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F2F Editable
URC
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F2FVF
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VGC
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VGC
Diagnosis
Eye(s):
Right Eye
Left Eye
Both Eyes
Diagnosis:
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Primary Open Angle Glaucoma
Ocular Hypertension
Normal Pressure Glaucoma
Glaucoma Suspect
Primary Angle Closure Suspect
Primary Angle Closure
Primary Angle Closure Glaucoma
Chronic Angle Closure Glaucoma
Pseudoexfoliation Glaucoma
Secondary Glaucoma
Steroid Response
Mixed Glaucoma
Other
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Treatment
Eye(s):
Right Eye
Left Eye
Both Eyes
Treatment Option:
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G Monopost Once daily at Night
G Cosopt PF Twice daily
G Fixapost PF Once daily in Morning
G Trusopt PF x twice daily
G Trusopt PF Three times daily
G Alphagan twice daily
G Alphagan three times a day
Tab Acetazolamide 250mg PO Twice daily
Tab Acetazolamide 250mg PO three times a day
Tab Acetazolamide 250mg PO Four times a day
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Findings
Vision
Right Eye: 6/
Left Eye: 6/
Intraocular Pressure
Right Eye:
Left Eye:
Impression
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Plan
Plan 1
Plan 2
Plan 3
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Title:
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Mrs
Gender:
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Lady
Patient's Name:
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