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<?php
/**
* forms/eye_mag/SpectacleRx.php
*
* Functions for printing a glasses prescription
*
* @package OpenEMR
* @link https://www.open-emr.org
* @author Ray Magauran <magauran@MedFetch.com>
* @copyright Copyright (c) 2016 Raymond Magauran <magauran@MedFetch.com>
* @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
*/
require_once(__DIR__ . "/../../globals.php");
require_once("$srcdir/api.inc");
require_once("$srcdir/forms.inc");
require_once("$srcdir/lists.inc");
require_once("$srcdir/options.inc.php");
require_once("$srcdir/patient.inc");
require_once("$srcdir/report.inc");
use OpenEMR\Services\FacilityService;
use OpenEMR\Core\Header;
$facilityService = new FacilityService();
$form_name = "Eye Form";
$form_folder = "eye_mag";
require_once("php/" . $form_folder . "_functions.php");
$RX_expir = "+1 years";
$CTL_expir = "+6 months";
if (!$_REQUEST['pid'] && $_REQUEST['id']) {
$_REQUEST['pid'] = $_REQUEST['id'];
}
if (!$_REQUEST['pid']) {
$_REQUEST['pid'] = $_SESSION['pid'];
}
$query = "select *,form_encounter.date as encounter_date
from forms,form_encounter,form_eye_base,
form_eye_hpi,form_eye_ros,form_eye_vitals,
form_eye_acuity,form_eye_refraction,form_eye_biometrics,
form_eye_external, form_eye_antseg,form_eye_postseg,
form_eye_neuro,form_eye_locking
where
forms.deleted != '1' and
forms.formdir='eye_mag' and
forms.encounter=form_encounter.encounter and
forms.form_id=form_eye_base.id and
forms.form_id=form_eye_hpi.id and
forms.form_id=form_eye_ros.id and
forms.form_id=form_eye_vitals.id and
forms.form_id=form_eye_acuity.id and
forms.form_id=form_eye_refraction.id and
forms.form_id=form_eye_biometrics.id and
forms.form_id=form_eye_external.id and
forms.form_id=form_eye_antseg.id and
forms.form_id=form_eye_postseg.id and
forms.form_id=form_eye_neuro.id and
forms.form_id=form_eye_locking.id and
forms.encounter=? and
forms.pid=? ";
$data = sqlQuery($query, array($_REQUEST['encounter'], $_REQUEST['pid']));
$data['ODMPDD'] = $data['ODPDMeasured'];
$data['OSMPDD'] = $data['OSPDMeasured'];
$data['BPDD'] = (int) $data['ODMPDD'] + (int) $data['OSMPDD'];
@extract($data);
$ODMPDD = $ODPDMeasured;
$OSMPDD = $OSPDMeasured;
$BPDD = (int) $ODMPDD + (int) $OSMPDD;
$query = "SELECT * FROM users where id = ?";
$prov_data = sqlQuery($query, array($data['provider_id']));
$query = "SELECT * FROM patient_data where pid=?";
$pat_data = sqlQuery($query, array($data['pid']));
$practice_data = $facilityService->getPrimaryBusinessEntity();
$visit_date = oeFormatShortDate($data['encounter_date']);
if ($_REQUEST['mode'] == "update") { //store any changed fields in dispense table
$table_name = "form_eye_mag_dispense";
$query = "show columns from " . $table_name;
$dispense_fields = sqlStatement($query);
$fields = array();
if (sqlNumRows($dispense_fields) > 0) {
while ($row = sqlFetchArray($dispense_fields)) {
//exclude critical columns/fields, define below as needed
if (
$row['Field'] == 'id' ||
$row['Field'] == 'pid' ||
$row['Field'] == 'user' ||
$row['Field'] == 'groupname' ||
$row['Field'] == 'authorized' ||
$row['Field'] == 'activity' ||
$row['Field'] == 'date'
) {
continue;
}
if (isset($_POST[$row['Field']])) {
$fields[$row['Field']] = $_POST[$row['Field']];
}
}
$fields['RXTYPE'] = $RXTYPE;
$insert_this_id = formUpdate($table_name, $fields, $_POST['id'], $_SESSION['userauthorized']);
}
exit;
} elseif ($_REQUEST['mode'] == "remove") {
$query = "DELETE FROM form_eye_mag_dispense where id=?";
sqlStatement($query, array($_REQUEST['delete_id']));
echo xlt('Prescription successfully removed.');
exit;
} elseif ($_REQUEST['RXTYPE']) { //store any changed fields
$query = "UPDATE form_eye_mag_dispense set RXTYPE=? where id=?";
sqlStatement($query, array($_REQUEST['RXTYPE'], $_REQUEST['id']));
exit;
}
formHeader("OpenEMR Eye: " . text($prov_data['facility']));
if ($_REQUEST['REFTYPE']) {
$REFTYPE = $_REQUEST['REFTYPE'];
if ($REFTYPE == "AR") {
$RXTYPE = "Bifocal";
}
if ($REFTYPE == "MR") {
$RXTYPE = "Bifocal";
}
if ($REFTYPE == "CTL") {
$RXTYPE = "Bifocal";
}
$id = $_REQUEST['id'];
$table_name = "form_eye_mag";
if (!$_REQUEST['encounter']) {
$encounter = $_SESSION['encounter'];
} else {
$encounter = $_REQUEST['encounter'];
}
if ($REFTYPE == "W") {
//we have rx_number 1-5 to process...
