interface/forms/eye_mag/SpectacleRx.php

   1 <?php
   2
   3 /**
   4  * forms/eye_mag/SpectacleRx.php
   5  *
   6  * Functions for printing a glasses prescription
   7  *
   8  * Copyright (C) 2016 Raymond Magauran <magauran@MedFetch.com>
   9  *
  10  * LICENSE: This program is free software: you can redistribute it and/or modify
  11  *  it under the terms of the GNU Affero General Public License as
  12  *  published by the Free Software Foundation, either version 3 of the
  13  *  License, or (at your option) any later version.
  14  *
  15  *  This program is distributed in the hope that it will be useful,
  16  *  but WITHOUT ANY WARRANTY; without even the implied warranty of
  17  *  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  18  *  GNU Affero General Public License for more details.
  19  *
  20  *  You should have received a copy of the GNU Affero General Public License
  21  *  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  22  *
  23  * @package OpenEMR
  24  * @author Ray Magauran <magauran@MedFetch.com>
  25  * @link http://www.open-emr.org
  26  */
  27
  28
  29 require_once("../../globals.php");
  30 require_once("$srcdir/api.inc");
  31 require_once("$srcdir/acl.inc");
  32 require_once("$srcdir/forms.inc");
  33 require_once("$srcdir/lists.inc");
  34 require_once("$srcdir/options.inc.php");
  35 require_once("$srcdir/patient.inc");
  36 require_once("$srcdir/report.inc");
  37
  38 use OpenEMR\Services\FacilityService;
  39
  40 $facilityService = new FacilityService();
  41
  42 $form_name = "Eye Form";
  43 $form_folder = "eye_mag";
  44 require_once("php/" . $form_folder . "_functions.php");
  45
  46 //echo "<pre>";var_dump($_REQUEST);exit;
  47 if (!$_REQUEST['pid'] && $_REQUEST['id']) {
  48     $_REQUEST['pid'] = $_REQUEST['id'];
  49 }
  50 if (!$_REQUEST['pid']) {
  51     $_REQUEST['pid'] = $_SESSION['pid'];
  52 }
  53
  54 $query = "select  *,form_encounter.date as encounter_date
  55                from forms,form_encounter,form_eye_base,
  56                 form_eye_hpi,form_eye_ros,form_eye_vitals,
  57                 form_eye_acuity,form_eye_refraction,form_eye_biometrics,
  58                 form_eye_external, form_eye_antseg,form_eye_postseg,
  59                 form_eye_neuro,form_eye_locking
  60                     where
  61                     forms.deleted != '1'  and
  62                     forms.formdir='eye_mag' and
  63                     forms.encounter=form_encounter.encounter  and
  64                     forms.form_id=form_eye_base.id and
  65                     forms.form_id=form_eye_hpi.id and
  66                     forms.form_id=form_eye_ros.id and
  67                     forms.form_id=form_eye_vitals.id and
  68                     forms.form_id=form_eye_acuity.id and
  69                     forms.form_id=form_eye_refraction.id and
  70                     forms.form_id=form_eye_biometrics.id and
  71                     forms.form_id=form_eye_external.id and
  72                     forms.form_id=form_eye_antseg.id and
  73                     forms.form_id=form_eye_postseg.id and
  74                     forms.form_id=form_eye_neuro.id and
  75                     forms.form_id=form_eye_locking.id and
  76                     forms.encounter=? and
  77                     forms.pid=? ";
  78
  79 $data = sqlQuery($query, array($_REQUEST['encounter'], $_REQUEST['pid']));
  80 $data['ODMPDD'] = $data['ODPDMeasured'];
  81 $data['OSMPDD'] = $data['OSPDMeasured'];
  82 $data['BPDD']   = $data['ODMPDD'] + $data['OSMPDD'];
  83 @extract($data);
  84
  85 $ODMPDD     = $ODPDMeasured;
  86 $OSMPDD     = $OSPDMeasured;
  87 $BPDD       = $ODMPDD + $OSMPDD;
  88
  89 $query      = "SELECT * FROM users where id = ?";
  90 $prov_data  = sqlQuery($query, array($data['provider_id']));
  91
  92 $query      = "SELECT * FROM patient_data where pid=?";
  93 $pat_data   = sqlQuery($query, array($data['pid']));
  94
  95 $practice_data = $facilityService->getPrimaryBusinessEntity();
  96
  97 $visit_date = oeFormatShortDate($data['encounter_date']);
  98
  99 if ($_REQUEST['mode'] == "update") {  //store any changed fields in dispense table
 100     $table_name = "form_eye_mag_dispense";
 101     $query = "show columns from " . $table_name;
 102     $dispense_fields = sqlStatement($query);
 103     $fields = array();
 104
 105     if (sqlNumRows($dispense_fields) > 0) {
 106         while ($row = sqlFetchArray($dispense_fields)) {
 107             //exclude critical columns/fields, define below as needed
 108             if ($row['Field'] == 'id' ||
 109                 $row['Field'] == 'pid' ||
 110                 $row['Field'] == 'user' ||
 111                 $row['Field'] == 'groupname' ||
 112                 $row['Field'] == 'authorized' ||
 113                 $row['Field'] == 'activity' ||
 114                 $row['Field'] == 'date'
 115             ) {
 116                 continue;
 117             }
 118
 119             if (isset($_POST[$row['Field']])) {
 120                 $fields[$row['Field']] = $_POST[$row['Field']];
 121             }
 122         }
 123         $fields['RXTYPE'] = $RXTYPE;
 124
 125         $insert_this_id = formUpdate($table_name, $fields, $_POST['id'], $_SESSION['userauthorized']);
 126     }
 127
 128     exit;
 129 } else if ($_REQUEST['mode'] == "remove") {
 130     $query = "DELETE FROM form_eye_mag_dispense where id=?";
 131     sqlStatement($query, array($_REQUEST['delete_id']));
 132     echo xlt('Prescription successfully removed.');
 133     exit;
 134 } else if ($_REQUEST['RXTYPE']) {  //store any changed fields
 135     $query = "UPDATE form_eye_mag_dispense set RXTYPE=? where id=?";
 136     sqlStatement($query, array($_REQUEST['RXTYPE'], $_REQUEST['id']));
 137     exit;
 138 }
 139
 140 formHeader("OpenEMR Eye: " . $prov_data[facility]);
 141
 142 if ($_REQUEST['REFTYPE']) {
 143     $REFTYPE = $_REQUEST['REFTYPE'];
 144     if ($REFTYPE == "AR") {
 145         $RXTYPE = "Bifocal";
 146     }
 147
 148     if ($REFTYPE == "MR") {
 149         $RXTYPE = "Bifocal";
 150     }
 151
 152     if ($REFTYPE == "CTL") {
 153         $RXTYPE = "Bifocal";
 154     }
 155
 156     $id = $_REQUEST['id'];
 157     $table_name = "form_eye_mag";
 158     if (!$_REQUEST['encounter']) {
 159         $encounter = $_SESSION['encounter'];
 160     } else {
 161         $encounter = $_REQUEST['encounter'];
 162     }
 163
 164
 165
 166     if ($REFTYPE =="W") {
 167         //we have rx_number 1-5 to process...
