- DVBCVSCK ;ALB/GTS-557/THM-VISUAL EXAM ; 6/27/91 2:11 PM
- ;;2.7;AMIE;;Apr 10, 1995
- ;
- S PG=1,HD91="Department of Veterans Affairs",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
- EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
- W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1330 Worksheet" S HD7="VISUAL",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
- W "Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
- W !!!!,"Narrative: "
- S LX="TXT" F I=1:1 S LY=$T(@LX+I) Q:LY["END" W $P(LY,";;",2),!
- W !!,"A. Medical history:",!!!!!!!!!
- W !!,"B. Visual Acuity:",!!?44,"Near",?55,"Far",!?43,"______",?54,"______",!
- W ?13,"Right Eye",?28,"Uncorrected",?42,"|______",?49,"|",?53,"|______",?60,"|",!!?43,"______",?54,"______",!?30,"Corrected",?42,"|______",?49,"|",?53,"|______",?60,"|",!!!
- W ?44,"Near",?55,"Far",!?43,"______",?54,"______",!?13," Left Eye",?28,"Uncorrected",?42,"|______",?49,"|",?53,"|______",?60,"|",!!?43,"______",?54,"______",!?30,"Corrected",?42,"|______",?49,"|",?53,"|______",?60,"|",!!!
- D HD2 S LX="TXT" D ^DVBCVSC1 W !!!!!
- W "F. Diagnostic/clinical test results (other than visual acuity,visual fields",!,?4,"or diplopia):",!!!!!!!!!!,"G. Diagnosis:",!!!!!!!!!!
- W ?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
- ;S LN22="Attachment - Visual Exam" W @IOF,!!?(80-$L(LN22)\2),LN22,!!! D ^DVBCVSC2 W !
- K LN,LN1,LN22
- Q
- ;
- HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Examination",!,HD8," for ",NAME,!!!
- Q
- ;
- TXT ;
- ;;For visual acuity worse than 5/200 in either or both eyes, report
- ;; the distance in feet/inches (or meters/centimeters) from the face
- ;; at which the veteran can count fingers/detect hand motion/read the
- ;; largest line on the chart. If the veteran cannot detect hand motion
- ;; or count fingers at any distance, state whether he/she has light
- ;; perception.
- ;;END
- SETIOF ; ** Set device control var's
- D HOME^%ZIS
- Q
- --- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCVSCK 2167 printed Feb 18, 2025@23:15:46 Page 2
- DVBCVSCK ;ALB/GTS-557/THM-VISUAL EXAM ; 6/27/91 2:11 PM
- +1 ;;2.7;AMIE;;Apr 10, 1995
- +2 ;
- +3 SET PG=1
- SET HD91="Department of Veterans Affairs"
- SET HD9=$SELECT($DATA(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
- EN if '$DATA(IOF)
- DO SETIOF
- if (IOST?1"C-".E)
- WRITE @IOF
- +1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
- WRITE ?33,"# 1330 Worksheet"
- SET HD7="VISUAL"
- SET HD8="For "_HD7
- WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
- +2 WRITE "Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
- +3 WRITE !!!!,"Narrative: "
- +4 SET LX="TXT"
- FOR I=1:1
- SET LY=$TEXT(@LX+I)
- if LY["END"
- QUIT
- WRITE $PIECE(LY,";;",2),!
- +5 WRITE !!,"A. Medical history:",!!!!!!!!!
- +6 WRITE !!,"B. Visual Acuity:",!!?44,"Near",?55,"Far",!?43,"______",?54,"______",!
- +7 WRITE ?13,"Right Eye",?28,"Uncorrected",?42,"|______",?49,"|",?53,"|______",?60,"|",!!?43,"______",?54,"______",!?30,"Corrected",?42,"|______",?49,"|",?53,"|______",?60,"|",!!!
- +8 WRITE ?44,"Near",?55,"Far",!?43,"______",?54,"______",!?13," Left Eye",?28,"Uncorrected",?42,"|______",?49,"|",?53,"|______",?60,"|",!!?43,"______",?54,"______",!?30,"Corrected",?42,"|______",?49,"|",?53,"|______",?60,"|",!!!
- +9 DO HD2
- SET LX="TXT"
- DO ^DVBCVSC1
- WRITE !!!!!
- +10 WRITE "F. Diagnostic/clinical test results (other than visual acuity,visual fields",!,?4,"or diplopia):",!!!!!!!!!!,"G. Diagnosis:",!!!!!!!!!!
- +11 WRITE ?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
- +12 ;S LN22="Attachment - Visual Exam" W @IOF,!!?(80-$L(LN22)\2),LN22,!!! D ^DVBCVSC2 W !
- +13 KILL LN,LN1,LN22
- +14 QUIT
- +15 ;
- HD2 SET PG=PG+1
- WRITE @IOF,!,"Page: ",PG,!!,"Compensation and Pension Examination",!,HD8," for ",NAME,!!!
- +1 QUIT
- +2 ;
- TXT ;
- +1 ;;For visual acuity worse than 5/200 in either or both eyes, report
- +2 ;; the distance in feet/inches (or meters/centimeters) from the face
- +3 ;; at which the veteran can count fingers/detect hand motion/read the
- +4 ;; largest line on the chart. If the veteran cannot detect hand motion
- +5 ;; or count fingers at any distance, state whether he/she has light
- +6 ;; perception.
- +7 ;;END
- SETIOF ; ** Set device control var's
- +1 DO HOME^%ZIS
- +2 QUIT
