VistA-WorldVistAEHR/r/AUTOMATED_MED_INFO_EXCHANGE.../DVBCWEE1.m

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DVBCWEE1 ;ALB/CMM EYE EXAMINATION WKS TEXT - 1 ; 6 MARCH 1997
;;2.7;AMIE;**12**;Apr 10, 1995
;
;
TXT ;
;;A. Review of Medical Records:
;;
;;B. Medical History (Subjective Complaints):
;;
;; Comment on:
;; 1. Pain.
;; 2. Duration and frequency of periods of incapacitation, and rest
;; requirements.
;; 3. Visual symptoms, including distorted or enlarged image, etc.
;; 4. Current ophthalmologic treatment.
;; 5. For malignant neoplasms, state type of treatment and last date.
;; If treatment is current, describe.
;;
;;C. Physical Examination (Objective Findings):
;;
;; Address each of the following, as applicable, and fully describe
;; current findings:
;; 1. Visual Acuity:
;; a. Examine each eye independently and record the refractive
;; information indicated below.
;; b. Use conventional lenses for correction unless the patient
;; has keratoconus, is well adapted to contact lenses and wishes
;; to wear them, and contact lenses result in best corrected
;; visual acuity.
;; c. Use Snellen's test type or its equivalent.
;; d. Carry out an examination with the pupils dilated unless
;; contraindicated, and record the ophthalmic findings.
;; e. For visual acuity worse than 5/200 in either or both eyes,
;; report the distance in feet/inches (or meters/centimeters)
;; from the face at which the veteran can count fingers/detect
;; hand motion/read the largest line on the chart. If the
;; veteran cannot detect hand motion or count fingers at any
;; distance, state whether he or she has light perception.
;; f. If keratoconus is present, state whether contact lenses
;; are required or adequate correction is possible by other means.
;;
;;
;; NEAR FAR
;;
;; RIGHT EYE UNCORRECTED __________ _________
;;
;; RIGHT EYE CORRECTED __________ _________
;;
;;
;;
;; NEAR FAR
;;
;; LEFT EYE UNCORRECTED __________ _________
;;
;; LEFT EYE CORRECTED __________ _________
;;
;;
;; 2. Diplopia:
;; a. Perform the measurement of muscle function using a
;; Goldmann Perimeter Chart and chart the areas in which diplopia
;; exists. Include the chart as part of the examination report
;; to be sent to the regional office.
;; b. If diplopia is present, state whether it is constant or
;; intermittent, whether it is present at all distances or only
;; for near or distant vision, and whether it is correctable by
;; use of lenses or prisms.
;; c. If diplopia is constant and not correctable, indicate
;; which sectors of the visual field are affected and provide
;; the Goldmann perimeter chart showing the actual areas of
;; diplopia, according to the format below. Diplopia outside
;; these areas should also be reported even though it is not
;; considered disabling because it may be used in the evaluation
;; of the underlying disease or injury.
;;
;; CENTRAL 20 DEGREES _________
;;
;; 21 TO 30 DEGREES
;; DOWN
;; RIGHT LATERAL _________
;;
;; LEFT LATERAL _________
;;
;; UP
;; RIGHT LATERAL _________
;;
;; LEFT LATERAL _________
;;
;; 31 TO 40 DEGREES
;; DOWN
;; RIGHT LATERAL _________
;;
;; LEFT LATERAL _________
;;
;; UP
;; RIGHT LATERAL _________
;;
;; LEFT LATERAL _________
;;
;;
;; 3. Visual Field Deficit:
;; a. Chart any visual field defect using a Goldmann Perimeter
;; Chart and include the chart as part of the examination report
;; to be sent to the regional office.
;; b. For an aphakic eye which cannot be fitted with contact
;; lenses or intra-ocular implant, use the IV/4e test object.
;; For all other cases, use the III/4e test object.
;; c. If the examiner determines that charting with other test
;; objects is indicated, those test results should be reported
;; on a separate chart. All charts, along with an explanation
;; of the need for using a different test object and an
;; explanation of any discrepancies in results, should be
;; included as part of the examination report.
;; d. All scotomas should be plotted carefully in order to
;; allow measurements to be made for adjustments in the
;; calculation of visual field defects.
;; 4. Details of eye disease or injury (including eyebrows,
;; eyelashes, eyelids) other than loss of visual acuity, diplopia,
;; or visual field defect:
;;
;;D. Diagnostic and Clinical Tests: (Other than for visual acuity,
;;diplopia, and visual fields, as described above.)
;;
;; 1. Include results of all diagnostic and clinical tests
;; conducted in the examination report.
;;
;;E. Diagnosis:
;;
;;Signature: Date:
;;END