Policyholder Services

Revised Consent Form: Glaucoma Filtering Surgery (Trabeculectomy) and Use of Anti-Metabolites

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The glaucoma filtering surgery consent form was revised and updated on November 13, 2013, under the guidance of OMIC Board Member Steven V.L. Brown, MD, FACS. Dr. Brown, founder of Chicago Glaucoma Consultants, is a board certified and fellowship trained ophthalmologists specializing in the treatment of glaucoma disease and cataract surgery.

This form is intended as a sample form. It contains information OMIC recommends you as the surgeon personally discuss with the patient. Please review it and modify to fit your actual practice.