 168         $query = "select * from form_eye_mag_wearing where ENCOUNTER=? and FORM_ID=? and PID=? and RX_NUMBER=?";
 169         $wear = sqlStatement($query, array($encounter,$_REQUEST['form_id'],$_REQUEST['pid'],$_REQUEST['rx_number']));
 170         $wearing = sqlFetchArray($wear);
 171         $ODSPH = $wearing['ODSPH'];
 172         $ODAXIS = $wearing['ODAXIS'];
 173         $ODCYL = $wearing['ODCYL'];
 174         $OSSPH = $wearing['OSSPH'];
 175         $OSCYL = $wearing['OSCYL'];
 176         $OSAXIS = $wearing['OSAXIS'];
 177         $COMMENTS = $wearing['COMMENTS'];
 178         $ODMIDADD = $wearing['ODMIDADD'];
 179         $ODADD2 = $wearing['ODADD'];
 180         $OSMIDADD = $wearing['OSMIDADD'];
 181         $OSADD2 = $wearing['OSADD'];
 182         @extract($wearing);
 183         if ($wearing['RX_TYPE']=='0') {
 184             $Single="checked='checked'";
 185             $RXTYPE="Single";
 186         } elseif ($wearing['RX_TYPE']=='1') {
 187             $Bifocal ="checked='checked'";
 188             $RXTYPE="Bifocal";
 189         } elseif ($wearing['RX_TYPE']=='2') {
 190             $Trifocal ="checked='checked'";
 191             $RXTYPE="Trifocal";
 192         } elseif ($wearing['RX_TYPE']=='3') {
 193             $Progressive ="checked='checked'";
 194             $RXTYPE="Progressive";
 195         }
 196
 197         //do LT and Lens materials
 198     } elseif ($REFTYPE == "AR") {
 199         $ODSPH      = $data['ARODSPH'];
 200         $ODAXIS     = $data['ARODAXIS'];
 201         $ODCYL      = $data['ARODCYL'];
 202         $ODPRISM    = $data['ARODPRISM'];
 203         $OSSPH      = $data['AROSSPH'];
 204         $OSCYL      = $data['AROSCYL'];
 205         $OSAXIS     = $data['AROSAXIS'];
 206         $OSPRISM    = $data['AROSPRISM'];
 207         $COMMENTS   = $data['CRCOMMENTS'];
 208         $ODADD2     = $data['ARODADD'];
 209         $OSADD2     = $data['AROSADD'];
 210         $Bifocal    = "checked='checked'";
 211     } elseif ($REFTYPE == "MR") {
 212         $ODSPH      = $data['MRODSPH'];
 213         $ODAXIS     = $data['MRODAXIS'];
 214         $ODCYL      = $data['MRODCYL'];
 215         $ODPRISM    = $data['MRODPRISM'];
 216         $OSSPH      = $data['MROSSPH'];
 217         $OSCYL      = $data['MROSCYL'];
 218         $OSAXIS     = $data['MROSAXIS'];
 219         $OSPRISM    = $data['MROSPRISM'];
 220         $COMMENTS   = $data['CR_COMMENTS'];
 221         $ODADD2     = $data['MRODADD'];
 222         $OSADD2     = $data['MROSADD'];
 223         $Bifocal    = "checked='checked'";
 224     } elseif ($REFTYPE == "CR") {
 225         $ODSPH      = $data['CRODSPH'];
 226         $ODAXIS     = $data['CRODAXIS'];
 227         $ODCYL      = $data['CRODCYL'];
 228         $ODPRISM    = $data['CRODPRISM'];
 229         $OSSPH      = $data['CROSSPH'];
 230         $OSCYL      = $data['CROSCYL'];
 231         $OSAXIS     = $data['CROSAXIS'];
 232         $OSPRISM    = $data['CROSPRISM'];
 233         $COMMENTS   = $data['CRCOMMENTS'];
 234     } elseif ($REFTYPE == "CTL") {
 235         $ODSPH      = $data['CTLODSPH'];
 236         $ODAXIS     = $data['CTLODAXIS'];
 237         $ODCYL      = $data['CTLODCYL'];
 238         $ODPRISM    = $data['CTLODPRISM'];
 239
 240         $OSSPH      = $data['CTLOSSPH'];
 241         $OSCYL      = $data['CTLOSCYL'];
 242         $OSAXIS     = $data['CTLOSAXIS'];
 243         $OSPRISM    = $data['CTLOSPRISM'];
 244
 245         $ODBC       = $data['CTLODBC'];
 246         $ODDIAM     = $data['CTLODDIAM'];
 247         $ODADD      = $data['CTLODADD'];
 248         $ODVA       = $data['CTLODVA'];
 249
 250         $OSBC       = $data['CTLOSBC'];
 251         $OSDIAM     = $data['CTLOSDIAM'];
 252         $OSADD      = $data['CTLOSADD'];
 253         $OSVA       = $data['CTLOSVA'];
 254
 255         $COMMENTS   = $data['CTL_COMMENTS'];
 256
 257         $CTLMANUFACTUREROD  = getListItemTitle('CTLManufacturer', $data['CTLMANUFACTUREROD']);
 258         $CTLMANUFACTUREROS  = getListItemTitle('CTLManufacturer', $data['CTLMANUFACTUREROS']);
 259         $CTLSUPPLIEROD      = getListItemTitle('CTLManufacturer', $data['CTLSUPPLIEROD']);
 260         $CTLSUPPLIEROS      = getListItemTitle('CTLManufacturer', $data['CTLSUPPLIEROS']);
 261         $CTLBRANDOD         = getListItemTitle('CTLManufacturer', $data['CTLBRANDOD']);
 262         $CTLBRANDOS         = getListItemTitle('CTLManufacturer', $data['CTLBRANDOS']);
 263     }
 264
 265     //Since we selected the Print Icon, we must be dispensing this - add to dispensed table now
 266     $table_name      = "form_eye_mag_dispense";
 267     $query           = "show columns from " . $table_name;
 268     $dispense_fields = sqlStatement($query);
 269     $fields          = array();
 270
 271     if (sqlNumRows($dispense_fields) > 0) {
 272         while ($row = sqlFetchArray($dispense_fields)) {
 273             //exclude critical columns/fields, define below as needed
 274             if ($row['Field'] == 'id' ||
 275                 $row['Field'] == 'pid' ||
 276                 $row['Field'] == 'user' ||
 277                 $row['Field'] == 'groupname' ||
 278                 $row['Field'] == 'authorized' ||
 279                 $row['Field'] == 'activity' ||
 280                 $row['Field'] == 'RXTYPE' ||
 281                 $row['Field'] == 'REFDATE' ||
 282                 $row['Field'] == 'date'
 283             ) {
 284                 continue;
 285             }
 286             if (isset(${$row['Field']})) {
 287                 $fields[$row['Field']] = ${$row['Field']};
 288             }
 289         }
 290
 291         $fields['RXTYPE'] = $RXTYPE;
 292         $fields['REFDATE'] = $data['date'];
 293         $insert_this_id = formSubmit($table_name, $fields, $form_id, $_SESSION['userauthorized']);
 294     }
 295 }
 296
 297 if ($_REQUEST['dispensed']) {
 298     $query      = "SELECT * from form_eye_mag_dispense where pid =? ORDER BY date DESC";
 299     $dispensed  = sqlStatement($query, array($_REQUEST['pid']));
 300     //could put Robert's header here
 301     ?>
 302     <html>
 303 <title><?php echo xlt('Rx Dispensed History'); ?></title>
 304 <head>
 305     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-min-1-10-2/index.js"></script>
 306     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/bootstrap-3-3-4/dist/js/bootstrap.min.js"></script>
 307     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/qtip2-2-2-1/jquery.qtip.min.js"></script>
 308     <script type="text/javascript" src="<?php echo $webroot ?>/interface/main/tabs/js/include_opener.js"></script>
 309
 310     <link rel="stylesheet"
 311           href="<?php echo $GLOBALS['assets_static_relative'] ?>/bootstrap-3-3-4/dist/css/bootstrap.min.css">
 312     <link rel="stylesheet" href="<?php echo $GLOBALS['css_header']; ?>" type="text/css">
 313     <link rel="stylesheet"
 314           href="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-ui-1-10-4/themes/ui-lightness/jquery-ui.min.css">
