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Cosmetic eyelid surgery right eye left eye date(s) glaucoma surgery or laser right eye left eye date(s) retinal surgery or laser right eye left eye date(s)_____ other eye operations ... Access Full Source
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Strabismus Surgery (eye muscle surgery) Trabeculectomy (glaucoma surgery) Vitrectomy Other:_____ Ocular Significant Illnesses/Systemic Illnesses: Overall Healthy AIDS Please continue on the back side of this page Date:_____ Reviewed by:_____ Family History: Blindness ... Get Doc
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