$query = "select * from form_eye_mag_wearing where ENCOUNTER=? and FORM_ID=? and PID=? and RX_NUMBER=?";
$wear = sqlStatement($query, array($encounter,$_REQUEST['form_id'],$_REQUEST['pid'],$_REQUEST['rx_number']));
$wearing = sqlFetchArray($wear);
$ODSPH = $wearing['ODSPH'];
$ODAXIS = $wearing['ODAXIS'];
$ODCYL = $wearing['ODCYL'];
$OSSPH = $wearing['OSSPH'];
$OSCYL = $wearing['OSCYL'];
$OSAXIS = $wearing['OSAXIS'];
$COMMENTS = $wearing['COMMENTS'];
$ODMIDADD = $wearing['ODMIDADD'];
$ODADD2 = $wearing['ODADD'];
$OSMIDADD = $wearing['OSMIDADD'];
$OSADD2 = $wearing['OSADD'];
@extract($wearing);
if ($wearing['RX_TYPE'] == '0') {
$Single = "checked='checked'";
$RXTYPE = "Single";
} elseif ($wearing['RX_TYPE'] == '1') {
$Bifocal = "checked='checked'";
$RXTYPE = "Bifocal";
} elseif ($wearing['RX_TYPE'] == '2') {
$Trifocal = "checked='checked'";
$RXTYPE = "Trifocal";
} elseif ($wearing['RX_TYPE'] == '3') {
$Progressive = "checked='checked'";
$RXTYPE = "Progressive";
}
//do LT and Lens materials
} elseif ($REFTYPE == "AR") {
$ODSPH = $data['ARODSPH'];
$ODAXIS = $data['ARODAXIS'];
$ODCYL = $data['ARODCYL'];
$ODPRISM = $data['ARODPRISM'];
$OSSPH = $data['AROSSPH'];
$OSCYL = $data['AROSCYL'];
$OSAXIS = $data['AROSAXIS'];
$OSPRISM = $data['AROSPRISM'];
$COMMENTS = $data['CRCOMMENTS'];
$ODADD2 = $data['ARODADD'];
$OSADD2 = $data['AROSADD'];
$Bifocal = "checked='checked'";
} elseif ($REFTYPE == "MR") {
$ODSPH = $data['MRODSPH'];
$ODAXIS = $data['MRODAXIS'];
$ODCYL = $data['MRODCYL'];
$ODPRISM = $data['MRODPRISM'];
$OSSPH = $data['MROSSPH'];
$OSCYL = $data['MROSCYL'];
$OSAXIS = $data['MROSAXIS'];
$OSPRISM = $data['MROSPRISM'];
$COMMENTS = $data['CRCOMMENTS'];
$ODADD2 = $data['MRODADD'];
$OSADD2 = $data['MROSADD'];
$Bifocal = "checked='checked'";
} elseif ($REFTYPE == "CR") {
$ODSPH = $data['CRODSPH'];
$ODAXIS = $data['CRODAXIS'];
$ODCYL = $data['CRODCYL'];
$ODPRISM = $data['CRODPRISM'];
$OSSPH = $data['CROSSPH'];
$OSCYL = $data['CROSCYL'];
$OSAXIS = $data['CROSAXIS'];
$OSPRISM = $data['CROSPRISM'];
$COMMENTS = $data['CRCOMMENTS'];
} elseif ($REFTYPE == "CTL") {
$ODSPH = $data['CTLODSPH'];
$ODAXIS = $data['CTLODAXIS'];
$ODCYL = $data['CTLODCYL'];
$ODPRISM = $data['CTLODPRISM'];
$OSSPH = $data['CTLOSSPH'];
$OSCYL = $data['CTLOSCYL'];
$OSAXIS = $data['CTLOSAXIS'];
$OSPRISM = $data['CTLOSPRISM'];
$ODBC = $data['CTLODBC'];
$ODDIAM = $data['CTLODDIAM'];
$ODADD = $data['CTLODADD'];
$ODVA = $data['CTLODVA'];
$OSBC = $data['CTLOSBC'];
$OSDIAM = $data['CTLOSDIAM'];
$OSADD = $data['CTLOSADD'];
$OSVA = $data['CTLOSVA'];
$COMMENTS = $data['COMMENTS'];//in form_eye_mag_dispense there is no leading 'CTL_'
$CTLMANUFACTUREROD = getListItemTitle('CTLManufacturer', $data['CTLMANUFACTUREROD']);
$CTLMANUFACTUREROS = getListItemTitle('CTLManufacturer', $data['CTLMANUFACTUREROS']);
$CTLSUPPLIEROD = getListItemTitle('CTLManufacturer', $data['CTLSUPPLIEROD']);
$CTLSUPPLIEROS = getListItemTitle('CTLManufacturer', $data['CTLSUPPLIEROS']);
$CTLBRANDOD = getListItemTitle('CTLManufacturer', $data['CTLBRANDOD']);
$CTLBRANDOS = getListItemTitle('CTLManufacturer', $data['CTLBRANDOS']);
}
//Since we selected the Print Icon, we must be dispensing this - add to dispensed table now
$table_name = "form_eye_mag_dispense";
$query = "show columns from " . $table_name;
$dispense_fields = sqlStatement($query);
$fields = array();
if (sqlNumRows($dispense_fields) > 0) {
while ($row = sqlFetchArray($dispense_fields)) {
//exclude critical columns/fields, define below as needed
if (
$row['Field'] == 'id' ||
$row['Field'] == 'pid' ||
$row['Field'] == 'user' ||
$row['Field'] == 'groupname' ||
$row['Field'] == 'authorized' ||
$row['Field'] == 'activity' ||
$row['Field'] == 'RXTYPE' ||
$row['Field'] == 'REFDATE' ||
$row['Field'] == 'date'
) {
continue;
}
if (isset(${$row['Field']})) {
$fields[$row['Field']] = ${$row['Field']};
}
}
$fields['RXTYPE'] = $RXTYPE;
$fields['REFDATE'] = $data['date'];
$insert_this_id = formSubmit($table_name, $fields, $form_id, $_SESSION['userauthorized']);
}
}
if ($_REQUEST['dispensed']) {
$query = "SELECT * from form_eye_mag_dispense where pid =? ORDER BY date DESC";
$dispensed = sqlStatement($query, array($_REQUEST['pid']));
?><html>
<title><?php echo xlt('Rx Dispensed History'); ?></title>
<head>
<?php Header::setupHeader(['opener', 'pure', 'jscolor']); ?>
<link rel="stylesheet" href="../../forms/<?php echo $form_folder; ?>/css/style.css" type="text/css">
<style>
.title {
font-size:1em;
position:absolute;
right:10px;
top:30px;
font-size: 1em;
}
.refraction {
width:95%;
display: -moz-stack;
vertical-align: middle;
min-height:unset;
}
.refraction td {
text-align:center;
font-size:12px;
width:0.9in;
vertical-align: text-middle;
text-decoration: unset;
}
table {
font-size: 1.0em;
padding: 12px;
color: black;
vertical-align: text-top;
}
input[type=text] {
text-align: center;
width: 60px;
}
.refraction b {
font-weight: bold;
}
.refraction td.right {
text-align: right;
text-decoration: unset;
width: 0.7in;
vertical-align: middle; font-size:12px;
}
.refraction td.left {
vertical-align: middle;
text-align: left;
font-size:12px;
}
.right {
text-align: right;
vertical-align: middle;}
.left {
vertical-align: middle;
text-align: left;
}
.title {
font-size: 0.9em;
font-weight: normal;
}
.bold {
font-weight: 600;
}
input {
width: 60px;
}
input[type="radio"] {
width: 15px;
}
.underline {
text-decoration:underline !important
}
#CTLODQUANTITY, #CTLOSQUANTITY {
width: 300px;
}
</style>
<script language="JavaScript">
<?php
require_once("$srcdir/restoreSession.php"); ?>
function delete_me(delete_id) {
top.restoreSession();
var url = "../../forms/eye_mag/SpectacleRx.php";
$.ajax({
type: 'POST',
url: url,
data: {
