Fitting Guide

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ABOUT PARAGON CRT® CONTACT LENSES

CERTIFICATION

Paragon CRT® (Corneal Refractive Therapy) Contact Lenses are rigid gas permeable contact lenses approved for overnight wear. Paragon Vision Sciences is the only company to have FDA approval to manufacture both the lens design (Paragon CRT®) and material (Paragon HDS®100) for overnight wear.

FDA-APPROVAL INCLUDES:

The U.S. Food and Drug Administration (FDA) requires eye care professionals to be trained and certified prior to using and prescribing overnight orthokeratology lenses. Please visit ParagonVision.com/ecp to become certified and receive your unique CRT certification number.

MYOPIA ASTIGMATISM

≤ 1.75D≤ -6.00D

The approval is for patients of all ages.

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LENS PREPARATION

Wash hands thoroughly prior to lens handling.

Inspect the lens prior to application. If you have any concern after visual inspection, do not apply the lens.

Rinse and massage gas permeable lens conditioning solution onto front and back surface of Paragon CRT® lens.

The lens may be rinsed with preservative-free saline solution prior to application.

A drop of preservative-free artificial tears can be applied to the back surface of the lens prior to application.

NEVER USE TAP WATER. Tap water poses risk of infection.

Paragon CRT® Contact Lenses are manufactured in individual vials containing gas permeable lens disinfection solution.

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Wash hands thoroughly prior to lens handling.

Remove Paragon CRT® lens manually or utilize a removal plunger.

Follow disinfection solution guidelines, including rubbing the lenses when indicated.

Store lenses in a contact lens case with gas permeable solution of choice when not being used.

Cases and plungers should be cleaned daily and replaced according to manufacturer guidelines.

NEVER USE TAP WATER. Tap water poses risk of infection.

LENS DISINFECTION

RECOMMENDED SOLUTIONS FOR CLEANING AND DISINFECTION

UNIQUE PH BOSTON SIMPLUS

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SELECTING AN INITIAL PARAGON CRT® LENS

1. ELECTRONIC LENS CALCULATORVisit ParagonVision.com/ecp to download the initial lens calculator which will calculate the first recommended Paragon CRT® or Paragon CRT Dual Axis® lens for your patient.

REQUIRED:• Keratometry values (in mm or Diopters)• Manifest refraction sphere (in minus cylinder form)• Select lens diameter based patient’s HVID.

HVID-1MM= LENS DIAMETER (ROUNDED TO NEAREST 0.5MM)

2. PHONE CONSULTATIONConsultation through Paragon Vision Sciences 1-800-528-8279 ext. 2 or an authorized Paragon CRT® Contact Lens laboratory can help assist in customizing a patient’s first diagnostic lens.

REQUIRED:• Practitioner Certification Number• Keratometry values (in mm or Diopters)• Manifest Refraction• Corneal Diameter size (HVID, WTW)• Topography if available

9.5 - 12mm

0.5mm

6.5 - 10.5mm

0.1mm

400-800µm

25µm

25° to 40°

1°

BASE CURVEDIAMETER RZD1/RZD2

PARAMETERS

ADJUSTMENTS

max difference 200µm max 5° difference

-2.00D to +2.00D

0.25D

POWER

MATERIALS CENTER THICKNESSTINTSParagon HDS®100 | MeniconZ* 0.16mm | 0.22mm**

* MeniconZ lenses are only available in blue tint **Paragon CRT Dual Axis® lenses already incorporate increased lens thickness

Green Blue Red Yellow

PARAGON CRT® LENS PARAMETERS

LZA1/LZA2

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ABOUT• The diameter provides centration of a Paragon CRT® lens• Measured in millimeters (mm), 0.5mm steps• Adjusted based on patient’s HVID

HVID-1MM= LENS DIAMETER (ROUNDED TO NEAREST 0.5MM)

ADJUSTMENT

Insufficient coverage

Excessive coverage

Increase diameter (Ex: 10.5mm to 11.0mm)

Decrease diameter (Ex: 11.0mm to 10.5mm)

Example: 12.06mm - 1mm = 11.06mmRecommend diameter → 11.00mm

Example: 11.38mm - 1mm = 10.38mmRecommend diameter → 10.50mm

DIAMETER

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BASE CURVE OPTIC ZONE (BC)

RETURN ZONE (RZD)

LANDING ZONE (LZA)

805534

Paragon CRT® Contact Lens parameters are laser marked inside the RZD of the lens for easy identification.

