sw < 0.50 mm) measurements at far and near distances than Visioffice (co-efficient of variation > 2%, Sw > 0.50 mm). Fitting point heights measurements showed worse repeatability with all devices (frame ruler: co-efficient of variation close to 5%, Sw = 0.46 mm; Opticenter co-efficient of variation > 5%, Sw > 0.80 mm; Visioffice co-efficient of variation > 10%, Sw > 1.50 mm). Pantoscopic angle measurements showed very low repeatability with the ruler and Opticenter (co-efficient of variation > 25%, Sw > 1.90 mm). The frame wrap angle showed unacceptable repeatability values with the ruler (co-efficient of variation > 10%, Sw = 0.49º) and Visioffice (co-efficient of variation > 60%, Sw > 2.50º), but acceptable repeatability with Opticenter (co-efficient of variation < 1%, Sw = 0.05º).Conclusions: Interpupillary and nasopupillary distance measurement showed acceptable repeatability with all the assessed methods; however, these measurements alone are no longer sufficient for free-form progressive addition lens prescription, which requires fitting point heights and pantoscopic and frame wrap angle measurement. Such measures display a lack of repeatability that could induce centration errors and could affect vision and/or adaptation of the user.