ABSTRACT
PATIENT:_______________ DATE:_______ The above-mentioned patient is undergoing PUVA treatment (psoralen-ultraviolet A). An examination of the lens and retina is required
of all PUVA patients. Your cooperation in recording your findings is greatly appreciated. Please return to:
(1) Slit-lamp exam (2) Fundoscopic exam (3) Visual acuity (4) Evidence of cataracts
_________________M.D. Tel: Address:
