eyeForm: Myopia tracking for school-aged children
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Patient ID
Institution
Neurobit
TTT
HHH
Case No.
Date of visit
Date of birth
Age
Height (cm)
Preterm week
Week
Day
Sex
Male
Female
Fetal status
Single
Multiple
Father：degree of myopia ≦ -5D
Mother：degree of myopia ≦ -5D
OD BCVA
with glasses
OS BCVA
with glasses
OD SPH
OS SPH
OD CYL
OS CYL
OD Axis
0
90
180
10
170
20
160
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
100
105
110
115
120
125
130
135
140
145
150
155
160
165
170
175
OS Axis
0
90
180
10
170
20
160
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
100
105
110
115
120
125
130
135
140
145
150
155
160
165
170
175
OD AL(mm)
< 20
20
21
22
23
24
25
26
27
28
29
30
> 30
.00
.01
.02
.03
.04
.05
.06
.07
.08
.09
.10
.11
.12
.13
.14
.15
.16
.17
.18
.19
.20
.21
.22
.23
.24
.25
.26
.27
.28
.29
.30
.31
.32
.33
.34
.35
.36
.37
.38
.39
.40
.41
.42
.43
.44
.45
.46
.47
.48
.49
.50
.51
.52
.53
.54
.55
.56
.57
.58
.59
.60
.61
.62
.63
.64
.65
.66
.67
.68
.69
.70
.71
.72
.73
.74
.75
.76
.77
.78
.79
.80
.81
.82
.83
.84
.85
.86
.87
.88
.89
.90
.91
.92
.93
.94
.95
.96
.97
.98
.99
OS AL(mm)
< 20
20
21
22
23
24
25
26
27
28
29
30
> 30
.00
.01
.02
.03
.04
.05
.06
.07
.08
.09
.10
.11
.12
.13
.14
.15
.16
.17
.18
.19
.20
.21
.22
.23
.24
.25
.26
.27
.28
.29
.30
.31
.32
.33
.34
.35
.36
.37
.38
.39
.40
.41
.42
.43
.44
.45
.46
.47
.48
.49
.50
.51
.52
.53
.54
.55
.56
.57
.58
.59
.60
.61
.62
.63
.64
.65
.66
.67
.68
.69
.70
.71
.72
.73
.74
.75
.76
.77
.78
.79
.80
.81
.82
.83
.84
.85
.86
.87
.88
.89
.90
.91
.92
.93
.94
.95
.96
.97
.98
.99
Untreated/Under observation
Treatment procedure
Glasses
Regular_glasses
Myopia_control_glasses_Zeiss_MyoVision
Myopia_control_glasses_Hoya_MiyoSmart
Myopia_control_glasses_Essilor_Stellest
Myopia_control_glasses_CooperVision_MiSight
Mydriatic agent
Short_term
0.01%
0.02%
0.03%
0.05%
0.1%
0.3%
0.5%
1.0%
Ortho-K lenses
Ortho_K_lenses
Reminder: Please update the automatically filled recent visit date👆
Treatment recommendations
Axial length risk assessment
Spherical diopter risk assessment
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