 315     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/pure-0-5-0/pure-min.css">
 316     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/qtip2-2-2-1/jquery.qtip.min.css"/>
 317     <link rel="stylesheet"
 318           href="<?php echo $GLOBALS['assets_static_relative'] ?>/font-awesome-4-6-3/css/font-awesome.min.css">
 319     <link rel="stylesheet" href="../../forms/<?php echo $form_folder; ?>/css/style.css" type="text/css">
 320
 321     <style>
 322         .refraction {
 323             top: 1in;
 324             float: left;
 325             min-height: 1.0in;
 326             border: 1.00pt solid #000000;
 327             padding: 5px;
 328             border-radius: 8px;
 329             margin: 5px auto;
 330         }
 331
 332         .refraction td {
 333             text-align: center;
 334             font-size: 8pt;
 335             padding: 2;
 336             text-decoration: none;
 337         }
 338
 339         table {
 340             font-size: 1.0em;
 341             padding: 2px;
 342             color: black;
 343             vertical-align: text-top;
 344         }
 345
 346         input[type=text] {
 347             text-align: right;
 348             width: 50px;
 349             background-color: white;
 350         }
 351
 352         .refraction b {
 353             text-decoration: bold;
 354         }
 355
 356         .refraction td.right {
 357             text-align: right;
 358             text-decoration: none;
 359             vertical-align: text-top;
 360         }
 361
 362         .refraction td.left {
 363             text-align: left;
 364             vertical-align: top;
 365         }
 366
 367         .right {
 368             text-align: right;
 369             vertical-align: text-top;
 370         }
 371
 372         .left {
 373             text-align: left;
 374             vertical-align: top;
 375         }
 376
 377         .title {
 378             font-size: 0.9em;
 379             font-weight: normal;
 380         }
 381     </style>
 382     <script language="JavaScript">
 383         <?php       require_once("$srcdir/restoreSession.php");  ?>
 384
 385         function delete_me(delete_id) {
 386             top.restoreSession();
 387             var url = "../../forms/eye_mag/SpectacleRx.php";
 388             $.ajax({
 389                 type: 'POST',
 390                 url: url,
 391                 data: {
 392                     mode: 'remove',
 393                     delete_id: delete_id,
 394                     dispensed: '1'
 395                 } // our data object
 396             }).done(function (o) {
 397                 $('#RXID_' + delete_id).hide();
 398                 alert(o);
 399             });
 400         }
 401
 402     </script>
 403 </head>
 404 <?php echo report_header($pid, "web"); ?>
 405 <div class="row">
 406     <div class="col-sm-8 offset-sm-2" style="margin:5;text-align:center;">
 407         <table>
 408             <tr>
 409                 <td colspan="2"><h4 class="underline"><?php echo xlt('Rx History'); ?></h4></td>
 410             </tr>
 411             <?php
 412             if (sqlNumRows($dispensed) == 0) {
 413                 echo "<tr><td colspan='2' style='font-size:1.2em;text-align:middle;padding:25px;'>" . xlt('There are no Glasses or Contact Lens Presciptions on file for this patient') . "</td></tr>";
 414             }
 415             ?>
 416         </table>
 417         <?php
 418         while ($row = sqlFetchArray($dispensed)) {
 419             $i++;
 420             $Single = '';
 421             $Bifocal = '';
 422             $Trifocal = '';
 423             $Progressive = '';
 424             if ($row['RXTYPE'] == "Single") {
 425                 $Single = "checked='checked'";
 426             }
 427
 428             if ($row['RXTYPE'] == "Bifocal") {
 429                 $Bifocal = "checked='checked'";
 430             }
 431
 432             if ($row['RXTYPE'] == "Trifocal") {
 433                 $Trifocal = "checked='checked'";
 434             }
 435
 436             if ($row['RXTYPE'] == "Progressive") {
 437                 $Progressive = "checked='checked'";
 438             }
 439
 440             $row['REFDATE'] = oeFormatShortDate($row['REFDATE']);
 441             $row['date'] = oeFormatShortDate(date('Y-m-d', strtotime($row['date'])));
 442             if ($REFTYPE == "CTL") {
 443                 $expir = date("Y-m-d", strtotime("+1 years", strtotime($row['REFDATE'])));
 444             } else {
 445                 $expir = date("Y-m-d", strtotime("+6 months", strtotime($row['REFDATE'])));
 446             }
 447             $expir_date = oeFormatShortDate($expir);
 448
 449             ?>
 450             <div id="RXID_<?php echo attr($row['id']); ?>"
 451                  style="position:relative;text-align:center;width:80%;margin: 10 auto;">
 452                 <i class="pull-right fa fa-close"
 453                    onclick="delete_me('<?php echo attr(addslashes($row['id'])); ?>');"
 454                    title="<?php echo xla('Remove this Prescription from the list of RXs dispensed'); ?>"></i>
 455                 <table style="margin:2px auto;">
 456                     <tr>
 457                         <td class="right bold" style="width:250px;"><b><?php echo xlt('RX Date'); ?>: </b></td>
 458                         <td>&nbsp;&nbsp;<?php echo text($row['date']); ?></td>
 459                     </tr>
 460                     <tr>
 461                         <td class="right bold"><b><?php echo xlt('Visit Date'); ?>: </b></td>
 462                         <td>&nbsp;&nbsp;<?php echo text($row['REFDATE']); ?></td>
 463                     </tr>
 464                     <tr>
 465                         <td class="right bold"><b><?php echo xlt('Expiration Date'); ?>: </b></td>
 466                         <td>&nbsp;&nbsp;<?php
 467                             echo text($expir_date);
 468                             ?>
 469                         </td>
 470                     </tr>
 471
 472                     <tr>
 473                         <td class="right bold"><?php echo xlt('Refraction Method'); ?>:</td>
 474                         <td>&nbsp;&nbsp;<?php
 475                         if ($row['REFTYPE'] == "W") {
 476                             echo xlt('Duplicate Rx -- unchanged from current Rx{{The refraction did not change, New Rx=old Rx}}');
 477                         } else if ($row['REFTYPE'] == "CR") {
 478                             echo xlt('Cycloplegic (Wet) Refraction');
 479                         } else if ($row['REFTYPE'] == "MR") {
 480                             echo xlt('Manifest (Dry) Refraction');
 481                         } else if ($row['REFTYPE'] == "AR") {
 482                             echo xlt('Auto-Refraction');
 483                         } else if ($row['REFTYPE'] == "CTL") {
 484                             echo xlt('Contact Lens');
 485                         } else {
