Get the free Refractive Surgery Evaluation

Timothy D. Charity, M.D., P.C. Board Certified Cataract & Refractive Eye Surgeon www.tmcgaritymd.com Refractive Surgery Evaluation Please fax this completed exam form or your own form to 5734412288

How to fill out refractive surgery evaluation

How to fill out a refractive surgery evaluation:

1. Start by providing personal information such as your name, age, address, and contact details. This is essential for the medical staff to identify you accurately.
2. Next, answer questions about your medical history, including any past eye surgeries, eye conditions, or diseases you may have had. Be honest and thorough in your responses as this information can significantly impact the evaluation.
3. The evaluation will also require you to provide details about any current medications or allergies you have. It is crucial to disclose this information to ensure the safety and effectiveness of the refractive surgery.
4. You will likely be asked about your lifestyle and expectations from the surgery. Factors such as your occupation, hobbies, and desired visual outcomes can help the surgeon determine the most suitable procedure for you.
5. Visual acuity tests, such as reading an eye chart, may be performed during the evaluation. This helps assess your current vision and determine the extent of refractive error.
6. The evaluation may also involve a comprehensive eye examination, including measurements of eye pressure, pupil size, corneal thickness, and a dilated eye examination. These tests help the surgeon determine the overall health of your eyes and assess your candidacy for refractive surgery.

Who needs a refractive surgery evaluation:

1. Individuals who have nearsightedness, farsightedness, or astigmatism and are considering corrective surgery may require a refractive surgery evaluation.
2. People experiencing visual difficulties that significantly impact their daily activities, such as reading, driving, or playing sports, may seek a refractive surgery evaluation to explore potential treatment options.
3. Those who have tried contact lenses or glasses but are dissatisfied with the results or looking for a more permanent vision correction solution may benefit from a refractive surgery evaluation.

Please note that a refractive surgery evaluation should always be performed by a qualified ophthalmologist or eye surgeon to ensure accurate assessment and appropriate treatment recommendations.

For pdfFiller’s FAQs

What is refractive surgery evaluation?

Refractive surgery evaluation is a process to assess a patient's suitability for corrective eye surgery.

Who is required to file refractive surgery evaluation?

Patients who are considering undergoing a refractive surgery procedure are required to file a refractive surgery evaluation.

How to fill out refractive surgery evaluation?

Patients can fill out a refractive surgery evaluation by providing their medical history, undergoing a comprehensive eye exam, and discussing their expectations with an eye care professional.

What is the purpose of refractive surgery evaluation?

The purpose of refractive surgery evaluation is to determine if a patient is a good candidate for refractive surgery and to minimize the risk of complications.

What information must be reported on refractive surgery evaluation?

Refractive surgery evaluation must include the patient's medical history, current eye health status, visual acuity measurements, and the proposed surgical plan.

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