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    Opt502 Lab Evaluation - Oct2022

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    NUR FATIHAH SAIFUL EFFENDY
    This document contains forms for dispensing spectacles, including sections for patient information, frame details, lens details, prescription details, and a lab evaluation grading rubric. The forms are for a course on ophthalmic dispensing and require information such as patient PD and pupil size, frame brand and material, lens type and power, prescription details, and criteria for grading spectacle dispensing skills in the lab.

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    Opt502 Lab Evaluation - Oct2022

    Uploaded by

    NUR FATIHAH SAIFUL EFFENDY
    38 views2 pages
    This document contains forms for dispensing spectacles, including sections for patient information, frame details, lens details, prescription details, and a lab evaluation grading rubric. The forms are for a course on ophthalmic dispensing and require information such as patient PD and pupil size, frame brand and material, lens type and power, prescription details, and criteria for grading spectacle dispensing skills in the lab.

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    Opt502 Lab Evaluation_oct2022

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    This document contains forms for dispensing spectacles, including sections for patient information, frame details, lens details, prescription details, and a lab evaluation grading rubric. The forms are for a course on ophthalmic dispensing and require information such as patient PD and pupil size, frame brand and material, lens type and power, prescription details, and criteria for grading spectacle dispensing skills in the lab.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    38 views2 pages

    Opt502 Lab Evaluation - Oct2022

    Uploaded by

    NUR FATIHAH SAIFUL EFFENDY
    This document contains forms for dispensing spectacles, including sections for patient information, frame details, lens details, prescription details, and a lab evaluation grading rubric. The forms are for a course on ophthalmic dispensing and require information such as patient PD and pupil size, frame brand and material, lens type and power, prescription details, and criteria for grading spectacle dispensing skills in the lab.

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    UNIVERSITI TEKNOLOGI MARA

    FAKULTI SAINS KESIHATAN


    HS 246 SARJANA MUDA OPTOMETRI (KEPUJIAN)

    KOD KURSUS : OPT 502


    NAMA KURSUS : OPHTHALMIC DISPENSING I

    SPECTACLE DISPENSING FORM


    STUDENT’S NAME : STUDENT’S ID:
    GROUP : HS246 __
    SPECTACLE :

    PATIENT’S PATIENT’S PD:


    INFORMATION PATIENT’S PUPIL:

    FRAME TYPE: FULL FRAME / HALF FRAME / RIMLESS


    DESCRIPTION BRAND:
    MATERIAL:
    FRAME MEASUREMENT: PD/ HEIGHT /SIZE / BRIDGE / COLOR

    LENS TYPE: SINGLE VISION / BIFOCAL / PROGRESSIVE


    DESCRIPTION MATERIAL:
    COATING:
    LENS POWER: R) L)
    DECENTRATION REQUIRED:

    FINISHING

    ……………………………………………………………………………………………………………
    DISPENSED SPECTACLES’S PRESCRIPTION:

    PRESCRIPTION MONOCULAR PD PUPIL HEIGHT


    SPH CYL AXIS ADD DISTANCE NEAR
    RE

    LE

    DELIVER: YES / NO
    COMMENTS:
    SUPERVISOR SIGNATURE: DATE:
    UNIVERSITI TEKNOLOGI MARA
    FAKULTI SAINS KESIHATAN
    HS 246 SARJANA MUDA OPTOMETRI (KEPUJIAN)

    KOD KURSUS : OPT 502


    NAMA KURSUS : OPHTHALMIC DISPENSING I

    LAB EVALUATION MARKS – 60%

    STUDENT’S NAME : STUDENT’S ID:


    GROUP : HS246 __
    SPECTACLE :

    NO ITEMS MARKS MISTAKES TOTAL


    MARKS

    1 Power of the lens

     Sphere 1 Out by ± 0.25 DS

     Cylinder 1 Out by ± 0.25 DC

     Axis 1 Out by 5°

     ADD 1 Out by ± 0.25 DS

    2 PD measurement

     PD patient 2 Out by ±1mm


    o OD
    o OS
     Pupil height 1 Out by ±1mm

    3 Finishing work 3 Hole – deduct 1 mark

    Chip – deduct 1 mark

    Frame alignment not good


    – deduct 1 mark

    TOTAL MARKS / 10*

    *4 pair of spectacles (Total=40 marks)

    SUPERVISOR SIGNATURE: DATE:

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