 486                             echo $row['REFTYPE'];
 487                         } ?>
 488                             <input type="hidden" name="REFTYPE" value="<?php echo attr($row['REFTYPE']); ?>"/>
 489                         </td>
 490                     </tr>
 491                     <tr>
 492                         <td colspan="2"> <?php
 493                         if ($row['REFTYPE'] != "CTL") { ?>
 494                                 <table id="SpectacleRx" name="SpectacleRx" class="refraction" style="top:0px;">
 495                                     <tr style="font-style:bold;">
 496                                         <td></td>
 497                                         <td></td>
 498                                         <td class="center"><?php echo xlt('Sph{{Sphere}}'); ?></td>
 499                                         <td class="center"><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 500                                         <td class="center"><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
 501                                         <td rowspan="5" class="right bold underline" colspan="2"
 502                                             style="min-width:200px;font-weight:bold;">
 503                                             <?php echo xlt('Rx Type'); ?><br/><br/>
 504                                             <?php echo xlt('Single'); ?>
 505                                             <input type="radio" disabled <?php echo text($Single); ?>><br/>
 506                                             <?php echo xlt('Bifocal'); ?>
 507                                             <input type="radio" disabled <?php echo text($Bifocal); ?>><br/>
 508                                             <?php echo xlt('Trifocal'); ?>
 509                                             <input type="radio" disabled <?php echo text($Trifocal); ?>><br/>
 510                                             <?php echo xlt('Prog.{{Progressive lenses}}'); ?>
 511                                             <input type="radio" disabled <?php echo text($Progressive); ?>><br/>
 512                                         </td>
 513                                     </tr>
 514                                     <tr>
 515                                         <td rowspan="2"
 516                                             style="text-align:right;font-weight:bold;"><?php echo xlt('Distance'); ?></td>
 517                                         <td><b><?php echo xlt('OD{{right eye}}'); ?></b></td>
 518                                         <td><?php echo text($row['ODSPH']); ?></td>
 519                                         <td><?php echo text($row['ODCYL']); ?></td>
 520                                         <td><?php echo text($row['ODAXIS']); ?></td>
 521                                         <td><?php echo text($row['ODPRISM']); ?></td>
 522                                     </tr>
 523                                     <tr>
 524                                         <td><b><?php echo xlt('OS{{left eye}}'); ?></b></td>
 525                                         <td><?php echo text($row['OSSPH']); ?></td>
 526                                         <td><?php echo text($row['OSCYL']); ?></td>
 527                                         <td><?php echo text($row['OSAXIS']); ?></td>
 528                                         <td><?php echo text($row['OSPRISM']); ?></td>
 529                                     </tr>
 530                                     <tr class="NEAR">
 531                                         <td rowspan=2 nowrap><span
 532                                                     style="text-decoration:none;"><?php echo xlt('ADD'); ?>
 533                                                 :<br/><?php echo xlt("Mid{{Middle segment in a trifocal glasses prescription}}"); ?>
 534                                                 /<?php echo xlt("Near"); ?></span></td>
 535                                         <td><b><?php echo xlt('OD{{right eye}}'); ?></b></td>
 536                                         <td class="WMid"><?php echo text($row['ODMIDADD']); ?></td>
 537                                         <td class="WAdd2"><?php echo text($row['ODADD2']); ?></td>
 538                                     </tr>
 539                                     <tr class="NEAR">
 540                                         <td><b><?php echo xlt('OS{{left eye}}'); ?></b></td>
 541                                         <td class="WMid"><?php echo text($row['OSMIDADD']); ?></td>
 542                                         <td class="WAdd2"><?php echo text($row['OSADD2']); ?></td>
 543                                     </tr>
 544                                     <tr style="">
 545                                         <td colspan="2" class="up"
 546                                             style="text-align:right;vertical-align:top;top:0px;font-weight:bold;"><?php echo xlt('Comments'); ?>
 547                                             :
 548                                         </td>
 549                                         <td colspan="4" class="up"
 550                                             style="text-align:left;vertical-align:middle;top:0px;">
 551                                             <textarea style="width:100%;height:2.1em;" id="COMMENTS" disabled
 552                                                       name="COMMENTS"><?php echo text($row['COMMENTS']); ?></textarea>
 553                                         </td>
 554                                     </tr>
 555                                 </table>
 556                                 <?php
 557                         } else { ?>
 558                                 <table id="CTLRx" name="CTLRx" class="refraction">
 559                                     <tr>
 560                                         <td colspan="4"
 561                                         class="bold underline left"><?php echo xlt('Right Lens'); ?></u></td>
 562                                     </tr>
 563                                     <tr>
 564                                         <td colspan="3" class="left"><?php echo text($row['CTLBRANDOD']); ?></td>
 565                                     </tr>
 566                                     <tr class="bold" style="text-decoration:underline;">
 567                                         <td></td>
 568                                         <td><?php echo xlt('Sph{{Sphere}}'); ?></td>
 569                                         <td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 570                                         <td><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
 571                                         <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
 572                                         <td><?php echo xlt('Diam{{Diameter}}'); ?></td>
