Cooper Eye Care Brooklyn

Step 1 of 4

  • Jeffrey Cooper O.D., F.A.A.O., P.C. 

    Vanessa Conenna O.D. Gregory Borukhov O.D. 

    Eleni Sehremelis O.D. 

    Gregory Pamel M.D., F.A.C.S 

    1452 86th Street, Brooklyn, NY 11228 

    P: 718-265-2020, F: 718-837-0431 

     

    539 Park Ave, New York, NY 10021 INSTITUTE 

    P: 212-758-0772, F: 212-758-3532 

    www.coopereyecare.com 

     

    OPTOmap Consent 

    We ask that you carefully read and sign this form to acknowledge your understanding of our dilation policies

    What is Optomap and dilation? These procedures allow for a thorough examination of the internal health of your eyes. It is a required portion of your routine examination. You will choose to perform an optomap image or dilation by drops

    Why is it necessary? It is necessary in order to detect and treat eye diseases such as macular degeneration, glaucoma, retinal holes or detachments, and systemic diseases such as diabetes, stroke, and high blood pressure

    Optomap imaging allows your doctor to view everything a normal dilation does, without the inconvenient side effects of dilation drops. It also provides

    • An in-depth view of the retinal layers. 
    • permanent record for comparing future changes, which gives your doctor comparisons for tracking and diagnosing potential eye disease

    Because Optomap is a screening procedure not covered by most insurance plans, our office offers this service to our patients for a fee of $40.00 

  • MM slash DD slash YYYY