Dilation and/or Retinal Photography Consent Form
What is dilation?
Dilation is an integral part of a complete eye exam. Dilation will make your pupil (the center of your eye) larger allowing the doctor to check for any problems such as:
- Systemic Diseases: Diabetes, High Blood Pressure, Cancer, etc.
- Physical Changes: Cataracts, Glaucoma, Macular Degeneration, Retinal detachment, etc.
Do I need dilation?
It is highly recommended to have your eyes dilated if you are and/or have:
Possible Side Effects
Effects normally last for 3-6 hours, but it can last longer. Difficulty reading things up close with increased light and glare. While dilated, we recommend sunglasses with adequate UV protection. You may use personal sunglasses or we will provide you with temporary sunglasses.
Operation of vehicles & equipment: most people will be able to operate them, however, if you feel uncomfortable operating them, or have never had your eyes dilated, it may be best to have someone else operate them or wait until effects have passed.
Alternative to Dilation
Retinal photography is a procedure that uses digital photography to document the important anatomical structures of the back of the eye (the retina) without the use and side effects of dilating drops.
This instrument provides important diagnostic information for the doctor and ensures optimal eye care treatment. We will share the photographs and the results with you during your exam. They will become a part of your medical record. If done yearly, this will allow the doctor to form a baseline and track any changes.
There is an additional fee for retinal photography, and is not a complete substitute for dilation.
New to our office
Diabetic or high blood pressure
Over age of 45
Eye prescription over -6.00
Medical condition requiring yearly monitoring
Flashing Light / Recent new floaters
Eye pain and/or sudden loss of vision
Never been or 1+ years since dilated