 573                                         <td><?php echo xlt('ADD'); ?></td>
 574                                         <td>
 575                                         <td>
 576                                         <td><?php echo xlt('Supplier'); ?></td>
 577                                     </tr>
 578                                     <tr>
 579                                         <td></td>
 580                                         <td><?php echo text($row['ODSPH']); ?></td>
 581                                         <td><?php echo text($row['ODCYL']); ?></td>
 582                                         <td><?php echo text($row['ODAXIS']); ?></td>
 583                                         <td><?php echo text($row['ODBC']); ?></td>
 584                                         <td><?php echo text($row['ODDIAM']); ?></td>
 585                                         <td><?php echo text($row['ODADD']); ?></td>
 586                                         <td colspan="3" class="right"><?php echo text($row['CTLSUPPLIEROD']); ?></td>
 587                                     </tr>
 588                                     <tr>
 589                                         <td colspan="4" class="bold underline left">
 590                                         <u><?php echo xlt('Left Lens'); ?></u>
 591                                         </td>
 592                                     </tr>
 593                                     <tr>
 594                                         <td colspan="3" class="left"><?php echo text($row['CTLBRANDOS']); ?></td>
 595                                     </tr>
 596                                     <tr class="bold" style="text-decoration:underline;">
 597                                         <td></td>
 598                                         <td><?php echo xlt('Sph{{Sphere}}'); ?></td>
 599                                         <td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 600                                         <td><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
 601                                         <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
 602                                         <td><?php echo xlt('Diam{{Diameter}}'); ?></td>
 603                                         <td><?php echo xlt('ADD'); ?></td>
 604                                         <td>
 605                                         <td>
 606                                         <td><?php echo xlt('Supplier'); ?></td>
 607                                     </tr>
 608                                     <tr>
 609                                         <td></td>
 610                                         <td><?php echo text($row['OSSPH']); ?></td>
 611                                         <td><?php echo text($row['OSCYL']); ?></td>
 612                                         <td><?php echo text($row['OSAXIS']); ?></td>
 613                                         <td><?php echo text($row['OSBC']); ?></td>
 614                                         <td><?php echo text($row['OSDIAM']); ?></td>
 615                                         <td><?php echo text($row['OSADD']); ?></td>
 616                                         <td colspan="3" class="right"><?php echo text($row['CTLSUPPLIEROS']); ?></td>
 617
 618                                     </tr>
 619                                 </table>
 620
 621                                 <?php
 622                         } ?>
 623                         </td>
 624                     </tr>
 625                 </table>
 626                 <hr>
 627
 628             </div>
 629             <?php
 630         } ?>
 631     </div>
 632 </div>
 633 </body>
 634     </html>
 635     <?php
 636     exit;
 637 }
 638
 639 ob_start();
 640 ?>
 641 <html>
 642 <head>
 643     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-min-1-10-2/index.js"></script>
 644     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/bootstrap-3-3-4/dist/js/bootstrap.min.js"></script>
 645     <script src="<?php echo $GLOBALS['assets_static_relative'] ?>/qtip2-2-2-1/jquery.qtip.min.js"></script>
 646
 647     <link rel="stylesheet"
 648           href="<?php echo $GLOBALS['assets_static_relative'] ?>/bootstrap-3-3-4/dist/css/bootstrap.min.css">
 649     <link rel="stylesheet" href="<?php echo $GLOBALS['css_header']; ?>" type="text/css">
 650     <link rel="stylesheet"
 651           href="<?php echo $GLOBALS['assets_static_relative'] ?>/jquery-ui-1-10-4/themes/ui-lightness/jquery-ui.min.css">
 652     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/pure-0-5-0/pure-min.css">
 653     <link rel="stylesheet" href="<?php echo $GLOBALS['assets_static_relative'] ?>/qtip2-2-2-1/jquery.qtip.min.css"/>
 654     <link rel="stylesheet"
 655           href="<?php echo $GLOBALS['assets_static_relative'] ?>/font-awesome-4-6-3/css/font-awesome.min.css">
 656     <link rel="stylesheet" href="../../forms/<?php echo $form_folder; ?>/css/style.css" type="text/css">
 657
 658     <style>
 659         .title {
 660             font-size: 1em;
 661             position: absolute;
 662             right: 10px;
 663             top: 30px;
 664             font-size: 1em;
 665         }
 666
 667         .refraction {
 668             top: 1in;
 669             float: left;
 670             min-height: 1.0in;
 671             border: 1.00pt solid #000000;
 672             padding: 5;
 673             box-shadow: 10px 10px 5px #888888;
 674             border-radius: 8px;
 675             margin: 5 auto 10 10;
 676             width: 5.0in;
 677         }
 678
 679         .refraction td {
 680             text-align: center;
 681             font-size: 8pt;
 682             padding: 5;
 683             width: 0.35in;
 684             vertical-align: text-middle;
 685             text-decoration: none;
 686         }
 687
 688         table {
 689             font-size: 1.0em;
 690             padding: 2px;
 691             color: black;
 692             vertical-align: text-top;
 693         }
 694
 695         input[type=text] {
 696             text-align: center;
 697             width: 60px;
 698         }
 699
 700         .refraction b {
 701             text-decoration: bold;
 702         }
 703
 704         .refraction td.right {
 705             text-align: right;
 706             text-decoration: none;
 707             width: 0.7in;
 708             vertical-align: text-top;
 709         }
 710
 711         .refraction td.left {
 712             vertical-align: text-top;
 713             text-align: left;
 714         }
 715
 716         .right {
 717             text-align: right;
 718             vertical-align: text-top;
 719             xwidth: 10%;
 720         }
 721
 722         .left {
 723             vertical-align: text-top;
 724             text-align: left;
 725         }
 726
 727         .title {
 728             font-size: 0.9em;
 729             font-weight: normal;
