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4909 S. 118
th
St., Omaha, NE 68137
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(402) 397-2010
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(800) 433-2015
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(402) 397-8439 Fax •
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• www.nebraskaeye.com
Dr. Johnston cell: (402) 639-3250
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home: (402) 934-8078 or (712) 234-1411 / Dr. Goertz cell: (402) 657-2080
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home: (402) 333-6613
Nurse on call: (402) 657-6489
CATARACT POST-OPERATIVE REPORT
Dr. Date ____/____/____ Time ____________AM PM
Pt:
History:
Date of Procedure:
OD / /
OS / /
Post Op: 1day 1wk 2wks 1month other_______
Current Ocular Medications:
Pred Forte Zymaxid/Vigamox
Other
Examination
distance Near
Uncorrected
OD 20/
OD 20/
Visual Acuity
OS 20/
OS 20/
Manifest Refraction
OD 20/
OS 20/
IOP OD _____mmHg
OS _____mmHg
OD SLE OS
(Circle appropriate description)
closed Incision Closed
clear injected Conjunctiva clear injected
clear _____+striae Cornea clear _____+striae
deep and quiet _____+cells Anterior chamber deep and quiet _____+cells
in position/centered decentered IOL in position/centered decentered
clear _____+haze Posterior capsule clear _____+haze
Impression/Comments:
Plan: Pred Forte qid bid D/C RTC: 1wk 2wks 1mo 3mo 6mo 1yr prn
Zymaxid/Vigamox qid bid D/C
OU 20/ ____
J