|
R/B/A
• • •
|
Laser Consent
|
|
Topical Anesthetic
|
Retrobulbar block
|
|
|
|
|
Grid Laser OD
|
Grid Laser OS
|
|
PRP Laser OD
|
PRP Laser OS
|
|
Laser Retinopexy OD
|
Laser Retinopexy OS
|
|
Cryopexy OD
|
Cryopexy OS
|
|
Spot Size
|
Spot Size
|
|
Laser Lens
|
Laser Lens
|
|
Laser Power
|
Laser Power
|
|
Duration
|
Duration
|
|
Number of Spots
|
Number of Spots
|
|
Tolerated?
|
Tolerated?
|
|
Right Eye Diagram
|
Left Eye Diagram
|
|
|
|
|
YAG Capsulotomy Consent
|
|
|
YAG Capsulotomy OD
|
YAG Capsulotomy OS
|
|
YAG PI OD
|
YAG PI OS
|
|
YAG Floater Consent
|
LFT ABN
|
|
YAG Floater OD Initial
|
YAG Floater OS Initial
|
|
YAG Floater OD Secondary
|
YAG Floater OS Secondary
|
|
Laser Power
|
Laser Power
|
|
Number of Spots
|
Number of Spots
|
|
|
|
|
PDT Consent
|
ABN PDT
|
|
Treatment Size
|
Visudyne Volume
|
|
PDT OD
|
PDT OS
|
|
Tolerated?
|
|
