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General WNL
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General Abnormal
• • •
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General Comments
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VAsc OD
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VAsc OS
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VAcc OD
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Vacc OS
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Pinhole OD
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PInhole OS
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WRx OD
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WRx OS
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Secondary Glasses
• • •
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2nd glasses OD
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2nd glass OS
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ARx OD
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ARx OS
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VA ARx OD
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Va ARx OS
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Keratometry OD
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Keratometry OS
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MRx OD
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MRx OS
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VA MRx OD
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Va MRx OS
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CRx OD
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CRx OS
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IOP
/
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IOP Method
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Tono Initials
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Normal Exam
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Normal Preexam
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Normal SLE
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Normal Fundus
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Pupils
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Pupils Comment
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EOM
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EOM Comment
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Visual Fields
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Visual Field Comment
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Adnexa
• • •
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Adnexa comment
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SLE OD Normal
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SLE OD abnormal
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Slit Lamp OD Free text
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Lids, lacrima and Conjunctiva
• • •
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Lids, lashes, lacrimal OD commen
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Cornea OD
• • •
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Cornea OD comment
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Anterior chamber OD
• • •
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Anterior chamber OD comment
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Iris OD
• • •
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Iris OD comment
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Lens OD
• • •
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Lens OD comment
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Anterior vitreous OD
• • •
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Anterior vitreous OD comment
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SLE OS Normal
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SLE OS abnormal
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SLE OS free text
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Lids,lashes,lacrimal OS
• • •
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Lids,lashes,lacrimal OS comment
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Cornea OS
• • •
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Cornea OS comment
|
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Anterior Chamber OS
• • •
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Anterior Chamber OS comment
|
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Iris OS
• • •
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Iris OS comment
|
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Lens OS
• • •
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Lens OS comment
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Anterior Vitreous OS
• • •
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Anterior Vitreous OS comment
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Normal Fundus OU
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Dilation
• • •
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C:D ratio OD
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C:D ratio OS
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Fundus Exam OD WNL
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Fundus OD Abnormal
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Optic Disc OD
• • •
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Optic Disc OD comment
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Macula OD
• • •
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Macula OD comment
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Peripheral Retina OD
• • •
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Peripheral Retina OD comment
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Vitreous OD
• • •
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Vitreous OD comment
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Retinal Vessels OD
• • •
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Retinal Vessels OD comment
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Fundus Exam OS WNL
|
|
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Fundus Exam OS abnormal
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Optic Disc OS
• • •
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Optic Disc OS comments
|
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Macula OS
• • •
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Macula OS comments
|
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Peripheral Retina OS
• • •
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Peripheral Retina OS comments
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Vitreous OS
• • •
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Vitreous OS comment
|
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Retinal Vessels OS
• • •
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Retinal Vessels OS comment
|
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Keratometry OD
|
Axis OD
|
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Keratometry OS
|
Axis OS
|
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Keratometry comment
|
Stereopsis
• • •
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Schirmer's Test
/
|
|
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Retina Drawing
|
Visual field
|