mode: 'remove',
delete_id: delete_id,
dispensed: '1'
} // our data object
}).done(function (o) {
$('#RXID_' + delete_id).hide();
alert(o);
});
}
</script>
</head>
<?php echo report_header($pid, "web"); ?>
<div class="row">
<div class="col-sm-8 offset-sm-2 text-center m-3">
<table>
<tr>
<td colspan="2"><h4 class="underline"><?php echo xlt('Rx History'); ?></h4></td>
</tr>
<?php
if (sqlNumRows($dispensed) == 0) {
echo "<tr><td colspan='2' class='text-center p-3' style='font-size:1.2em;'>" . xlt('There are no Glasses or Contact Lens Presciptions on file for this patient') . "</td></tr>";
}
?>
</table>
<?php
while ($row = sqlFetchArray($dispensed)) {
$i++;
$Single = '';
$Bifocal = '';
$Trifocal = '';
$Progressive = '';
if ($row['RXTYPE'] == "Single") {
$Single = "checked='checked'";
}
if ($row['RXTYPE'] == "Bifocal") {
$Bifocal = "checked='checked'";
}
if ($row['RXTYPE'] == "Trifocal") {
$Trifocal = "checked='checked'";
}
if ($row['RXTYPE'] == "Progressive") {
$Progressive = "checked='checked'";
}
$row['date'] = oeFormatShortDate(date('Y-m-d', strtotime($row['date'])));
if ($row['REFTYPE'] == "CTL") {
$expir = date("Y-m-d", strtotime($CTL_expir, strtotime($row['REFDATE'])));
} else {
$expir = date("Y-m-d", strtotime($RX_expir, strtotime($row['REFDATE'])));
}
$expir_date = oeFormatShortDate($expir);
$row['REFDATE'] = oeFormatShortDate($row['REFDATE']);
?>
<div class="position-relative text-center mt-2 mb-2 mx-auto" id="RXID_<?php echo attr($row['id']); ?>">
<i class="float-right fas fa-times"
onclick="delete_me('<?php echo attr(addslashes($row['id'])); ?>');"
title="<?php echo xla('Remove this Prescription from the list of RXs dispensed'); ?>"></i>
<div class="table-responsive">
<table class="table mt-1 mb-1 mx-auto">
<tr>
<td class="text-right align-middle font-weight-bold" style="width:250px;">
<?php echo xlt('RX Print Date'); ?>:
</td>
<td>&nbsp;&nbsp;<?php echo text($row['date']); ?></td>
</tr>
<tr>
<td class="text-right align-middle font-weight-bold">
<?php echo xlt('Visit Date'); ?>:
</td>
<td>&nbsp;&nbsp;<?php echo text($row['REFDATE']); ?></td>
</tr>
<tr>
<td class="text-right align-middle font-weight-bold">
<?php echo xlt('Expiration Date'); ?>:
</td>
<td>&nbsp;&nbsp;<?php echo text($expir_date); ?></td>
</tr>
<tr>
<td class="text-right align-middle font-weight-bold"><?php echo xlt('Refraction Method'); ?>:</td>
<td>&nbsp;&nbsp;<?php
if ($row['REFTYPE'] == "W") {
echo xlt('Duplicate Rx -- unchanged from current Rx{{The refraction did not change, New Rx=old Rx}}');
} elseif ($row['REFTYPE'] == "CR") {
echo xlt('Cycloplegic (Wet) Refraction');
} elseif ($row['REFTYPE'] == "MR") {
echo xlt('Manifest (Dry) Refraction');
} elseif ($row['REFTYPE'] == "AR") {
echo xlt('Auto-Refraction');
} elseif ($row['REFTYPE'] == "CTL") {
echo xlt('Contact Lens');
} else {
echo $row['REFTYPE'];
} ?>
<input type="hidden" name="REFTYPE" value="<?php echo attr($row['REFTYPE']); ?>"/>
</td>
</tr>
<tr>
<td colspan="2" class="text-center"> <?php
if ($row['REFTYPE'] != "CTL") { ?>
<table id="SpectacleRx" name="SpectacleRx" class="refraction" style="top:0px;">
<tr class="font-weight-bold">
<td></td>
<td></td>
<td class="center font-weight-bold underline"><?php echo xlt('Sph{{Sphere}}'); ?></td>
<td class="center font-weight-bold underline"><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
<td class="center font-weight-bold underline"><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
<td rowspan="5" class="text-right align-middle font-weight-bold underline" colspan="2"
style="min-width:100px;">
<?php echo xlt('Rx Type'); ?><br/><br/>
<?php echo xlt('Single'); ?>
<input type="radio" disabled <?php echo text($Single); ?>><br/>
<?php echo xlt('Bifocal'); ?>
<input type="radio" disabled <?php echo text($Bifocal); ?>><br/>
<?php echo xlt('Trifocal'); ?>
<input type="radio" disabled <?php echo text($Trifocal); ?>><br/>
<?php echo xlt('Prog.{{Progressive lenses}}'); ?>
<input type="radio" disabled <?php echo text($Progressive); ?>><br/>
</td>
</tr>
<tr>
<td class="font-weight-bold text-right" rowspan="2"><?php echo xlt('Distance'); ?></td>
<td class="font-weight-bold"><?php echo xlt('OD{{right eye}}'); ?></td>
<td><?php echo text($row['ODSPH']); ?></td>
<td><?php echo text($row['ODCYL']); ?></td>
<td><?php echo text($row['ODAXIS']); ?></td>
<td><?php echo text($row['ODPRISM']); ?></td>
</tr>
<tr>
<td class="font-weight-bold"><?php echo xlt('OS{{left eye}}'); ?></td>
<td><?php echo text($row['OSSPH']); ?></td>
<td><?php echo text($row['OSCYL']); ?></td>
<td><?php echo text($row['OSAXIS']); ?></td>
<td><?php echo text($row['OSPRISM']); ?></td>
</tr>
<tr class="NEAR">
<td class="text-nowrap" rowspan="2"><span class="font-weight-bold text-decoration-none"><?php echo xlt('ADD'); ?>
:<br/><?php echo xlt("Mid{{Middle segment in a trifocal glasses prescription}}"); ?>
/<?php echo xlt("Near"); ?></span></td>
<td class="font-weight-bold"><?php echo xlt('OD{{right eye}}'); ?></td>
<td class="WMid"><?php echo text($row['ODMIDADD']); ?></td>
<td class="WAdd2"><?php echo text($row['ODADD2']); ?></td>
</tr>
<tr class="NEAR">
<td class="font-weight-bold"><?php echo xlt('OS{{left eye}}'); ?></td>
<td class="WMid"><?php echo text($row['OSMIDADD']); ?></td>
<td class="WAdd2"><?php echo text($row['OSADD2']); ?></td>
</tr>
<tr>
<td colspan="2" class="up" class="font-weight-bold text-right align-top"
style="top:0px;"><?php echo xlt('Comments'); ?>
:
</td>
<td colspan="4" class="up text-left"></td>
<?php echo text($row['CRCOMMENTS']); ?>
</td>
</tr>
</table>
<?php
} else {
if (!empty($row['ODADD']) || !empty($row['OSADD'])) {
$adds = 1;
} else {
$adds = '';
}
?>
<table id="CTLRx" name="CTLRx" class="refraction">
