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CATARACT POST OP VISIT
EYE / Surgery Date
/
EYE / Surgery Date
/
Surgeon
• • •
Drops used
• • •
Drops Comments
Symptoms
• • •
Symptom Comments
VAsc OD
• • •
VA OS
• • •
Pupils
• • •
Pupil Comments
EOMs
• • •
EOM Comments
SLE OD
• • •
SLE OD Comments
SLE OS
• • •
SLE OS Comments
IOP OD/OS iCare
/
IOP OD/OS Goldmann
/
Refraction OD
VAcc @ Dist OD
Refraction OS
VAcc@Distance OS
Add OU
VAcc@Near OU
Fundus Eval OD
• • •
Fundus Comments OD
Fundus Eval OS
• • •
Fundus Comments OS
Assessment
Plan
• • •
RTC
• • •

Cataract Post-Op Medical Form

Optometrist

Cataract post-op template

There are 36 copies in use.
Published: May 29, 2012, 3:35 p.m.
Doctor: Dr. History Physical
Rating: +15   /

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