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Working Diagnosis
Type of Photos
• • •
Why photo?
• • •
OD
OS
Status
Plan
• • •
Type of VF
• • •
Why VF?
• • •
Reliable?
• • •
Results
Status
• • •
Assess/Plan
OCT
• • •
Why OCT?
• • •
Signal strength good?
Results
Status
• • •
Assess/Plan
2nd OCT
• • •
Why 2nd OCT?
• • •
Signal Strength good?
Results
Status
• • •
Assess/Plan
Pachymetry?
Why Pachy?
• • •
Measurements
/
Status
• • •
Assess/Plan
• • •
Gonioscopy?
Why gonioscopy?
• • •
Angles
• • •
Angle Comments
Status
• • •
Assess/Plan
• • •
D-15?
Why D-15?
Results
• • •
Status
• • •
Assess/Plan
• • •

Ancillary Testing Medical Form

Optometrist

Ancillary tests report for VF, OCT, pachy, gonio, photos, D-15

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Published: Aug. 21, 2012, 7:04 p.m.
Doctor: Dr. History Physical
Rating: +3   /

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