Biometry

Phakic/ K-Reading IOL Comp-

Sr. # OPD# Date Name Age Aphakic/Pseudo-
Gates
Axial Length IOL Formula A-Constant Power
IOL Power
etency
Supervisor
phakic
Adjustment
(PC)
(AC)
Level Signature
K1 K2
 Peadiatric Refraction
Retinoscopy Squint Amblyopia Comp-
Subjective Rx/ Supervisor
Sr. # OPD# Date Name VA Cover Test EOM Management Diagnosis management (If etency
Verification with Refraction required) Referral Level Signature
Cycloplegic
 Clinical Cases

Best Management / Compe- Supervisor

Sr. # OPD# Date Name Chief Complaint Corrected IOP Clinical Findings Diagnosis Referrel tency Signature
Visual Acuity Level
 Refraction
RE:
RE: Acuity
Visual Near Compe-
RE: RE:
Sr. # OPD# Date Name Visual RE: SubjectivePD:
Refraction Final Visual Acuity tency
Without With With Acuity - - Level Supervisor
- RE:
Glasses -
Glasses Pinhole Signature
- -
RE: -
RE:
RE: RE:
RE: PD:
- - - RE:
-
- -
RE: -LE:
RE:
RE: RE:
RE: PD:
LE: - Add: -
LE: LE: - RE:
LE: -
- - LE:
RE: -LE:
RE:
RE: RE:
RE: PD:
LE: - Add: -
LE: LE: - RE:
LE: - LE:
- -
RE: -LE:
RE:
RE: RE:
RE: PD:
LE: - Add: -
LE: LE: - RE:
LE: -
- - LE:
RE: -LE:
RE:
RE: RE:
RE: PD:
LE: - Add: -
LE: LE: - RE:
LE: -
- - LE:
RE: -LE:
RE:
RE: RE:
RE: PD:
LE: - Add: -
LE: LE: - RE:
LE: - LE:
- -
RE: -LE:
RE:
RE: RE:
RE: PD:
LE: - Add: -
LE: LE: - RE:
LE: -
- - LE:
RE: -LE:
RE:
RE: RE:
RE: PD:
LE: - Add: -
LE: LE: - LE: - RE:
- - LE:
-LE:
LE: Add:
LE: LE:
LE:
LE:
LE:
LE: Add:
LE: LE: