Gary Perez
 
 
 From: DAVID GOLDMAN 
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 Fax: (610) 354-8946 
 Page: 15 of 72 
 2019/24/10 5:01 PM 
 Gary Perez 
 Visit Note - 2016/15/06 
 PMS ID: 
 Sex: 
 DOB: 
 Female 
 1998/13/04 
 061885 
 Plan: Counseling - Dry ARMD. 
 I counseled the patient regarding the following: 
 Eye care: Age related macular degeneration is usually treated with nutritional supplements to slow or prevent progression of the disease. If the age 
 related macular degeneration progresses from dry to wet, treatment with injections of medication into the eye, or laser treatment, is often of benefit. 
 It is also important to use sunglasses with 100% UV (ultraviolet) protection when outside. UV light, as in the spectrum of harmful light for the sun, 
 has been shown to cause macular degeneration to progress. 
 Expectations: Age related macular degeneration is a deterioration of the retinal pigment epithelium (RPE), the layer underneath the retina. Loss of 
 central vision in this condition is usually very slow, unless leakage occurs, in which case the loss of vision can be very quick and profound. 
 Contact Office if: Age related macular degeneration progresses with loss of central vision or visual distortion. Call immediately if the vision worsens 
 despite treatment. 
 AREDS Counseling: Patients with AMD or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the AREDS 
 formulation for preventing progression of AMD 
 After counseling the patient, we decided on the following plan for the right eye: AREDS Vitamins and Observation 
 After counseling the patient, we decided on the following plan for the left eye: AREDS Vitamins and Observation 
 Active 
 Yes 
 Staff: 
 Mark Milner (Primary Provider) (Bill Under) 
 Vivian Moreno 
 Electronically Signed By: Mark Milner, 2019/23/04 08:47 PM EST 
 Mark Milner (Primary Provider) (Bill Under) 
 David A. Goldman MD LLC 
 Page 7  
 Suite B 
 Palm Beach Gardens, FL 33410