 730         }
 731
 732         .bold {
 733             font-weight: 600;
 734         }
 735
 736         input {
 737             width: 60px;
 738         }
 739
 740         input[type="radio"] {
 741             width: 15px;
 742         }
 743     </style>
 744     <!-- jQuery library -->
 745
 746     <script language="JavaScript">
 747         <?php require_once("$srcdir/restoreSession.php"); ?>
 748         function pick_rxType(rxtype, id) {
 749             var url = "../../forms/eye_mag/SpectacleRx.php";
 750             var formData = {
 751                 'RXTYPE': rxtype,
 752                 'id': id
 753             };
 754             top.restoreSession();
 755             $.ajax({
 756                 type: 'POST',
 757                 url: url,
 758                 data: formData
 759             });
 760             if (rxtype == 'Trifocal') {
 761                 $("[name$='MIDADD']").show();
 762                 $("[name$='ADD2']").show();
 763             } else if (rxtype == 'Bifocal') {
 764                 $("[name$='MIDADD']").hide().val('');
 765                 $("[name$='ADD2']").show();
 766             } else if (rxtype == 'Progressive') {
 767                 $("[name$='MIDADD']").hide().val('');
 768                 $("[name$='ADD2']").show();
 769             } else if (rxtype == "Single") {
 770                 $("[name$='MIDADD']").hide().val('');
 771                 $("[name$='ADD2']").hide().val('');
 772             }
 773         }
 774
 775         function submit_form() {
 776             var url = "../../forms/eye_mag/SpectacleRx.php?mode=update";
 777             formData = $("form#Spectacle").serialize();
 778             top.restoreSession();
 779             $.ajax({
 780                 type: 'POST',
 781                 url: url,
 782                 data: formData
 783             });
 784         }
 785
 786         //add sph and cyl, flip cyl sign, rotate axis 90.
 787         function reverse_cylinder() {
 788             var Rsph = $('#ODSPH').val();
 789             var Rcyl = $('#ODCYL').val();
 790             var Raxis = $('#ODAXIS').val();
 791             var Lsph = $('#OSSPH').val();
 792             var Lcyl = $('#OSCYL').val();
 793             var Laxis = $('#OSAXIS').val();
 794             if (Rsph == '' && Rcyl == '' && Lsph == '' && lcyl == '') return;
 795             if ((!Rcyl.match(/SPH/i)) && (Rcyl > '')) {
 796                 if (Rsph.match(/plano/i)) Rsph = '0';
 797                 Rsph = Number(Rsph);
 798                 Rcyl = Number(Rcyl);
 799                 Rnewsph = Rsph + Rcyl;
 800                 if (Rnewsph == 0) Rnewsph = "PLANO";
 801                 Rnewcyl = Rcyl * -1;
 802                 if (Rnewcyl > 0) Rnewcyl = "+" + Rnewcyl;
 803                 if (parseInt(Raxis) < 90) {
 804                     Rnewaxis = parseInt(Raxis) + 90;
 805                 } else {
 806                     Rnewaxis = parseInt(Raxis) - 90;
 807                 }
 808                 if (Rnewcyl == '0') Rnewcyl = "SPH";
 809                 if (Rnewsph == '0') {
 810                     Rnewsph = "PLANO";
 811                     if (Rnewcyl == "SPH") Rnewcyl = '';
 812                 }
 813                 $("#ODSPH").val(Rnewsph);
 814                 $("#ODCYL").val(Rnewcyl);
 815                 $("#ODAXIS").val(Rnewaxis);
 816                 $('#ODAXIS').trigger('blur');
 817                 $('#ODSPH').trigger('blur');
 818                 $('#ODCYL').trigger('blur');
 819             }
 820             if ((!Lcyl.match(/SPH/i)) && (Lcyl > '')) {
 821                 if (!Lsph.match(/\d/)) Lsph = '0';
 822                 Lsph = Number(Lsph);
 823                 Lcyl = Number(Lcyl);
 824                 Lnewsph = Lsph + Lcyl;
 825                 Lnewcyl = Lcyl * -1;
 826                 if (Lnewcyl > 0) Lnewcyl = "+" + Lnewcyl;
 827                 if (parseInt(Laxis) < 90) {
 828                     Lnewaxis = parseInt(Laxis) + 90;
 829                 } else {
 830                     Lnewaxis = parseInt(Laxis) - 90;
 831                 }
 832
 833                 if (Lnewcyl == '0') Lnewcyl = "SPH";
 834                 if (Lnewsph == '0') {
 835                     Lnewsph = "PLANO";
 836                     if (Lnewcyl == "SPH") Lnewcyl = '';
 837                 }
 838
 839                 $("#OSSPH").val(Lnewsph);
 840                 $("#OSCYL").val(Lnewcyl);
 841                 $("#OSAXIS").val(Lnewaxis);
 842                 $('#OSAXIS').trigger('blur');
 843                 $('#OSSPH').trigger('blur');
 844                 $('#OSCYL').trigger('blur');
 845             }
 846         }
 847     </script>
 848 </head>
 849 <body>
 850 <?php echo report_header($pid, "web");  ?>
 851 <br/><br/>
 852 <form method="post" action="<?php echo $rootdir; ?>/forms/<?php echo text($form_folder); ?>/SpectacleRx.php?mode=update"
 853       id="Spectacle" class="eye_mag pure-form" name="Spectacle" style="text-align:center;">
 854     <!-- start container for the main body of the form -->
 855     <input type="hidden" name="REFDATE" id="REFDATE" value="<?php echo attr($data['date']); ?>">
 856     <input type="hidden" name="RXTYPE" id="RXTYPE" value="<?php echo attr($RXTYPE); ?>">
 857     <input type="hidden" name="REFTYPE" value="<?php echo attr($REFTYPE); ?>"/>
 858     <input type="hidden" name="pid" id="pid" value="<?php echo attr($pid); ?>">
 859     <input type="hidden" name="id" id="id" value="<?php echo attr($insert_this_id); ?>">
 860     <input type="hidden" name="encounter" id="encounter" value="<?php echo $encounter; ?>">
 861
 862     <div style="margin:5;text-align:center;display:inline-block;">
 863
 864         <table style="min-width:615px;">
 865             <tr>
 866                 <td>
 867                     <?php
 868
 869                     if ($REFTYPE != "CTL") { ?>
 870                         <table id="SpectacleRx" name="SpectacleRx" class="refraction bordershadow"
 871                                style="min-width:610px;top:0px;">
 872                             <tr style="font-weight:bold;text-align:center;">
 873                                 <td><i name="reverse" id="reverse" class="fa fa-gamepad fa-2x"></i></td>
 874                                 <td></td>
 875                                 <td><?php echo xlt('Sph{{Sphere}}'); ?></td>
 876                                 <td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 877                                 <td><?php echo xlt('Axis{{Axis of a glasses prescription}}'); ?></td>
 878                                 <td rowspan="5" class="right" colspan="3" style="min-width:200px;font-weight:bold;">
 879                                     <b style="font-weight:bold;text-decoration:underline;"><?php echo xlt('Rx Type'); ?></b><br/><br/>
 880                                     <b id="SingleVision_span" name="SingleVision_span"><?php echo xlt('Single'); ?>
 881                                         <input type="radio"