RZD is rounded to the nearest two digits | Example: 525 (53), 550 (55), 575 (58)

Example: 8.0-550-34

PARAGON CRT® LENS DESIGN

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BASE CURVE (BC)

EXAMPLEBC 8.8 and Refraction Over Lens: Plano. An additional 1.00D of treatment is needed to reach ROL target of +1.00DNew BC: 9.0mm.

• The base curve provides the mold for the orthokeratology treatment for myopia correction• Measured in millimeters of radius (mm), adjusted in 0.1mm increments.• Adjusted only when the Refraction Over Lens (ROL) is not at target: +0.50D to +1.00D.

ABOUT

ADJUSTMENT

ROL is more myopic than +0.50D Flatten BC (Ex: 8.9mm to 9.0mm)

ROL is more hyperopic than +1.00D Steepen BC (Ex: 8.9mm to 8.8mm)

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ABOUT• The Return Zone Depth provides the sagittal depth of a Paragon CRT® lens.• Measured in microns of sagittal depth (µm), adjusted in 25µm increments.• Adjust Return Zone Depth to manage overall sagittal lens depth. The ideal sagittal depth will provide good centration and the uniform

landing of the lens on the cornea.

EXAMPLE↑ RZD from 575 to 600 raises the lens 25µm from the cornea ↓ RZD from 575 to 550 lowers the lens 25µm to the cornea

ADJUSTMENT

If sagittal depth is excessive

If sagittal depth is inadequate Increase RZD (Ex: 550µm to 575µm)

Decrease RZD (Ex: 575µm to 550µm)

RETURN ZONE DEPTH (RZD)

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ABOUT• The Landing Zone Angle provides the amount of edge lift.• Measured in degrees (°), adjusted in 1° increments.• LZA contributes to the overall sagittal depth of the Paragon CRT® lens. For every 1° change, there is a 15µm change in saggittal depth.

EXAMPLESteepening LZA from 33° to 34° will decrease Edge Lift and increase the sagittal depth of the lens by 15µm.

ADJUSTMENT

Edge lift > 1.0mm

Edge lift < 0.5mm

Steepen LZA (Ex: 32° to 33°)

Flatten LZA (Ex: 32° to 31°)

LANDING ZONE ANGLE (LZA)

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805533 5834

Example: 8.0-550/575-33/34

When applied to the patient’s cornea, a CRT Dual Axis® lens will rotate such that the steep meridian of the lens aligns with the cornea’s steep meridian.

BASE CURVE OPTIC ZONE

RZD1

RZD2

LZA1

LZA2

PARAGON CRT DUAL AXIS® LENS DESIGNParagon CRT Dual Axis® laser markings are 90° apart.

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FEATURES OF A PARAGON CRT DUAL AXIS® LENS

DUAL DEPTH RETURN ZONES RZD1/RZD2

ENHANCES UNIFORM LANDING ON A TORIC CORNEA

DUAL LANDING ZONES LZA1/LZA2

ENHANCES EDGE LIFT ON A TORIC PERIPHERAL CORNEA

DUAL RETURN AND LANDING ZONES RZD1/RZD2 LZA1/LZA2

ENHANCES OVERALL CENTRATION AND TREATMENT

EXAMPLE:

8.5-500/550-33

EXAMPLE:

8.5-500-33/34

EXAMPLE:

8.5-500/550-33/34

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500500

When the mid-peripheral cornea exhibits toricity upon fluorescein evaluation, a dual depth Return Zone is recommended.

