|
Orientation
|
|
|
VA Test Modality
|
Correction?
|
|
Visual Acuity OD
|
Visual Acuity OD 2
• • •
|
|
Visual Acuity OS
|
Visual Acuity OS 2
• • •
|
|
Pinhole OD
|
Pinhole OS
|
|
Afferent Pupil Defect OD
• • •
|
Afferent Pupil Defect OS
• • •
|
|
Pupils
• • •
|
Comments on pupils
|
|
Pilocarpine Test
|
|
|
EOM OD
• • •
|
EOM OS
• • •
|
|
Cover Tests
• • •
|
Comment
|
|
Three Step Test
• • •
|
Nystagmus
|
|
Cranial Nerves
|
Pursuit and Saccade
|
|
CVF OD
• • •
|
CVF OS
• • •
|
|
Ptosis VF OD
|
Ptosis VF OS
|
|
Color Plates OD
• • •
|
Color Plates OS
• • •
|
|
Red Desat OD
• • •
|
Red Desat OS
• • •
|
|
Brightness Desat OD
• • •
|
Brightness Desat OS
• • •
|
|
IOP OD
|
IOP OS
|
|
No IOP check
|
|
|
Anterior Segment Normal OU
|
|
|
Anterior Segment Normal OD
|
|
|
L/L/A OD Normal
|
L/L/A OS Normal
|
|
Lid/adnexa OD
• • •
|
Lid/Adnexa OS
• • •
|
|
Lower lid/adnexa OD
• • •
|
Lower lid/adnexa OS
• • •
|
|
Lagophthalmos OD
• • •
|
Lagophthalmos OS
• • •
|
|
Belll's Phenomenon OD
|
Bell's Phenomenon OS
|
|
Lid comments
|
Lid comments
|
|
Lid Crease OD
|
Lid Crease OS
|
|
MRD1 OD
|
MRD1 OS
|
|
Pseudo-MRD1 OD
|
Pseudo-MRD1 OS
|
|
LF OD
|
LF OS
|
|
PF OD
|
PF OS
|
|
Hering's Phenomenon
• • •
|
|
|
Phenylephrine Test
• • •
|
|
|
Fatigue Test
• • •
|
Ice Test
• • •
|
|
Lid Crease OD
|
Lid Crease OS
|
|
Sup Scleral Show OD
|
Sup Scleral Show OS
|
|
Inf Scleral Show OD
|
Inf Scleral Show OS
|
|
Snap Back OD
• • •
|
Snap Back OS
• • •
|
|
Hertel OD
|
Hertel OS
|
|
Lacrimal OD
• • •
|
Lacrimal OS
• • •
|
|
Conjunctiva/Sclera Normal OD
|
Conjunctiva/Sclera Normal OS
|
|
Conjunctiva/Sclera OD
• • •
|
Conjunctiva/Sclera OS
• • •
|
|
Conjunctiva Location OD
• • •
|
Conjunctiva Location OS
• • •
|
|
Cornea Normal OD
|
Cornea Normal OS
|
|
Cornea OD
• • •
|
Cornea OS
• • •
|
|
Cornea Location OD
• • •
|
Corneal Location OS
• • •
|
|
Lissamine Green OD
• • •
|
Lissamine Green OS
• • •
|
|
Schirmer OD
• • •
|
Schirmer OS
• • •
|
|
Tear Break-Up OD
• • •
|
Tear Break-Up
• • •
|
|
DDT OD
• • •
|
DDT OS
• • •
|
|
AC OD Normal
|
AC OS Normal
|
|
Anterior Chamber OD
• • •
|
Anterior Chamber OS
• • •
|
|
Iris Normal OD
|
Iris Normal OS
|
|
Iris OD
• • •
|
Iris OS
• • •
|
|
Lens Normal OD
|
Lens Normal OS
|
|
Lens OD
• • •
|
Lens OS
• • •
|
|
Anterior Segment Normal OS
|
|
|
Anterior Segment OD
|
Anterior Segment OS
|
|
Dilation OD
|
Dilation OS
|
|
No dilation
|
No dilation
|
|
No view
|
No View
|
|
Cup to Disc Ratio OD
|
Cup to Disc Ratio OS
|
|
Posterior Segment Normal OU
|
|
|
Posterior Segment Normal OD
|
|
|
Vitreous Normal OD
|
Vitreous OD
• • •
|
|
Vitreous Normal OS
|
Vitreous OS
• • •
|
|
Optic Nerve Normal OD
|
Optic Nerve OD
• • •
|
|
Optic Nerve Normal OS
|
Optic Nerve OS
• • •
|
|
Macula Normal OD
|
Macula OD
• • •
|
|
Macula Normal OS
|
Macula OS
• • •
|
|
Vessels Normal OD
|
Vessels OD
• • •
|
|
Vessels Normal OS
|
Vessels OS
• • •
|
|
Periphery Normal OD
|
Periphery OD
• • •
|
|
Peripheral Location OD
• • •
|
|
|
Periphery Normal OS
|
Periphery OS
• • •
|
|
Peripheral Location OS
• • •
|
|
|
Posterior Segment Normal OS
|
|
|
External Adnexa OD
|
External Adnexa OS
|
|
Visual Fields
|
|
|
MRI of brain
|
MRI of orbit
|
|
MRI of brain w/o
|
MRI of orbit w/o
|
|
MRA head
|
MRV head
|
|
CT of brain
|
CT of orbit
|
|
CT of the maxface:
|
Probe and Irrigation
|
|
ERG
|
VEP
|
|
Labs
|
Photos
|
