Risk Management



Corneal Surgery (Addendum to General Consent)  (Download)

Complications which could occur weeks, months, or even years later:
1. Poor vision, total loss of vision, or loss of eye
2. Bleeding in eye
3. Loss of corneal clarity
4. Chronic inflammation
5. Infection
6. Temporary or permanent blurring of vision because of retinal swelling
7. Detachment of the retina
8. Glaucoma
9. Double vision

Local complications of anesthesia injections around the eye:
1. Perforation of eyeball
2. Destruction of optic nerve
3. Interference with circulation of retina
4. Possible drooping of eyelid
5. Respiratory depression
6. Hypotension

Additional comments:

Patient (or person authorized to sign for patient) Date

Witness Date

(Download to view full document.)

Please refer to OMIC's Copyright and Disclaimer regarding the contents on this website

Leave a comment



Six reasons OMIC is the best choice for ophthalmologists in America.

Expertise unmatched.

OMIC's sole mission is to serve ophthalmology. The premier source of ophthalmic claims data and loss prevention materials, OMIC's member hotline is the most used ophthalmic consultative service of its kind and OMIC.com is the most visited web site in America for ophthalmic risk management advice and patient consent documents.

61864684