Surgical Consent
|
General Anesthesia Consent
|
Surgical Header
|
|
Preoperative Diagnosis OD
• • •
|
Preoperative Diagnosis OS
• • •
|
Postoperative Diagnosis
• • •
|
Procedure
• • •
|
Retrobulbar Anesthesia
|
Subtenon’s block
|
Anesthesiologist
|
Complications
• • •
|
Specimens
• • •
|
Report Header
|
Eye
|
Retrobulbar Anesthesia
|
Prep
|
Subtenon’s block
|
Scleral Loops
|
Corneal Epi Debridement
|
Vitrectomy Phakic
|
Vitrectomy Pseudophakic
|
Vitrectomy Phakic 25g
|
Vitrectomy Pseudophakic 25g
|
PVD
|
Prior Vitrectomy
|
Kenalog
|
|
TRD Repair
|
Hemostasis
|
Silicone Oil Removal
|
BBG
|
ICG
|
Membrane Peel
|
PVR Peel
|
Retinectomy
|
Degrees of Retinectomy
|
Subretinal Bands
|
Retinotomy
|
Perfluoron
|
AFE
|
SRF Drainage
|
Scleral Fixation of New Lens
|
Scleral Fixation of Old Lens
|
Lens Power
|
Free Text
|
Focal Retinopexy
|
PRP
|
Laser Retinopexy
|
360 Laser
|
Endophotocoagulation
|
Cryopexy
• • •
|
Scleral Buckle
|
Vitreous Substitute
|
Buckle Closure
|
IOP/Optic Nerve
|
Sutures-less
|
Comments
|
Close
|
|
Retinal Diagram OD
|
Retinal Diagram OS
|
Eye Diagram
|
|