500550

CRT DUAL AXIS® RETURN ZONE DEPTH (RZD1/RZD2)

• When the landing of the lens is not uniform, or there appears to be NaFl leaking between the Return Zone and Landing Zone, a dual RZD is required.

• Consider utilizing a dual depth Return Zone (RZD1/RZD2) by keeping the current RZD as RZD1 and adding 50µm to create RZD2.

Example: 8.6-550-33 change to 8.6-550/600-33

PARAGON CRT® (RZD 500µm) PARAGON CRT DUAL AXIS® (RZD1/RZD2 500/550µm)

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When the peripheral cornea exhibits toricity upon fluorescein evaluation, a Dual Axis Landing Zone Angle is recommended.

• Increased lens edge thickness in the steep meridian allows the lens edge to land uniformly on an even surface• When edge lift is not uniform or appears to be adequate in one meridian but too thin in another meridian a

dual Landing Zone is needed.• Consider utilizing a dual Landing Zone (LZA1/LZA2) by keeping the current LZA and steepen LZA2 if edge lift is too excessive.

FLAT MERIDIAN

STEEPMERIDIAN

CRT DUAL AXIS® LANDING ZONE ANGLE (LZA1/LZA2)

EXAMPLE: LZA 32°• Excessive edge lift superior and inferior• Adequate edge lift nasal and temporal.

A dual LZA is needed for this toric cornea.

EXAMPLE: LZA 32°/33°A dual LZA now provides adequate edge lift 360°

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1 DAY 1 WEEK 3 MONTHS1 MONTH

FOLLOW UP

Check visual acuity

Perform Refraction Over Lens (ROL)

Perform slit lamp examination to evaluate centration and fluorescein pattern• Bull’s eye pattern, lens centered on cornea• 3-4mm treatment zone• If bubbles attempt re-insertion with artificial tears to see if consistent• Uniform lens landing• 0.5-1mm uniform edge lift

Reinforce proper application and removal technique

EXAM WITH LENSES ON EYE

EXAM WITH LENSES REMOVED

Check visual acuity

Perform auto-refraction and subjective refraction

Assess corneal health

Topography (if available)

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WHEN TO CHANGE A PARAGON CRT® CONTACT LENSMake a change to a dispensed lens when findings include:

At 1-Day Follow Up

• Moderate to severe corneal epithelial defects• Insufficient edge lift resulting in lens binding• No clearance or tear film resulting in lens binding• ROL is not at target

At 1-Week Follow Up

• > 0.5mm of decentration on topography• Uneven treatment seen on post-treatment topography• Undercorrection

WHAT TO EXPECT AT A 1-DAY FOLLOW UP EXAMINATION• Optimal centration• ROL is in range (+0.50 to +1.00)• Slit lamp examination is unremarkable• Treatment is 50-70% of target correction as measured by auto-refraction

DIAGNOSTIC LENS EVALUATION

1 Day 1 Week

IDEAL TOPOGRAPHY OUTCOMES

PROPER FIT OF A CRT DUAL AXIS® LENS

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Utilize Paragon CRT Dual Axis® RZD1/RZD2

