|
Surgical Consent
|
Surgical Header
|
|
Preoperative Diagnosis OD
• • •
|
Preoperative Diagnosis OS
• • •
|
|
Postoperative Diagnosis
• • •
|
Procedure
• • •
|
|
Retrobulbar Anesthesia
|
Anesthesiologist
|
|
Complications
• • •
|
Specimens
• • •
|
|
Report Header
|
Eye
|
|
Retrobulbar Anesthesia
|
Prep
|
|
Scleral Loops
|
|
|
Vitrectomy Phakic
|
Vitrectomy Pseudophakic
|
|
PVD
|
Prior Vitrectomy
|
|
Membrane Peel
|
AFE
|
|
Retinotomy
|
SRF Drainage
|
|
Perfluoron
|
|
|
Endophotocoagulation
|
Laser Retinopexy
|
|
PRP
|
360 Laser
|
|
Scleral Buckle
|
|
|
Vitreous Substitute
|
IOP/Optic Nerve
|
|
Sutures-less
|
Buckle Closure
|
|
Close
|
Comments
|
|
Retinal Diagram OD
|
Retinal Diagram OS
|
|
Eye Diagram
|
|
