Below you will find the intake report of a 58 yo female patient suffering from Convergence Insufficiency and various other visual deficiencies. This report was compiled based on two separate one hour testing sessions. The two sessions were done on two different days in order not to have fatigue skew the results. 

Page 1 gives a statistical overview of how the patient did in terms of population percentile or age equivalent and whether or not this performance was adequate for healthy every day visual function. Page 2 to 5 explain what the various categories mean followed by a prognosis of what a treatment plan might address. The report was further explained to the patient verbally by the treating Doctor of Optometry.

I hope this report sample might be useful in showing patients and partents what kinds of treatment standards are out there. I personally was very impressed by how professionally this intake process is conducted and how it leads to a clear prognosis and treatment plan. It takes away some of the uncertainty and gives patients a clear (numerical) explanation of what’s going on. I would love to have a report like this done on myself.

Extra PDF download link here.

Visual Processing Report_Redacted

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