<tr>
<td colspan="4"
class="font-weight-bold text-left align-middle text-uppercase text-top" style="display: flex;
align-items:top"><u><?php echo xlt('Right Lens'); ?></u>
</td>
</tr>
<tr class="font-weight-bold underline">
<td></td>
<td><?php echo xlt('Sph{{Sphere}}'); ?></td>
<td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
<td><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
<td><?php echo xlt('BC{{Base Curve}}'); ?></td>
<td><?php echo xlt('Diam{{Diameter}}'); ?></td>
<?php
if ($adds) {
?>
<td><?php echo xlt('ADD'); ?></td>
<?php }
?>
</tr>
<tr>
<td></td>
<td><?php echo text($row['ODSPH']); ?></td>
<td><?php echo text($row['ODCYL']); ?></td>
<td><?php echo text($row['ODAXIS']); ?></td>
<td><?php echo text($row['ODBC']); ?></td>
<td><?php echo text($row['ODDIAM']); ?></td>
<?php
if ($adds) {
?>
<td><?php echo text($row['ODADD']); ?></td>
<?php } ?>
</tr>
<tr>
<td colspan="2" class="text-right align-middle font-weight-bold">
<?php echo xlt('Brand'); ?>: <br />
<?php echo xlt('Quantity'); ?>: <br />
<?php echo xlt('Supplier'); ?>: </td>
<td colspan="5" class="text-left align-middle align-middle align-top" style="padding-left:10px;">
<?php echo text($row['CTLBRANDOD']); ?>
<?php
if (!empty($row['CTLMANUFACTUREROD'])) {
echo "(" . text($row['CTLMANUFACTUREROD']) . ")";
} ?>
<br />
<?php echo text($row['CTLODQUANTITY']); ?><br />
<?php echo text($row['CTLSUPPLIEROD']); ?>
</td>
</tr>
<tr>
<td colspan="7">
<hr />
</td>
</tr>
<tr>
<td colspan="4"
class="font-weight-bold text-left align-middle text-uppercase text-top d-flex align-items-start">
<u><?php echo xlt('Left Lens'); ?></u>
</td>
</tr>
<tr class="font-weight-bold underline">
<td></td>
<td><?php echo xlt('Sph{{Sphere}}'); ?></td>
<td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
<td><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
<td><?php echo xlt('BC{{Base Curve}}'); ?></td>
<td><?php echo xlt('Diam{{Diameter}}'); ?></td>
<?php
if ($adds) {
?>
<td><?php echo xlt('ADD'); ?></td>
<?php }
?>
</tr>
<tr>
<td></td>
<td><?php echo text($row['OSSPH']); ?></td>
<td><?php echo text($row['OSCYL']); ?></td>
<td><?php echo text($row['OSAXIS']); ?></td>
<td><?php echo text($row['OSBC']); ?></td>
<td><?php echo text($row['OSDIAM']); ?></td>
<?php
if ($adds) {
?>
<td><?php echo text($row['OSADD']); ?></td>
<?php
} ?>
</tr>
<tr>
<td colspan="2" class="text-right align-middle font-weight-bold">
<?php echo xlt('Brand'); ?>: <br />
<?php echo xlt('Quantity'); ?>: <br />
<?php echo xlt('Supplier'); ?>: </td>
<td colspan="5" class="text-left align-middle align-top" style="padding-left:10px;"><?php echo text($row['CTLBRANDOS']); ?>
<?php
if (!empty($row['CTLMANUFACTUREROS'])) {
echo "(" . text($row['CTLMANUFACTUREROS']) . ")";
} ?>
<br />
<?php echo text($row['CTLOSQUANTITY']); ?><br />
<?php echo text($row['CTLSUPPLIEROS']); ?>
</td>
</tr>
<?php if (!empty($row['COMMENTS'])) { ?>
<tr><td colspan="7"><hr /></td></tr>
<tr>
<td colspan="3" class="font-weight-bold text-right align-middle"><?php echo xlt('Comments'); ?>:
</td>
<td colspan="3" class="text-left align-middle" style="padding-left:10px;top:0px;">
<?php echo text($row['COMMENTS']); ?>
</td>
</tr>
<?php } ?>
</table>
<?php
} ?>
</td>
</tr>
</table>
</div>
<hr>
</div>
<?php
} ?>
</div>
</div>
</body>
</html>
<?php
exit;
}
ob_start();
?>
<html>
<head>
<?php Header::setupHeader([ 'opener', 'jquery-ui', 'jquery-ui-redmond', 'pure', 'jscolor' ]); ?>
<link rel="stylesheet" href="../../forms/<?php echo $form_folder; ?>/css/style.css">
<style>
.title {
font-size:1em;
position:absolute;
right:10px;
top:30px;
font-size: 1em;
}
.refraction {
width:95%;
display: -moz-stack;
vertical-align: middle;
min-height:unset;
}
.refraction td {
text-align:center;
font-size:12px;
padding:5;
width:0.35in;
vertical-align: text-middle;
text-decoration: unset;
}
table {
font-size: 1.0em;
padding: 12px;
color: black;
vertical-align: text-top;
}
input[type=text] {
text-align: center;
width: 60px;
padding: 0.2em 0.4em !important;
}
.refraction b {
font-weight: bold;
}
.refraction td.right {
text-align: right;
text-decoration: unset;
width: 0.7in;
vertical-align: middle; font-size:12px;
}
.refraction td.left {
vertical-align: middle;
text-align: left;
font-size:12px;
}
.right {
text-align: right;
vertical-align: middle;}
.left {
vertical-align: middle;
text-align: left;
}
.title {
font-size: 0.9em;
font-weight: normal;
}
.bold {
font-weight: 600;
}
input {
width: 60px;
}
input[type="radio"] {
width: 15px;
}
.underline {
text-decoration:underline !important
}
#CTLODQUANTITY, #CTLOSQUANTITY {
width: 300px;
text-align: left;
padding-left: 10px !important;
}
hr {
margin:1px;
}
label {
font-size:12px;
}
</style>
<!-- jQuery library -->
<script language="JavaScript">
<?php require_once("$srcdir/restoreSession.php"); ?>
function pick_rxType(rxtype, id) {
var url = "../../forms/eye_mag/SpectacleRx.php";
var formData = {
'RXTYPE': rxtype,
'id': id
};
top.restoreSession();
$.ajax({
type: 'POST',
url: url,
data: formData
});
if (rxtype == 'Trifocal') {
$("[name$='MIDADD']").show();
$("[name$='ADD2']").show();
} else if (rxtype == 'Bifocal') {
$("[name$='MIDADD']").hide().val('');
$("[name$='ADD2']").show();
} else if (rxtype == 'Progressive') {
$("[name$='MIDADD']").hide().val('');
$("[name$='ADD2']").show();
} else if (rxtype == "Single") {
$("[name$='MIDADD']").hide().val('');
$("[name$='ADD2']").hide().val('');
}
}
function submit_form() {
var url = "../../forms/eye_mag/SpectacleRx.php?mode=update";
formData = $("form#Spectacle").serialize();
top.restoreSession();
$.ajax({
type: 'POST',
url: url,
data: formData
});
}
//add sph and cyl, flip cyl sign, rotate axis 90.
