• between 25 to 30 microns, consider prescribing a one-step (25-micron)
increase in RZD.
• between 31 to 60 microns, consider prescribing a two-step (50-micron) RZD
dierence.
• between 60 to 90 microns, consider prescribing a three-step (75-micron)
RZD dierence.
• > 90 microns, consider prescribing a four-step (100-micron) RZD dierence.
e average elevation dierences are calculated using this best t sphere example:
A standard two 25-micron step (50-micron) dierence in the RZD, 90 degrees
apart is oered to compensate for dierences in peripheral corneal elevation. e
recommended method of tting is to continue the use of the RZD suggested by the
Initial Lens Selector (ex: 550) and observed to provide the recommended uorescein
pattern. (Image C) is RZD continues to be recommended for the at meridian
with the respective higher peripheral elevation. An RZD increase of 50 microns
(two 25-micron steps) is recommended for the steep meridian with the lower or
shallower peripheral elevation. (Image D) In this case, no change is recommended
in the LZA. e LZA will remain constant circumferentially. Some eyes may
Image A Image B
Image C