Greenwich Eye Care Location

(203) 698-5049

Pro Eye Care Location

(203) 202-0202

Patient Intake

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Medical and Social Information

Do you have problems with any of these systems?
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Do you have diabetes?
Allergies?
Medication allergy?
Do you have frequent headaches?
Do you have migraines?
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Are you pregnant or nursing?
Have you had any surgery?
Do you currently use cigarettes/tobacco?
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Do you use a computer?
Do you drive?
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Family History

Please check all that apply

Personal Eye Information

Do you have any of the following?
Have you had any eye surgeries or treatment for eyes?
Have you had any eye injuries?
Have you been diagnosed with any of the following?
Were you ever advised to wear an eye patch during childhood?
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Do you wear glasses?
Do you wear contacts?

We are pleased to offer Optomap ultra-wide digital retinal imaging to our patients. The Optomap is the latest in eye care technology and is the recommended method for retinal screening by our doctor.


The benefits of the Optomap system are:

  • Testing is fast, easy and comfortable
  • Provides a more complete view of the retina (back of the eye) than has previously been possible
  • A study showed that 1/3 more pathology was found with the Optomap than with dilated exam alone
  • Provides a digital record of your retina which becomes part of your permanent file
  • Enables us to better monitor your eye health annually
  • Continues our commitment to offer all of our patients the highest standard of care available
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How do you prefer to have your appointment confirmed?

Please do not submit any Protected Health Information (PHI).

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    Visit our Office

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    Address

    36 Old Kings Hwy S #110
    Darien, CT 06820

    Contact Information (203) 202-0202

    [email protected]

    Hours of Operation

    Early or Late Appointments Available by Request

    Monday  

    10:00 am - 6:00 pm

    Tuesday  

    10:00 am - 6:00 pm

    Wednesday  

    10:00 am - 6:00 pm

    Thursday  

    10:00 am - 6:00 pm

    Friday  

    10:00 am - 5:00 pm

    Saturday  

    10:00 am - 2:00 pm

    Sunday  

    Closed