Cataract/Lensectomy Post-Op Form

Use the following form to submit reports on Cataract/Lensectomy procedures. The submitted form will be automatically sent to the Braverman Eye Center. You will also be able to print a copy for your records after submitting your form.

Please complete all applicable form fields:

Co-managing OD/MD:
Patient Name:(last name first)
Age:
Procedure:
Procedure Date OD:
Procedure Date OS:
Select if patient did not show up for scheduled appointment
Left message for patient to reschedule
Unable to contact patient
PRE-OP Rx:
OD: VA: 20/
OS: VA: 20/
Post-Op Information:
Assessment Date
Binocular UCVA 20 /
OD UCVA 20 /
OS UCVA 20 /
OD Manifest * (if no cyl, select 0)
x ==> 20/
OS Manifest * (if no cyl, select 0)
x ==> 20/
OD SL Exam:
Wound
Cornea
Ant. Chamber
Lens Implant
Posterior Capsule
OS SL Exam:
Wound
Cornea
Ant. Chamber
Lens Implant
Posterior Capsule
TaG:
OD mm. Hg. OS mm. Hg.
Retina:
OD OS
Alert Issues - (If present, must include in alert issue comments below)
Dissatisfaction Issues
Nighttime Halos/Glare
Glare/Light Sensitivity
Alert Issue Comments:
Medications:
Patient/Doctors Comments:
Follow Up:
RV: With BEC With Co-care provider
Leave this field blank:

The surgeons of Braverman Eye Center are well known as South Florida, Ft. Lauderdale and LASIK Miami specialists. These renowned surgeons have also helped many Ft. Lauderdale and Miami cataract surgery patients enhance their vision. When you think of Miami cataracts or Miami LASIK, think of Braverman Eye Center.

Cataract/Lensectomy Post-Op Form

Learn about LASIK in Ft Lauderdale, Miami & South Florida