Prior exam
Nov 25, 2025 · Dr. Austin Ekeoba locked
Pull this visit into the current exam
Chief complaint
"Diabetic retinopathy screening."
44F T2DM x12y on insulin. Last A1c 7.4. Asymptomatic vision-wise.
Visual acuity
OD20/25
OS20/20
(cc)
IOP · NCT
OD15 mmHg
OS14 mmHg
Fundus / DFE
Disc ODC/D 0.4 · Pink, sharp.
Disc OSC/D 0.4 · Pink, sharp.
Macula ODFew dot heme temporal
Macula OSFew dot heme temporal
Assessment
- • Mild NPDR OU
- • T2DM with A1c 7.4
Plan
- • Continue annual DR screening
- • Reinforce glycemic control with PCP
- • OCT macula obtained — no CSME
- • RTC 12 months or sooner if symptoms
Copying does not modify the prior locked encounter.
1 template suggested for Amara based on diabetic retinopathy.
Comprehensive Eye Exam
Tuesday, June 23
Chief complaint, HPI & visual acuity
Verbatim from patient -- Claude will weave this into your SOAP.
Visual acuity
Snellen - distance 6m / near 40cm - sc (uncorrected) & cc (corrected)Corrected with:
OD
OS
OU