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Physical Exam of the Prosthesis
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Surface Deposit:
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Surface Condition
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Size
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Thickness
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Lid Correction:
• • •
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Additional Comments
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Maintenance
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Frequency of Removal
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Comments
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Sleeps with Prosthesis?
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Dry Eyes or Crusting?
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Polish Frequency
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Recommended polish frequency comments
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Cosmesis
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Cosmesis
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Describe:
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Iris Color
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Socket and Lids
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Fit
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Describe
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Tearing Problems
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Comments (tearing problems)
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Eyelid/Eyelash Problems
• • •
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Mucus
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