Risk Management

Strabismus Surgery Consent (Addendum to General Consent Form)







Complications which could occur weeks, months, or even years later

  1. Infection
  2. Accidental penetration of the eye
  3. Over- and under-correction
  4. Double vision
  5. Unusual suture reaction
  6. Loss of vision or loss of eye


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

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Publicly-traded insurance companies exist to make profits for shareholders while physician-owned carriers often return profits to their policyholders. Don’t underestimate this benefit; it can add up to tens of thousands of dollars over the course of your career. OMIC has one of the most generous dividend programs for ophthalmologists and has returned more than $20 Million to our members through dividends.