 882                                                onclick="pick_rxType('Single','<?php echo attr(addslashes($insert_this_id)); ?>');"
 883                                                value="Single" id="RXTYPE" name="RXTYPE"
 884                                                class="input-helper--radio input-helper--radio" <?php echo attr($Single); ?>></b><br/>
 885                                     <b id="Bifocal_span" name="Bifocal_span"><?php echo xlt('Bifocal'); ?>
 886                                         <input type="radio"
 887                                                onclick="pick_rxType('Bifocal','<?php echo attr(addslashes($insert_this_id)); ?>');"
 888                                                value="Bifocal" id="RXTYPE" name="RXTYPE" <?php echo attr($Bifocal); ?>></b><br/>
 889                                     <b id="Trifocal_span" name="Trifocal_span"><?php echo xlt('Trifocal'); ?>
 890                                         <input type="radio"
 891                                                onclick="pick_rxType('Trifocal','<?php echo attr(addslashes($insert_this_id)); ?>');"
 892                                                value="Trifocal" id="RXTYPE"
 893                                                name="RXTYPE" <?php echo attr($Trifocal); ?>></b><br/>
 894                                     <b id="Progressive_span"><?php echo xlt('Prog.{{Progressive lenses}}'); ?>
 895                                         <input type="radio"
 896                                                onclick="pick_rxType('Progressive','<?php echo attr(addslashes($insert_this_id)); ?>');"
 897                                                value="Progressive" id="RXTYPE"
 898                                                name="RXTYPE" <?php echo attr($Progressive); ?>></b><br/>
 899                                 </td>
 900                             </tr>
 901                             <tr class="center">
 902                                 <td rowspan="2"
 903                                     style="text-align:right;font-weight:bold;"><?php echo xlt('Distance'); ?></td>
 904                                 <td style="text-align:right;font-weight:bold;"><?php echo xlt('OD{{right eye}}'); ?></td>
 905                                 <td><input type=text id="ODSPH" name="ODSPH" value="<?php echo attr($ODSPH); ?>"></td>
 906                                 <td><input type=text id="ODCYL" name="ODCYL" value="<?php echo attr($ODCYL); ?>"></td>
 907                                 <td><input type=text id="ODAXIS" name="ODAXIS" value="<?php echo attr($ODAXIS); ?>">
 908                                 </td>
 909                             </tr>
 910                             <tr class="center">
 911                                 <td name="W_wide"
 912                                     style="text-align:right;font-weight:bold;"><?php echo xlt('OS{{left eye}}'); ?></td>
 913                                 <td><input type=text id="OSSPH" name="OSSPH" value="<?php echo attr($OSSPH); ?>"></td>
 914                                 <td><input type=text id="OSCYL" name="OSCYL" value="<?php echo attr($OSCYL); ?>"></td>
 915                                 <td><input type=text id="OSAXIS" name="OSAXIS" value="<?php echo attr($OSAXIS); ?>">
 916                                 </td>
 917                             </tr>
 918                             <tr class="NEAR center">
 919                                 <td rowspan=2 nowrap
 920                                     style="text-decoration:none;text-align:right;font-weight:bold;"><?php echo xlt('ADD'); ?>
 921                                     :<br/><?php echo xlt("Mid{{Middle segment in a trifocal glasses prescription}}"); ?>
 922                                     /<?php echo xlt("Near"); ?></td>
 923                                 <td style="text-align:right;font-weight:bold;"><?php echo xlt('OD{{right eye}}'); ?></td>
 924                                 <td name="COLADD1"><input type="text" id="ODMIDADD" name="ODMIDADD"
 925                                                           value="<?php echo attr($ODMIDADD); ?>"></td>
 926                                 <td class="WAdd2"><input type="text" id="ODADD2" name="ODADD2"
 927                                                          value="<?php echo attr($ODADD2); ?>"></td>
 928                             </tr>
 929                             <tr class="NEAR center">
 930                                 <td style="text-align:right;font-weight:bold;"><?php echo xlt('OS{{left eye}}'); ?></td>
 931                                 <td name="COLADD1"><input type="text" id="OSMIDADD" name="OSMIDADD"
 932                                                           value="<?php echo attr($OSMIDADD); ?>"></td>
 933                                 <td class="WAdd2"><input type="text" id="OSADD2" name="OSADD2"
 934                                                          value="<?php echo attr($OSADD2); ?>"></td>
 935                             </tr>
 936                             <tr>
 937                                 <td colspan="2"
 938                                     style="text-align:right;font-weight:bold;"><?php echo xlt('Comments'); ?>:
 939                                 </td>
 940                                 <td colspan="4">
 941                                     <textarea style="width:100%;height:5em;" id="COMMENTS"
 942                                               name="COMMENTS"><?php echo text($COMMENTS); ?></textarea>
 943                                 </td>
 944                             </tr>
 945                             <!-- start Dispense data -->
 946                             <tr class="header closeButton">
 947                                 <td colspan="9" class="right">
 948                                                 <span><?php
 949                                                 if ($ODHPD || $ODHBASE || $ODVPD || $ODVBASE || $ODSLABOFF || $ODVERTEXDIST ||
 950                                                         $OSHPD || $OSHBASE || $OSVPD || $OSVBASE || $OSSLABOFF || $OSVERTEXDIST ||
 951                                                         $ODMPDD || $ODMPDN || $OSMPDD || $OSMPDN || $BPDD || $BPDN ||
 952                                                         $LENS_MATERIAL || $LENS_TREATMENTS) {
 953                                                           $detailed = '1';
 954                                                         ?><i class="fa fa-minus-square-o"></i><?php
 955                                                 } else {
 956                                                     $detailed = '0';
 957                                                     ?><i class="fa fa-plus-square-o"></i><?php
 958                                                 }
 959                                                     ?>
 960                                                 </span>
