Optomap Form Please check off yes or noWe now perform the Optomap retinal exam with all of our patients. The Optomap Retinal Exam, is an ultra-widefield retinal examination, it’s a revolutionary diagnostic tool that allows clinicians to view the majority of the retina. The Optomap Retinal Exam is a non-dilating camera that captures a digital image of the retina. The Optomap allows the doctor to capture a 200° high-resolution image of the retina in a single shot-- without dilation. It’s easy for you as the patient, takes just a few minutes to perform, and is immediately available for review with the patient in the exam room. The 35.00 co-pay for this procedure is generally a non-covered service unless being used to actively follow disease.Please check below if you would like to have this service at your appointment Yes No Name First Middle Last Email Phone Number Δ