function reverse_cylinder() {
var Rsph = $('#ODSPH').val();
var Rcyl = $('#ODCYL').val();
var Raxis = $('#ODAXIS').val();
var Lsph = $('#OSSPH').val();
var Lcyl = $('#OSCYL').val();
var Laxis = $('#OSAXIS').val();
if (Rsph == '' && Rcyl == '' && Lsph == '' && lcyl == '') return;
if ((!Rcyl.match(/SPH/i)) && (Rcyl > '')) {
if (Rsph.match(/plano/i)) Rsph = '0';
Rsph = Number(Rsph);
Rcyl = Number(Rcyl);
Rnewsph = Rsph + Rcyl;
if (Rnewsph == 0) Rnewsph = "PLANO";
Rnewcyl = Rcyl * -1;
if (Rnewcyl > 0) Rnewcyl = "+" + Rnewcyl;
if (parseInt(Raxis) < 90) {
Rnewaxis = parseInt(Raxis) + 90;
} else {
Rnewaxis = parseInt(Raxis) - 90;
}
if (Rnewcyl == '0') Rnewcyl = "SPH";
if (Rnewsph == '0') {
Rnewsph = "PLANO";
if (Rnewcyl == "SPH") Rnewcyl = '';
}
$("#ODSPH").val(Rnewsph);
$("#ODCYL").val(Rnewcyl);
$("#ODAXIS").val(Rnewaxis);
$('#ODAXIS').trigger('blur');
$('#ODSPH').trigger('blur');
$('#ODCYL').trigger('blur');
}
if ((!Lcyl.match(/SPH/i)) && (Lcyl > '')) {
if (!Lsph.match(/\d/)) Lsph = '0';
Lsph = Number(Lsph);
Lcyl = Number(Lcyl);
Lnewsph = Lsph + Lcyl;
Lnewcyl = Lcyl * -1;
if (Lnewcyl > 0) Lnewcyl = "+" + Lnewcyl;
if (parseInt(Laxis) < 90) {
Lnewaxis = parseInt(Laxis) + 90;
} else {
Lnewaxis = parseInt(Laxis) - 90;
}
if (Lnewcyl == '0') Lnewcyl = "SPH";
if (Lnewsph == '0') {
Lnewsph = "PLANO";
if (Lnewcyl == "SPH") Lnewcyl = '';
}
$("#OSSPH").val(Lnewsph);
$("#OSCYL").val(Lnewcyl);
$("#OSAXIS").val(Lnewaxis);
$('#OSAXIS').trigger('blur');
$('#OSSPH').trigger('blur');
$('#OSCYL').trigger('blur');
}
}
</script>
</head>
<body>
<?php echo report_header($pid, "web"); ?>
<br/><br/>
<?php
if ($REFTYPE == "CTL") {
$expir = date("Y-m-d", strtotime($CTL_expir, strtotime($data['date'])));
} else {
$expir = date("Y-m-d", strtotime($RX_expir, strtotime($data['date'])));
}
$expir_date = oeFormatShortDate($expir);
?>
<p><span class="font-weight-bold"><?php echo xlt('Expiration Date'); ?>: </span>
&nbsp;&nbsp; <?php echo text($expir_date); ?>
</p>
<form method="post" action="<?php echo $rootdir; ?>/forms/<?php echo text($form_folder); ?>/SpectacleRx.php?mode=update"
id="Spectacle" class="eye_mag pure-form text-center" name="Spectacle">
<!-- start container for the main body of the form -->
<input type="hidden" name="REFDATE" id="REFDATE" value="<?php echo attr($data['date']); ?>">
<input type="hidden" name="RXTYPE" id="RXTYPE" value="<?php echo attr($RXTYPE); ?>">
<input type="hidden" name="REFTYPE" value="<?php echo attr($REFTYPE); ?>"/>
<input type="hidden" name="pid" id="pid" value="<?php echo attr($pid); ?>">
<input type="hidden" name="id" id="id" value="<?php echo attr($insert_this_id); ?>">
<input type="hidden" name="encounter" id="encounter" value="<?php echo attr($encounter); ?>">
<div style="width: 650px;">
<table class="mx-auto">
<tr>
<td>
<?php
if ($REFTYPE != "CTL") { ?>
<table id="SpectacleRx" name="SpectacleRx" class="refraction bordershadow"
style="min-width:610px;top:0px;">
<tr class="font-weight-bold text-center">
<td><i name="reverse" id="reverse" class="fa fa-gamepad fa-2x"></i></td>
<td></td>
<td><?php echo xlt('Sph{{Sphere}}'); ?></td>
<td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
<td><?php echo xlt('Axis{{Axis of a glasses prescription}}'); ?></td>
<td rowspan="5" class="text-right align-middle font-weight-bold" colspan="1" >
<span class="font-weight-bold underline"><?php echo xlt('Rx Type'); ?></span>
<br/><br/>
<span id="SingleVision_span" name="SingleVision_span">
<label for="RXTYPE_Single"><?php echo xlt('Single'); ?></label>
<input type="radio"
onclick="pick_rxType('Single',<?php echo attr_js($insert_this_id); ?>);"
value="Single" id="RXTYPE_Single" name="RXTYPE"
<?php echo attr($Single); ?> />
</span>
<br/>
<span id="Bifocal_span" name="Bifocal_span">
<label for="RXTYPE_Bifocal"><?php echo xlt('Bifocal'); ?></label>
<input type="radio"
onclick="pick_rxType('Bifocal',<?php echo attr_js($insert_this_id); ?>);"
value="Bifocal" id="RXTYPE_Bifocal" name="RXTYPE" <?php echo attr($Bifocal); ?> />
</span>
<br/>
<span id="Trifocal_span" name="Trifocal_span">
<label for="RXTYPE_Trifocal"><?php echo xlt('Trifocal'); ?></label>
<input type="radio"
onclick="pick_rxType('Trifocal',<?php echo attr_js($insert_this_id); ?>);"
value="Trifocal" id="RXTYPE_Trifocal"
name="RXTYPE" <?php echo attr($Trifocal); ?>>
</span>
<br/>
<span id="Progressive_span">
<label for="RXTYPE_Progressive">
<?php echo xlt('Prog.{{Progressive lenses}}'); ?>
</label>
<input type="radio"
onclick="pick_rxType('Progressive',<?php echo attr_js($insert_this_id); ?>);"
value="Progressive" id="RXTYPE_Progressive"
name="RXTYPE" <?php echo attr($Progressive); ?>>
</span>
<br/>
</td>
<td></td>
</tr>
<tr class="center">
<td rowspan="2" colspan="1" class="text-right align-middle font-weight-bold"><?php echo xlt('Distance'); ?>: </td>
<td class="text-right align-middle font-weight-bold"><?php echo xlt('OD{{right eye}}'); ?></td>
<td><input type="text" id="ODSPH" name="ODSPH" value="<?php echo attr($ODSPH); ?>"></td>
<td><input type="text" id="ODCYL" name="ODCYL" value="<?php echo attr($ODCYL); ?>"></td>
<td><input type="text" id="ODAXIS" name="ODAXIS" value="<?php echo attr($ODAXIS); ?>">
</td>
</tr>
<tr class="center">
<td name="W_wide" class="text-right align-middle font-weight-bold"><?php echo xlt('OS{{left eye}}'); ?></td>
<td><input type="text" id="OSSPH" name="OSSPH" value="<?php echo attr($OSSPH); ?>"></td>
<td><input type="text" id="OSCYL" name="OSCYL" value="<?php echo attr($OSCYL); ?>"></td>