ASYMMETRICAL PERIPHERAL ALIGNMENT

FIRST Increase Diameter

SECOND Increase RZD

10.5mm to 11.0mm

8.6-550-33 to 8.6-575-33

EXAMPLEADJUSTMENT

SMALL TREATMENT ZONE Utilize CRT Dual Axis®

LARGE TREATMENT ZONE Increase RZD

8.6-550-33 to 8.6-550/600-33

8.6-550-33 to 8.6-575-33

TIGHT EDGE LIFT Increase Diameter + Flatten LZA

0.5-1.0 MM EDGE LIFT Increase Diameter

8.6-525-33-10.5 to 8.6-525-32-11.0

10.5mm to 11.0mm

Flatten LZA

Decrease RZD

8.6-550-34 to 8.6-550-33

8.6-525-33 to 8.6-500-33

8.6-550-33 to 8.6-550/600-33

LATERAL DECENTRATION

INFERIOR DECENTRATION

SUPERIOR DECENTRATION

CENTRAL ISLAND

FIRST

FIRST

SECOND

PARAGON CRT® TROUBLESHOOTING

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FIRST Increase Diameter

SECOND Increase RZD2

10.5mm to 11.0mm

8.6-500/550-33 to 8.6-500/575-33

EXAMPLEADJUSTMENT

SMALL TREATMENT ZONE Increase RZD2

LARGE TREATMENT ZONE Increase RZD1/RZD2

8.6-550/575-33 to 8.6-550/600-33

8.6-550/575-33 to 8.6-575/600-33

TIGHT EDGE LIFT

0.5-1.0 MM EDGE LIFT Increase Diameter

8.6-525/575-33-10.5 to 8.6-525/575-32-11.0

10.5mm to 11.0mm

Flatten LZA

Decrease RZD1

8.6-550/600-34 to 8.6-550/600-33

8.6-500/550-33 to 8.6-475/550-33

LATERAL DECENTRATION

INFERIOR DECENTRATION

SUPERIOR DECENTRATION

CENTRAL ISLAND

TIGHT EDGE LIFT

0.5-1.0 MM EDGE LIFT

ASYMMETRICAL EDGE LIFT

THIN EDGE

ADEQUATE EDGE

Utilize Paragon CRT Dual Axis® LZA1/LZA2

8.6-550-33 to 8.6-550-32/33FIRST

PARAGON CRT DUAL AXIS® TROUBLESHOOTING

Increase Diameter + Flatten LZA

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TIPS FOR EFFECTIVE CONSULTATION

NEW PATIENT• Keratometry values• Refraction• HVID• Baseline Topography (Axial/Power Map)

EXISTING PATIENT• Current Issue (Decentration, Staining, Undertreatment)• Refraction over lenses (+0.50 to +1.00 optimal)• Subjective Refraction• Fluorescein Pattern (Photos if available)• Topography (Tangential / Instantaneous Maps )• HVID/Corneal Diameter Size

Phone: 1-800-528-8279 option 2E-mail: consultation@paragonvision.com

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ABB OPTICAL GROUP1-800-772-3911 ART OPTICAL CONTACT LENS, INC.1-800-253-9364

ESSILOR CUSTOM CONTACT LENS SPECIALISTS1-800-366-3933

GP SPECIALISTS1-800-889-0379

PARAGON VISION SCIENCES1-800-528-827

X-CEL SPECIALTY CONTACTS1-800-241-9312

US & CANADA AUTHORIZED PARAGON CRT® LABS

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PRACTICE MANAGEMENT• Patient Fee Analysis• Patient Agreement• What to include• Diagnostic Dispensing System• Fitting Empirically• Spare Pairs• Cancellation Policies

MARKETING• Brochures• Posters & Banners• Social Media Content• Patient Consultation Guide• On Hold Messaging Scripts• Direct Consumer Videos

CONSULTATION• Diagnostic Testing• Lens Selection• Appointment Process• Discuss Risks and Benefits• Identifying Proper Candidates• Fitting and Dispensing Options• Insertion, Removal and Lens Care

PARAGON CRT® PRACTITIONER RESOURCES

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Product DescriptionParagon Z CRT Dual Axis®Contact Lens

Blue Menicon Z

Paragon CRT Dual Axis® Contact Lens

Green HDS®100

Paragon Z CRT® Contact Lens

Blue Menicon Z

Stock Paragon CRT®Contact Lens

Green HDS®100

Paragon CRT® Diagnostic Stock Lens (Green tint, HDS®100 material)

Paragon CRT® Contact Lens Rx

Paragon CRT® Contact Lens Spare

Paragon CRT® Contact Lens Warranty Exchange Rx Program

Paragon CRT® Contact Lens Diagnostic Dispensing System 100 (Green , HDS®100)

Paragon CRT® Contact Lens Extended Diagnostic Dispensing System Extended 36 (Green , HDS®100)

