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OPTO-K
IS16 / IS19
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Account Name
Account Number
Date of order
Order required by
Order Number
Patient Reference
Order Reference
Person placing this order
Name
Email
This order is for
Pair
Right lens only
Left lens only
OD / Right Eye
Design
IS16
IS19
Select the trail lens used
K1
K2
K3
K4
K5
K6
K7
K8
K9
K10
K11
K12
K13
Adjustments required in each quadrant
Limbal Clearance
0
90
180
270
Each step = 25 microns “+ = more clearance, - = less clearance”
Scleral alignment
Each step = 25 microns “+ = flattening, - = steepening”
Limbal Clearance
0
90
180
270
Each 0.5 = 75 microns “+ = more clearance, - = less clearance”
Sag at landing diam.
Each 0.1 = 15 microns “+ = more clearance, - = less clearance”
Scleral alignment
Each 0.1 = 15 microns “+ = flattening, - = steepening”
Power
Over-refraction
Spherical
Sphero-cylindrical
Over-refraction
Spherical
Sphero-cylindrical
Sphere
Back vertex distance
mm
Sphere
/
Cylinder
x
Axis
Back vertex distance
mm
R0 locates at
degrees
Positive value = Counter-Clockwise, Negative value = Clockwise
Notes
OS / Left Eye
Design
IS16
IS19
Select the trail lens used
K1
K2
K3
K4
K5
K6
K7
K8
K9
K10
K11
K12
K13
Adjustments required in each quadrant
Limbal Clearance
0
90
180
270
Each step = 25 microns “+ = more clearance, - = less clearance”
Scleral alignment
Each step = 25 microns “+ = flattening, - = steepening”
Limbal Clearance
0
90
180
270
Each 0.5 = 75 microns “+ = more clearance, - = less clearance”
Sag at landing diam.
Each 0.1 = 15 microns “+ = more clearance, - = less clearance”
Scleral alignment
Each 0.1 = 15 microns “+ = flattening, - = steepening”
Power
Over-refraction
Spherical
Sphero-cylindrical
Over-refraction
Spherical
Sphero-cylindrical
Sphere
Back vertex distance
mm
Sphere
/
Cylinder
x
Axis
Back vertex distance
mm
R0 locates at
degrees
Positive value = Counter-Clockwise, Negative value = Clockwise
Notes
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Optosoft.
All rights reserved.