<td><input type="text" id="OSAXIS" name="OSAXIS" value="<?php echo attr($OSAXIS); ?>">
</td>
</tr>
<tr class="NEAR center">
<td rowspan="2" colspan="1" class="text-right align-middle font-weight-bold text-nowrap"><?php echo xlt('ADD'); ?>:<br/>
<?php echo xlt("Mid{{Middle segment in a trifocal glasses prescription}}"); ?>
/<?php echo xlt("Near"); ?></td>
<td class="text-right align-middle font-weight-bold"><?php echo xlt('OD{{right eye}}'); ?></td>
<td name="COLADD1"><input type="text" id="ODMIDADD" name="ODMIDADD"
value="<?php echo attr($ODMIDADD); ?>"></td>
<td class="WAdd2"><input type="text" id="ODADD2" name="ODADD2"
value="<?php echo attr($ODADD2); ?>"></td>
</tr>
<tr class="NEAR center">
<td class="text-right align-middle font-weight-bold"><?php echo xlt('OS{{left eye}}'); ?></td>
<td name="COLADD1">
<input type="text" id="OSMIDADD" name="OSMIDADD" value="<?php echo attr($OSMIDADD); ?>"></td>
<td class="WAdd2">
<input type="text" id="OSADD2" name="OSADD2" value="<?php echo attr($OSADD2); ?>"></td>
</tr>
<tr>
<td colspan="2" class="center font-weight-bold"><?php echo xlt('Comments'); ?>: </td>
<td colspan="4">
<textarea class="w-100" style="height:3em;" id="CRCOMMENTS"
name="CRCOMMENTS"><?php echo text($COMMENTS); ?></textarea>
</td>
</tr>
<!-- start Dispense data -->
<tr class="header closeButton">
<td colspan="9" class="right">
<span><?php
if (
$ODHPD || $ODHBASE || $ODVPD || $ODVBASE || $ODSLABOFF || $ODVERTEXDIST ||
$OSHPD || $OSHBASE || $OSVPD || $OSVBASE || $OSSLABOFF || $OSVERTEXDIST ||
$ODMPDD || $ODMPDN || $OSMPDD || $OSMPDN || $BPDD || $BPDN ||
$LENS_MATERIAL || $LENS_TREATMENTS
) {
$detailed = '1';
?><i class="fa fa-minus-square-o"></i><?php
} else {
$detailed = '0';
?><i class="fa fa-plus-square-o"></i><?php
}
?>
</span>
</td>
</tr>
<tr>
<td colspan="7">
<hr/>
</td>
</tr>
<tr class="dispense_data" style="font-weight:bold;text-align:center;">
<td name="W_wide" colspan="1"></td>
<td name="W_wide"
title="<?php echo xla('Horizontal Prism Power'); ?>"><?php echo xlt('Horiz Prism{{abbreviation for Horizontal Prism Power}}'); ?></td>
<td name="W_wide"
title="<?php echo xla('Horizontal Prism Base'); ?>"><?php echo xlt('Horiz Base{{abbreviation for Horizontal Prism Base}}'); ?></td>
<td name="W_wide"
title="<?php echo xla('Vertical Prism Power'); ?>"><?php echo xlt('Vert Prism{{abbreviation for Vertical Prism Power}}'); ?></td>
<td name="W_wide"
title="<?php echo xla('Vertical Prism Base'); ?>"><?php echo xlt('Vert Base{{abbreviation for Vertical Prism Base}}'); ?></td>
<td name="W_wide"
title="<?php echo xla('Slab Off'); ?>"><?php echo xlt('Slab Off'); ?></td>
<td name="W_wide"
title="<?php echo xla('Vertex Distance'); ?>"><?php echo xlt('Vert Distance{{abbreviation for Vertex Distance}}'); ?></td>
</tr>
<tr class="dispense_data">
<td name="W_wide" style="text-align:right;font-weight:bold;"
colspan="1"><?php echo xlt('OD{{right eye}}'); ?></td>
<td name="W_wide"><input type="text" class="prism" id="ODHPD" name="ODHPD"
value="<?php echo attr($ODHPD); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="ODHBASE" name="ODHBASE"
value="<?php echo attr($ODHBASE); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="ODVPD" name="ODVPD"
value="<?php echo attr($ODVPD); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="ODVBASE" name="ODVBASE"
value="<?php echo attr($ODVBASE); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="ODSLABOFF" name="ODSLABOFF"
value="<?php echo attr($ODSLABOFF); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="ODVERTEXDIST" name="ODVERTEXDIST"
value="<?php echo attr($ODVERTEXDIST); ?>"></td>
</tr>
<tr class="dispense_data">
<td name="W_wide" style="text-align:right;font-weight:bold;"
colspan="1"><?php echo xlt('OS{{left eye}}'); ?></td>
<td name="W_wide"><input type="text" class="prism" id="OSHPD" name="OSHPD"
value="<?php echo attr($OSHPD); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="OSHBASE" name="OSHBASE"
value="<?php echo attr($OSHBASE); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="OSVPD" name="OSVPD"
value="<?php echo attr($OSVPD); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="OSVBASE" name="OSVBASE"
value="<?php echo attr($OSVBASE); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="OSSLABOFF" name="OSSLABOFF"
value="<?php echo attr($OSSLABOFF); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="OSVERTEXDIST" name="OSVERTEXDIST"
value="<?php echo attr($OSVERTEXDIST); ?>"></td>
</tr>
<tr class="dispense_data">
<td colspan="7" class="center">
<hr/>
</td>
</tr>
<tr class="dispense_data" style="font-weight:bold;text-align:center;">
<td></td>
<td name="W_wide"
title="<?php echo xla('Monocular Pupillary Diameter - Distance'); ?>"><?php echo xlt('MPD-D{{abbreviation for Monocular Pupillary Diameter - Distance}}'); ?></td>
<td name="W_wide"
title="<?php echo xla('Monocular Pupillary Diameter - Near'); ?>"><?php echo xlt('MPD-N{{abbreviation for Monocular Pupillary Diameter - Near}}'); ?></td>
<td name="W_wide"
title="<?php echo xla('Binocular Pupillary Diameter - Distance'); ?>"><?php echo xlt('BPD-D{{abbreviation for Binocular Pupillary Diameter - Distance}}'); ?></td>
<td name="W_wide"
title="<?php echo xla('Binocular Pupillary Diameter - Near'); ?>"><?php echo xlt('BPD-N{{abbreviation for Binocular Pupillary Diameter - Near}}'); ?></td>
<td colspan="2">Lens Material:</td>
</tr>
<tr>
<td name="W_wide" style="text-align:right;font-weight:bold;"