Paragon CRT Dual Axis® Contact Lens Diagnostic Dispensing System 80

Paragon CRT Dual Axis® Contact Lens Diagnostic Dispensing System 40

Paragon CRT Dual Axis® Contact Lens Diagnostic Dispensing System 16

N/A

$117.50

$62.50

$137.50

N/A

N/A

$3,536.00

$1,768.00

$707.20

N/A

$102.50

$52.50

$122.50

N/A

N/A

$2,776.00

$1,388.00

$555.20

N/A

$107.50

$57.50

$127.50

N/A

N/A

N/A

N/A

N/A

$92.50

$92.50

$47.50

$112.50

$996.00

$358.56

N/A

N/A

N/A

Billing and credit policies will be administered through the practitioner’s Authorized Paragon CRT® Contact Lens Laboratory or directly billed based on practitioner’s choice.

All Paragon CRT® Contact Lenses are automatically plasma treated, unless otherwise requested, and have the parameters laser marked on the lens. Shipping and handling fees are charged separately. The prices reflected above are MSRP for Certified Practitioners. Valid in U.S. only. Pricing and policies are subject to change without notice.

PARAGON CRT® CONTACT LENS PRICING

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POLICIES AND PROCEDURES

Paragon CRT® Contact Lens Marketing LiteratureParagon CRT® Contact Lens consumer marketing literature is provided as a complimentary service from Paragon Vision Sciences. To receive complimentary marketing materials, the Eye Care Practitioner’s account must be active within a 90-day period of placing the marketing literature order.

Stock Paragon CRT® Contact LensesPricing is per lens and lenses are not covered under the warranted replacement program. Stock Paragon CRT® Contact Lenses can only be ordered by a Paragon CRT® Contact Lens certified practitioner. Stock lenses can be ordered in any quantity and parameters must fall within the 136 Paragon CRT® Contact Lens Diagnostic Dispensing System.

Rx Paragon CRT® Contact LensesPricing is per lens and lenses are not covered under the warranted replacement program. With every two full-priced Rx lenses purchased on the same order, you are eligible to receive one free Patient Care Kit. Please notify Paragon Vision Sciences Customer Service Department when you are in need of the care kits. Your qualifying kits will be shipped via ground delivery, unless you request the kit(s) shipped next day delivery with a patient order. Spare Paragon CRT® Contact LensesPricing is per lens and lenses are not covered under the warranted replacement program. Spare lenses allow you to offer patients a reduced price on a spare pair to ensure uninterrupted treatment, in case of lost or broken lenses. Spare lenses must be ordered within 90 days of the primary Rx Paragon CRT® Contact Lens order. Spare lens orders must indicate the original serial number, a patient name, or patient ID, and must be clarified as a spare lens at the time of order. Only one spare lens order per primary Rx Paragon CRT® Contact Lens order is permitted. Parameters must match the primary dispensed lens. Failing to meet these requirements will result in a declined spare lens order. Spare lens orders do not qualify to receive a Patient Care kit.

Paragon CRT® Contact Lens Warranty Replacement ProgramThe Warranty Replacement Rx Program is a simple and cost effective way for practitioners to fit Paragon CRT® Contact Lenses empirically, with or without a Paragon CRT® Contact Lens Diagnostic Dispensing System. Practitioners ordering under the Warranty Exchange Rx Program must request lens(es) as being either a new warranty or a warranty exchange at the time of order. Please call Paragon Vision Sciences Customer Service Department at 800-528-8279 to initiate the exchange lens order.

• The 1st lens is billable (Lens price plus additional $20 for warranty).• If a 2nd lens is needed, the lens will be replaced at no charge.• If a 3rd lens is needed, the lens must be ordered through Paragon Vision Sciences’ Consultation or a $25 per lens handling fee will be assigned.

