How care providers can submit cases

The data collection process was designed with anesthesiologists in mind, although other health care professionals may be able to assist in its completion.

If you have a case of visual loss following non-ophthalmic surgery to report, please download one of the packets below (Requires a PDF Reader) .  If you prefer, you can receive these packets via US Postal Mail.

Care providers have several options open to them for submitting cases:

• Fill out case reports forms themselves
  Providers retain all medical records and only give the anonymous case report form to the Registry
• Provide copies of medical records to the Registry
  Providers send copies of blinded medical records to the Registry and the Registry fills out the case report forms
• Patient provides copies of medical records to the Registry
  Patients send copies of blinded medical records to the Registry and the Registry fills out the case report forms.
  

Select your Submission Option

Educational Materials from the Registry

Fill out case reports yourself Document contains Instructions · Registration and Acknowledgment Form · Study Identification Code Sheet · Primary Case Report Form · Multiple Procedures Report Physician submits medical records Document contains Instructions · Consent form · "To-Do" List · Study Identification Code Sheet · Provider Registry and Acknowledgment Form · Release form Patient submits medical records Document contains Instructions · Consent form · "To-Do" List · Study Identification Code Sheet · Patient Registry and Acknowledgment Form · Release form

APSF display posters Five 11" by 17" posters presented at the ASA Annual Meeting APSF booth for 2000. Educational booklet for care providers A 10 page booklet for anesthesiologists describing in brief the issue of postoperative blindness. Educational handout for patients A 1 page overview of postoperative visual loss for patients.

To receive these materials via US Postal Service, contact:

Karen Posner, Ph.D. Department of Anesthesiology University of Washington Box 356540 Seattle, WA 98195-6540 U.S.A. Telephone: (206) 616-2630 Fax: (206) 543-2958 E-mail:  posner@u.washington.edu    Download Dr. Posner's vCard:

Lorri A. Lee, M.D. Director, Postoperative Visual Loss Registry Department of Anesthesiology University of Washington Box 356540 Seattle, WA 98195-6540 U.S.A. E-mail: lorlee@u.washington.edu