San Diego Eye Care Center
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Online Evaluation

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  1. Has patient been diagnosed with open angle glaucoma?

  2. Has patient been diagnosed with cataracts?

  3. Check box of each procedure patient had performed in the eye or eyes in question

  4. Is patient currently using eye drops to control their glaucoma?

  5. Patient's last eye exam?

  6. Patient's gender?

  7. Patient's age?

  8. Patient's current intraocular eye pressure (IOP)?

  9. How should we notify your with our assessment?

  10. I understand a diagnosis or treatment recommendation can not be made until patient's full medical history is obtained and patient is seen and exmained by Dr. Mellgren *

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