Get the free Dilated Retinal Eye Exam Communication Form - dhs wisconsin

DILATED RETINAL EYE EXAM COMMUNICATION FORM. This form is to document dilated eye exam results. Place form directly in the person's medical record.

How to fill out dilated retinal eye exam

Who needs dilated retinal eye exam?

1. Patients with certain eye conditions: Dilated retinal eye exams are typically recommended for individuals with a history of eye conditions such as diabetic retinopathy, macular degeneration, or glaucoma. These conditions can cause changes in the blood vessels or the retina, making a dilated exam necessary to assess the health of the eye.
2. Individuals with a family history of eye diseases: If you have a family history of certain eye diseases, such as macular degeneration or retinal detachment, your eye doctor may recommend regular dilated retinal eye exams as a preventive measure. This allows for early detection and intervention, helping to preserve your vision.
3. People over a certain age: As we age, the risk of developing certain eye conditions increases. Therefore, individuals over the age of 50, even without any preexisting eye conditions or family history, may be advised to undergo regular dilated retinal eye exams to monitor for changes in the eye health.

Question:

How to fill out dilated retinal eye exam?

1. Schedule an appointment: Contact an eye care professional, such as an optometrist or ophthalmologist, to schedule a dilated retinal eye exam. It is important to make sure the eye care provider has the necessary equipment and expertise to perform this type of examination.
2. Prepare for the exam: Prior to the appointment, gather any relevant medical records or information about your eye health history. If you wear contact lenses, you may be advised to remove them before the exam. It is advisable to bring a pair of sunglasses to wear afterwards as the dilation may cause sensitivity to light.
3. Undergo the dilation process: At the beginning of the exam, eye drops will be administered to dilate your pupils. The drops take approximately 15-30 minutes to take effect. During this time, you may experience some blurriness or sensitivity to light. It is important to remain still and relaxed during the process.
4. Examination of the eye: Once the pupils are dilated, the eye care professional will use specialized equipment, such as a retinal camera or an ophthalmoscope, to examine the inside of your eye. They will look for any signs of damage, changes in blood vessels, or abnormalities in the retina. The doctor may also conduct other tests, such as visual acuity or intraocular pressure measurement.
5. Post-exam care: After the exam, your vision may remain blurry for a few hours due to the dilation. It is recommended to have someone accompany you to the appointment and drive you home if needed. Additionally, wearing sunglasses and avoiding bright lights can help reduce discomfort. Follow any specific instructions or recommendations given by your eye care professional regarding post-exam care.
6. Discuss the results: After the examination, the eye care professional will discuss the findings and provide any necessary recommendations for further treatment or monitoring. If any abnormalities or concerns are identified, a follow-up appointment may be scheduled.

Remember, regular dilated retinal eye exams are crucial for maintaining good eye health, especially for individuals at higher risk or with preexisting eye conditions. Don't hesitate to reach out to an eye care professional if you have any questions or concerns regarding dilated retinal eye exams.

For pdfFiller’s FAQs

What is dilated retinal eye exam?

A dilated retinal eye exam is a procedure where the eye doctor uses special drops to widen the pupil and examine the back of the eye including the retina and optic nerve.

Who is required to file dilated retinal eye exam?

Individuals with certain medical conditions or who are at risk for eye diseases may be required to have a dilated retinal eye exam.

How to fill out dilated retinal eye exam?

To fill out a dilated retinal eye exam, the individual needs to visit an eye doctor who will perform the exam and fill out the necessary forms.

What is the purpose of dilated retinal eye exam?

The purpose of a dilated retinal eye exam is to detect eye diseases and conditions early on, before they cause significant vision loss.

What information must be reported on dilated retinal eye exam?

The dilated retinal eye exam must include information on the condition of the retina, optic nerve, and any abnormalities or potential issues detected.

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