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Paragon CRT® Contact Lens Diagnostic Dispensing System 100The Paragon CRT® Contact Lens Diagnostic Dispensing System 100 is manufactured in Paragon HDS®100 green tint. This system includes Base Curves of: 7.9 to 8.8 in 0.10mm steps with various RZD/LZA combinations, fitting manual, three patient care kits, practice management tools, unlimited consultation, and clinical support. The Paragon CRT® Contact Lens Diagnostic Dispensing System (100 lens) offers a 90-day Risk Free Test Drive with three equal installment payments (30/60/90 day terms). The practitioner will receive up to two complimentary Rx orders to be used for two staff members (patient orders do not apply). Providers receive a 50% discount for up to three immediate family members that meet the FDA approved treatment guidelines for Paragon CRT® Contact Lenses.

The Paragon CRT® Contact Lens Diagnostic Dispensing System is fully refundable within 90 days of the original shipment date (shown on the Paragon Vision Sciences Packing Slip). If the System is returned with the original 100 lenses, opened or unopened with all labeling intact, and the Practice Management Kit and Paragon CRT® Contact Lens Certificate are returned, full credit will be issued, less shipping and handling charges. Paragon CRT® Contact Lenses that are missing will be billed at $92.50 per lens. Failure to return all items listed above will delay credit processing. To initiate the return of the Paragon CRT® Contact Lens Diagnostic Dispensing System, contact Paragon Vision Sciences Customer Service Department at 800-528-8279.

Paragon CRT® Contact Lens Diagnostic Dispensing System 36 LensThe Paragon CRT® Contact Lens Diagnostic Dispensing System Extended 36 is manufactured in Paragon HDS®100, green tint. This System includes Base Curves of: 8.9 to 9.2 in 0.10mm steps with various RZD/LZA combinations. Each base curve in the Diagnostic Dispensing System Extended 36 consists of 9 lenses each.

Paragon CRT Dual Axis® Contact Lens Diagnostic Dispensing System 80, 40, and 16 LensParagon Vision Sciences offers three Paragon CRT Dual Axis® Contact Lens Diagnostic Dispensing Systems. All Paragon CRT Dual Axis® Contact Lens Systems are manufactured in Paragon HDS®100, green tint. • The Paragon CRT Dual Axis® Contact Lens Diagnostic Dispensing System 80 includes the same lenses in the two 40 lens sets . • The Paragon CRT Dual Axis® Contact Lens Diagnostic Dispensing System 40 (first set) includes Base Curves of 8.3 to 8.6 in 0.10 mm steps with RZD of 50 microns and

LZA’s varying from -32 to -34.• The Paragon CRT Dual Axis® Contact Lens Diagnostic Dispensing System 16 includes Base Curves of 8.3, 8.4, 8.5, 8.6, 8.7, 8.8, 8.9/9.0 with RZD’s of 50 microns with a

-32 or -33 LZA only.

Manufacturers Defect • Broken LensesParagon Vision Sciences guarantees each Paragon CRT® Contact Lens to be free from manufacturing defects and will provide a replacement lens within 90 days of the original invoice date for any lens found to be defective. If an Rx lens breaks within 90 days of the original invoice date, a replacement lens will be provided. To receive a replacement lens under either circumstance, call Paragon Vision Sciences Customer Service Department at 800-528-8279. You will be billed full price for the replacement lens. Return the defective/broken lens with the return authorization in its original vial to Paragon Vision Sciences within 42 days to receive credit. If the original vial is not available, the appropriate Serial Number must accompany the lens with the return authorization. Paragon Vision Sciences will issue credit for the returned qualifying lens. Lenses returned due to defect will be inspected for the noted defect(s). Lenses showing evidence of wear or mishandling are not eligible for credit.

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BECOME PARAGON CRT CERTIFIED

VISIT : PARAGONVISION.COM/GETCERTIFIED

Certification for Paragon CRT® is not only an FDA requirement, but is an essential part of Paragon’s investment in your education and training. Certification ensures that you are on the right path to delivering optimum treatment outcomes to your patients.

We wish you the best of luck as you take these first steps towards expanding your practice.

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