colspan="1"><?php echo xlt('OD{{right eye}}'); ?></td>
<td name="W_wide"><input type="text" class="prism" id="ODMPDD" name="ODMPDD"
value="<?php echo attr($ODMPDD); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="ODMPDN" name="ODMPDN"
value="<?php echo attr($ODMPDN); ?>"></td>
<td name="W_wide" rowspan="2" style="vertical-align:middle;"><input type="text"
class="prism"
id="BPDD"
name="BPDD"
value="<?php echo attr($BPDD); ?>">
</td>
<td name="W_wide" rowspan="2" style="vertical-align:middle;"><input type="text"
class="prism"
id="BPDN"
name="BPDN"
value="<?php echo attr($BPDN); ?>">
</td>
<td colspan="2"> <?php
echo generate_select_list("LENS_MATERIAL", "Eye_Lens_Material", "$LENS_MATERIAL", '', ' ', '', 'restoreSession;submit_form();', '', array('style' => 'width:120px'));
?>
</td>
</tr>
<tr>
<td name="W_wide" style="text-align:right;font-weight:bold;"
colspan="1"><?php echo xlt('OS{{left eye}}'); ?></td>
<td name="W_wide"><input type="text" class="prism" id="OSMPDD" name="OSMPDD"
value="<?php echo attr($OSMPDD); ?>"></td>
<td name="W_wide"><input type="text" class="prism" id="OSMPDN" name="OSMPDN"
value="<?php echo attr($OSMPDN); ?>"></td>
</tr>
<tr style="font-weight:bold;text-align:center;">
<td colspan="3"><?php echo xlt('Lens Treatments'); ?>
</td>
</tr>
<tr style="text-align:left;vertical-align:top;">
<td colspan="4" class="bold left">
<?php echo generate_lens_treatments($W, $LENS_TREATMENTS); ?>
</td>
</tr>
</table>&nbsp;<br/><br/><br/>
<?php
} else {
if (!empty($ODADD) || !empty($OSADD)) {
$adds = 1;
} else {
$adds = '';
}
?>
<table id="CTLRx" name="CTLRx" class="refraction bordershadow">
<tr class="bold center">
<td class="right bold underline"><?php echo xlt('Right Lens'); ?></td>
</tr>
<tr>
<td colspan="2" class="right bold text-uppercase"><?php echo xlt('Brand'); ?>:</td>
<td colspan="4" class="left"><?php echo text($CTLBRANDOD); ?> <?php if ($CTLMANUFACTUREROD) {
echo "(" . text($CTLMANUFACTUREROD) . ")";} ?></td>
</tr>
<tr class="bold">
<td><?php echo xlt('SPH{{Sphere}}'); ?></td>
<td><?php echo xlt('CYL{{Cylinder}}'); ?></td>
<td><?php echo xlt('AXIS{{Axis of a glasses prescription}}'); ?></td>
<td><?php echo xlt('BC{{Base Curve}}'); ?></td>
<td><?php echo xlt('DIAM{{Diameter}}'); ?></td>
<?php
if ($adds) {
?>
<td><?php echo xlt('ADD{{Bifocal Add}}'); ?></td>
<?php } ?>
</tr>
<tr>
<td><input type=text id="CTLODSPH" name="CTLODSPH" value="<?php echo attr($ODSPH); ?>">
</td>
<td><input type=text id="CTLODCYL" name="CTLODCYL" value="<?php echo attr($ODCYL); ?>">
</td>
<td><input type=text id="CTLODAXIS" name="CTLODAXIS"
value="<?php echo attr($ODAXIS); ?>"></td>
<td><input type=text id="CTLODBC" name="CTLODBC" value="<?php echo attr($ODBC); ?>">
</td>
<td><input type=text id="CTLODDIAM" name="CTLODDIAM"
value="<?php echo attr($ODDIAM); ?>"></td>
<?php
if ($adds) {
?>
<td><input type=text id="CTLODADD" name="CTLODADD" value="<?php echo attr($ODADD); ?>">
</td>
<?php } ?>
</tr>
<tr>
<td colspan="2" class="right bold text-uppercase"><?php echo xlt('Quantity:'); ?></td>
<td colspan="4" class="left"><input id="CTLODQUANTITY" name="CTLODQUANTITY" value="<?php echo attr($CTLODQUANTITY); ?>" type="text" class="left" /></td>
</tr>
<tr>
<td colspan="7">
<hr />
</td>
</tr>
<tr>
<td class="right bold large underline"><?php echo xlt('Left Lens'); ?></td>
</tr>
<tr>
<td colspan="2" class="right bold text-uppercase"><?php echo xlt('Brand'); ?>:</td>
<td colspan="4" class="left"><?php echo text($CTLBRANDOS); ?> <?php if ($CTLMANUFACTUREROS) {
echo "(" . text($CTLMANUFACTUREROS) . ")";} ?></td>
</tr>
<tr class="bold" style="line-height:0.3em;font-size:0.6em;">
<td><?php echo xlt('SPH{{Sphere}}'); ?></td>
<td><?php echo xlt('CYL{{Cylinder}}'); ?></td>
<td><?php echo xlt('AXIS{{Axis of a glasses prescription}}'); ?></td>
<td><?php echo xlt('BC{{Base Curve}}'); ?></td>
<td><?php echo xlt('DIAM{{Diameter}}'); ?></td>
<?php
if ($adds) {
?>
<td><?php echo xlt('ADD{{Bifocal Add}}'); ?></td>
<?php } ?>
</tr>
<tr>
<td><input type=text id="CTLOSSPH" name="CTLOSSPH" value="<?php echo attr($OSSPH); ?>">
</td>
<td><input type=text id="CTLOSCYL" name="CTLOSCYL" value="<?php echo attr($OSCYL); ?>">
</td>
<td><input type=text id="CTLOSAXIS" name="CTLOSAXIS"
value="<?php echo attr($OSAXIS); ?>"></td>
<td><input type=text id="CTLOSBC" name="CTLOSBC" value="<?php echo attr($OSBC); ?>">
</td>
<td><input type=text id="CTLOSDIAM" name="CTLOSDIAM"
value="<?php echo attr($OSDIAM); ?>"></td>
<?php
if ($adds) {
?>
<td><input type=text id="CTLOSADD" name="CTLOSADD" value="<?php echo attr($OSADD); ?>"></td>
<?php } ?>
</tr>
<tr>
<td colspan="2" class="right bold text-uppercase"><?php echo xlt('Quantity:'); ?></td>
<td colspan="4" class="left"><input id="CTLOSQUANTITY" name="CTLOSQUANTITY" value="<?php echo attr($CTLOSQUANTITY); ?>" type="text" class="left" /></td>
</tr>
<?php if ($CTL_COMMENTS > '') { ?>
<tr>
<td colspan="7">
<hr />
</td>
</tr>
<tr>
<td class="right bold red" colspan="2"
style="vertical-align:top;"><?php echo xlt('Comments'); ?>:</u></td>
<td colspan="4" class="left">
<textarea cols="30" rows="4" id="COMMENTS" name="COMMENTS"><?php echo text($CTL_COMMENTS); ?></textarea>
</td>
</tr>
<?php } ?>
</table>
<?php
} ?>
</td>
</tr>
<tr>
<?php
$signature = $GLOBALS["webserver_root"] . "/interface/forms/eye_mag/images/sign_" . attr($_SESSION['authUserID']) . ".jpg";
if (file_exists($signature)) {
?>
<td class="center" style="margin:25px auto;">
