CATARACT SURGERY QUALITY ASSURANCE: 4-6 Week Post-op Report
In an effort to track our results, please fax the information below.
Right Eye
Refraction:
-20.00
-19.75
-19.50
-19.25
-19.00
-18.75
-18.50
-18.25
-18.00
-17.75
-17.50
-17.25
-17.00
-16.75
-16.50
-16.25
-16.00
-15.75
-15.50
-15.25
-15.00
-14.75
-14.50
-14.25
-14.00
-13.75
-13.50
-13.25
-13.00
-12.75
-12.50
-12.25
-12.00
-11.75
-11.50
-11.25
-11.00
-10.75
-10.50
-10.25
-10.00
-9.75
-9.50
-9.25
-9.00
-8.75
-8.50
-8.25
-8.00
-7.75
-7.50
-7.25
-7.00
-6.75
-6.50
-6.25
-6.00
-5.75
-5.50
-5.25
-5.00
-4.75
-4.50
-4.25
-4.00
-3.75
-3.50
-3.25
-3.00
-2.75
-2.50
-2.25
-2.00
-1.75
-1.50
-1.25
-1.00
-0.75
-0.50
-0.25
Balance
0.00
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
+4.25
+4.50
+4.75
+5.00
+5.25
+5.50
+5.75
+6.00
+6.25
+6.50
+6.75
+7.00
+7.25
+7.50
+7.75
+8.00
+8.25
+8.50
+8.75
+9.00
+9.25
+9.50
+9.75
+10.00
+10.25
+10.50
+10.75
+11.00
+11.25
+11.50
+11.75
+12.00
-20.00
-19.75
-19.50
-19.25
-19.00
-18.75
-18.50
-18.25
-18.00
-17.75
-17.50
-17.25
-17.00
-16.75
-16.50
-16.25
-16.00
-15.75
-15.50
-15.25
-15.00
-14.75
-14.50
-14.25
-14.00
-13.75
-13.50
-13.25
-13.00
-12.75
-12.50
-12.25
-12.00
-11.75
-11.50
-11.25
-11.00
-10.75
-10.50
-10.25
-10.00
-9.75
-9.50
-9.25
-9.00
-8.75
-8.50
-8.25
-8.00
-7.75
-7.50
-7.25
-7.00
-6.75
-6.50
-6.25
-6.00
-5.75
-5.50
-5.25
-5.00
-4.75
-4.50
-4.25
-4.00
-3.75
-3.50
-3.25
-3.00
-2.75
-2.50
-2.25
-2.00
-1.75
-1.50
-1.25
-1.00
-0.75
-0.50
-0.25
SPH
0.00
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
+4.25
+4.50
+4.75
+5.00
+5.25
+5.50
+5.75
+6.00
+6.25
+6.50
+6.75
+7.00
+7.25
+7.50
+7.75
+8.00
+8.25
+8.50
+8.75
+9.00
+9.25
+9.50
+9.75
+10.00
+10.25
+10.50
+10.75
+11.00
+11.25
+11.50
+11.75
+12.00
×
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176
177
178
179
180
20 /
15
20
25
30
40
50
60
70
80
90
100
200
400
800
CF
Left Eye
Refraction:
-20.00
-19.75
-19.50
-19.25
-19.00
-18.75
-18.50
-18.25
-18.00
-17.75
-17.50
-17.25
-17.00
-16.75
-16.50
-16.25
-16.00
-15.75
-15.50
-15.25
-15.00
-14.75
-14.50
-14.25
-14.00
-13.75
-13.50
-13.25
-13.00
-12.75
-12.50
-12.25
-12.00
-11.75
-11.50
-11.25
-11.00
-10.75
-10.50
-10.25
-10.00
-9.75
-9.50
-9.25
-9.00
-8.75
-8.50
-8.25
-8.00
-7.75
-7.50
-7.25
-7.00
-6.75
-6.50
-6.25
-6.00
-5.75
-5.50
-5.25
-5.00
-4.75
-4.50
-4.25
-4.00
-3.75
-3.50
-3.25
-3.00
-2.75
-2.50
-2.25
-2.00
-1.75
-1.50
-1.25
-1.00
-0.75
-0.50
-0.25
Balance
0.00
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
+4.25
+4.50
+4.75
+5.00
+5.25
+5.50
+5.75
+6.00
+6.25
+6.50
+6.75
+7.00
+7.25
+7.50
+7.75
+8.00
+8.25
+8.50
+8.75
+9.00
+9.25
+9.50
+9.75
+10.00
+10.25
+10.50
+10.75
+11.00
+11.25
+11.50
+11.75
+12.00
-20.00
-19.75
-19.50
-19.25
-19.00
-18.75
-18.50
-18.25
-18.00
-17.75
-17.50
-17.25
-17.00
-16.75
-16.50
-16.25
-16.00
-15.75
-15.50
-15.25
-15.00
-14.75
-14.50
-14.25
-14.00
-13.75
-13.50
-13.25
-13.00
-12.75
-12.50
-12.25
-12.00
-11.75
-11.50
-11.25
-11.00
-10.75
-10.50
-10.25
-10.00
-9.75
-9.50
-9.25
-9.00
-8.75
-8.50
-8.25
-8.00
-7.75
-7.50
-7.25
-7.00
-6.75
-6.50
-6.25
-6.00
-5.75
-5.50
-5.25
-5.00
-4.75
-4.50
-4.25
-4.00
-3.75
-3.50
-3.25
-3.00
-2.75
-2.50
-2.25
-2.00
-1.75
-1.50
-1.25
-1.00
-0.75
-0.50
-0.25
SPH
0.00
+0.25
+0.50
+0.75
+1.00
+1.25
+1.50
+1.75
+2.00
+2.25
+2.50
+2.75
+3.00
+3.25
+3.50
+3.75
+4.00
+4.25
+4.50
+4.75
+5.00
+5.25
+5.50
+5.75
+6.00
+6.25
+6.50
+6.75
+7.00
+7.25
+7.50
+7.75
+8.00
+8.25
+8.50
+8.75
+9.00
+9.25
+9.50
+9.75
+10.00
+10.25
+10.50
+10.75
+11.00
+11.25
+11.50
+11.75
+12.00
×
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20 /
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20
25
30
40
50
60
70
80
90
100
200
400
800
CF
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please notify us immediately at the number below and destroy this facsimile. Thank You.
655 Medical Center Dr NE
| Salem, Oregon 97301
|
503.581.5287
|
Fax 503.386.1377
| mceyeclinic.com
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