<span style="position:relative;padding-left:40px;">
<img src='<?php echo $web_root; ?>/interface/forms/eye_mag/images/sign_<?php echo attr($_SESSION['authUserID']); ?>.jpg'
style="width:240px;height:85px;border-block-end: 1pt solid black;margin:5px;"/>
</span><br/>
<?php
} else {
?>
<td class="center">
<hr style="border:solid 1px black;width:50%;margin:0.5in auto 0;" />
<?php
} ?>
<?php echo xlt('Provider'); ?>
: <?php echo text($prov_data['fname']); ?> <?php echo text($prov_data['lname']);
if ($prov_data['suffix']) {
echo ", " . $prov_data['suffix'];
} ?><br/>
<small><?php echo xlt('e-signed'); ?> <input type="checkbox" checked="checked"></small>
</td>
</tr>
</table>
</div>
</form>
</body>
<script>
$(function () {
$('.header').click(function () {
var $this = $(this);
$(this).nextUntil('tr.header').slideToggle(100).promise().done(function () {
$this.find('span').html(function (_, value) {
return value == '<i class="fa fa-plus-square-o"></i>' ? '<i class="fa fa-minus-square-o"></i>' : '<i class="fa fa-plus-square-o"></i>';
});
});
});
<?php
if (!$detailed) {
echo "$('.header').trigger('click');";
} ?>
$("input[name$='PD']").blur(function () {
//make it all caps
var str = $(this).val();
str = str.toUpperCase();
$(this).val(str);
});
$('input[name$="SPH"]').blur(function () {
var mid = $(this).val();
if (mid.match(/PLANO/i)) {
$(this).val('PLANO');
return;
}
if (mid.match(/^[\+\-]?\d{1}$/)) {
mid = mid + ".00";
}
if (mid.match(/\.[27]$/)) {
mid = mid + '5';
}
if (mid.match(/\.\d$/)) {
mid = mid + '0';
}
//if near is +2. make it +2.00
if (mid.match(/\.$/)) {
mid = mid + '00';
}
if ((!mid.match(/\./)) && (mid.match(00 | 25 | 50 | 75))) {
var front = mid.match(/(\d{0,2})(00|25|50|75)/)[1];
var back = mid.match(/(\d{0,2})(00|25|50|75)/)[2];
if (front == '') front = '0';
mid = front + "." + back;
}
if (!mid.match(/\./)) {
var front = mid.match(/([\+\-]?\d{0,2})(\d{2})/)[1];
var back = mid.match(/(\d{0,2})(\d{2})/)[2];
if (front == '') front = '0';
if (front == '-') front = '-0';
mid = front + "." + back;
}
if (!mid.match(/^(\+|\-){1}/)) {
mid = "+" + mid;
}
$(this).val(mid);
});
$("input[name$='ADD'],input[name$='ADD2']").blur(function () {
var add = $(this).val();
add = add.replace(/=/g, "+");
//if add is one digit, eg. 2, make it +2.00
if (add.match(/^\d{1}$/)) {
add = "+" + add + ".00";
}
//if add is '+'one digit, eg. +2, make it +2.00
if (add.match(/^\+\d{1}$/)) {
add = add + ".00";
}
//if add is 2.5 or 2.0 make it 2.50 or 2.00
if (add.match(/\.[05]$/)) {
add = add + '0';
}
//if add is 2.2 or 2.7 make it 2.25 or 2.75
if (add.match(/\.[27]$/)) {
add = add + '5';
}
//if add is +2. make it +2.00
if (add.match(/\.$/)) {
add = add + '00';
}
if ((!add.match(/\./)) && (add.match(/(0|25|50|75)$/))) {
var front = add.match(/([\+]?\d{0,1})(00|25|50|75)/)[1];
var back = add.match(/([\+]?\d{0,1})(00|25|50|75)/)[2];
if (front == '') front = '0';
add = front + "." + back;
}
if (!add.match(/^(\+)/) && (add.length > 0)) {
add = "+" + add;
}
$(this).val(add);
if (this.id == "ODADD2") $('#OSADD2').val(add);
if (this.id == "ODMIDADD") $('#OSMIDADD').val(add);
if (this.id == "CTLODADD") $('#CTLOSADD').val(add);
});
$("input[name$='AXIS']").blur(function () {
// Make this a 3 digit leading zeros number.
// we are not translating text to numbers, just numbers to
// a 3 digit format with leading zeroes as needed.
// assume the end user KNOWS there are only numbers presented and
// more than 3 digits is a mistake...
// (although this may change with topographic answer)
var axis = $(this).val();
var group = this.name.replace("AXIS", "CYL");
;
var cyl = $("#" + group).val();
if ((cyl > '') && (cyl != 'SPH')) {
if (!axis.match(/\d\d\d/)) {
if (!axis.match(/\d\d/)) {
if (!axis.match(/\d/)) {
axis = '0';
}
axis = '0' + axis;
}
axis = '0' + axis;
}
} else {
axis = '';
}
$(this).val(axis);
});
$("[name$='CYL']").blur(function () {
var mid = $(this).val();
var group = this.name.replace("CYL", "SPH");
;
var sphere = $("#" + group).val();
if (((mid.length == 0) && (sphere.length > 0)) || (mid.match(/sph/i))) {
$(this).val('SPH');
var axis = this.name.replace("CYL", "AXIS");
$("#" + axis).val('');
return;
} else if (sphere.length > 0) {
if (mid.match(/^[\+\-]?\d{1}$/)) {
mid = mid + ".00";
}
if (mid.match(/^(\d)(\d)$/)) {
mid = mid[0] + '.' + mid[1];
}
//if mid is 2.5 or 2.0 make it 2.50 or 2.00
if (mid.match(/\.[05]$/)) {
mid = mid + '0';
}
//if mid is 2.2 or 2.7 make it 2.25 or 2.75
if (mid.match(/\.[27]$/)) {
mid = mid + '5';
}
//if mid is +2. make it +2.00
if (mid.match(/\.$/)) {
mid = mid + '00';
}
if (mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)) {
var front = mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)[1];
var back = mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)[2];
if (front == '') front = '0';
mid = front + "." + back;
}
if (!mid.match(/^(\+|\-){1}/) && (sphere.length > 0)) {
//Since it doesn't start with + or - then give it '+'
mid = "+" + mid;
}
$(this).val(mid);
}
});
$("input,textarea,text,checkbox").change(function () {
submit_form($(this));
});
$("#reverse").click(function () {
//alert('Start');
reverse_cylinder('');
//alert('Finish');
});
$("input[name$='SPH'],input[name$='CYL']").on('keyup', function (e) {
if (e.keyCode == '61' || e.keyCode == '74') {
now = $(this).val();
now = now.replace(/=/g, "+").replace(/^j/g, "J");
$(this).val(now);
}
});
});
</script>
</html>
<?php
$content = ob_get_clean();
echo $content;
exit;
?>