 961
 962                                 </td>
 963                             </tr>
 964                             <tr>
 965                                 <td colspan="9" class="right">
 966                                     <xhr/>
 967                                 </td>
 968                             </tr>
 969                             <tr class="dispense_data" style="font-weight:bold;text-align:center;">
 970                                 <td name="W_wide" colspan="2"></td>
 971                                 <td name="W_wide"
 972                                     title="<?php echo xla('Horizontal Prism Power'); ?>"><?php echo xlt('Horiz Prism{{abbreviation for Horizontal Prism Power}}'); ?></td>
 973                                 <td name="W_wide"
 974                                     title="<?php echo xla('Horizontal Prism Base'); ?>"><?php echo xlt('Horiz Base{{abbreviation for Horizontal Prism Base}}'); ?></td>
 975                                 <td name="W_wide"
 976                                     title="<?php echo xla('Vertical Prism Power'); ?>"><?php echo xlt('Vert Prism{{abbreviation for Vertical Prism Power}}'); ?></td>
 977                                 <td name="W_wide"
 978                                     title="<?php echo xla('Vertical Prism Base'); ?>"><?php echo xlt('Vert Base{{abbreviation for Vertical Prism Base}}'); ?></td>
 979                                 <td name="W_wide"
 980                                     title="<?php echo xla('Slab Off'); ?>"><?php echo xlt('Slab Off'); ?></td>
 981                                 <td name="W_wide"
 982                                     title="<?php echo xla('Vertex Distance'); ?>"><?php echo xlt('Vert Distance{{abbreviation for Vertex Distance}}'); ?></td>
 983                             </tr>
 984                             <tr class="dispense_data">
 985                                 <td name="W_wide" style="text-align:right;font-weight:bold;"
 986                                     colspan="2"><?php echo xlt('OD{{right eye}}'); ?></td>
 987                                 <td name="W_wide"><input type="text" class="prism" id="ODHPD" name="ODHPD"
 988                                                          value="<?php echo attr($ODHPD); ?>"></td>
 989                                 <td name="W_wide"><input type="text" class="prism" id="ODHBASE" name="ODHBASE"
 990                                                          value="<?php echo attr($ODHBASE); ?>"></td>
 991                                 <td name="W_wide"><input type="text" class="prism" id="ODVPD" name="ODVPD"
 992                                                          value="<?php echo attr($ODVPD); ?>"></td>
 993                                 <td name="W_wide"><input type="text" class="prism" id="ODVBASE" name="ODVBASE"
 994                                                          value="<?php echo attr($ODVBASE); ?>"></td>
 995                                 <td name="W_wide"><input type="text" class="prism" id="ODSLABOFF" name="ODSLABOFF"
 996                                                          value="<?php echo attr($ODSLABOFF); ?>"></td>
 997                                 <td name="W_wide"><input type="text" class="prism" id="ODVERTEXDIST" name="ODVERTEXDIST"
 998                                                          value="<?php echo attr($ODVERTEXDIST); ?>"></td>
 999                             </tr>
1000                             <tr class="dispense_data">
1001                                 <td name="W_wide" style="text-align:right;font-weight:bold;"
1002                                     colspan="2"><?php echo xlt('OS{{left eye}}'); ?></td>
1003                                 <td name="W_wide"><input type="text" class="prism" id="OSHPD" name="OSHPD"
1004                                                          value="<?php echo attr($OSHPD); ?>"></td>
1005                                 <td name="W_wide"><input type="text" class="prism" id="OSHBASE" name="OSHBASE"
1006                                                          value="<?php echo attr($OSHBASE); ?>"></td>
1007                                 <td name="W_wide"><input type="text" class="prism" id="OSVPD" name="OSVPD"
1008                                                          value="<?php echo attr($OSVPD); ?>"></td>
1009                                 <td name="W_wide"><input type="text" class="prism" id="OSVBASE" name="OSVBASE"
1010                                                          value="<?php echo attr($OSVBASE); ?>"></td>
1011                                 <td name="W_wide"><input type="text" class="prism" id="OSSLABOFF" name="OSSLABOFF"
1012                                                          value="<?php echo attr($OSSLABOFF); ?>"></td>
1013                                 <td name="W_wide"><input type="text" class="prism" id="OSVERTEXDIST" name="OSVERTEXDIST"
1014                                                          value="<?php echo attr($OSVERTEXDIST); ?>"></td>
1015                             </tr>
1016                             <tr class="dispense_data">
1017                                 <td colspan="9" class="center">
1018                                     <xhr/>
1019                                 </td>
1020                             </tr>
1021                             <tr class="dispense_data" style="font-weight:bold;text-align:center;">
1022                                 <td></td>
1023                                 <td></td>
1024                                 <td name="W_wide"
1025                                     title="<?php echo xla('Monocular Pupillary Diameter - Distance'); ?>"><?php echo xlt('MPD-D{{abbreviation for Monocular Pupillary Diameter - Distance}}'); ?></td>
1026                                 <td name="W_wide"
1027                                     title="<?php echo xla('Monocular Pupillary Diameter - Near'); ?>"><?php echo xlt('MPD-N{{abbreviation for Monocular Pupillary Diameter - Near}}'); ?></td>
1028                                 <td name="W_wide"
1029                                     title="<?php echo xla('Binocular Pupillary Diameter - Distance'); ?>"><?php echo xlt('BPD-D{{abbreviation for Binocular Pupillary Diameter - Distance}}'); ?></td>
1030                                 <td name="W_wide"
1031                                     title="<?php echo xla('Binocular Pupillary Diameter - Near'); ?>"><?php echo xlt('BPD-N{{abbreviation for Binocular Pupillary Diameter - Near}}'); ?></td>
1032
1033                                 <td colspan="2">Lens Material:</td>
1034                             </tr>
1035                             <tr>
1036                                 <td name="W_wide" style="text-align:right;font-weight:bold;"
1037                                     colspan="2"><?php echo xlt('OD{{right eye}}'); ?></td>
1038                                 <td name="W_wide"><input type="text" class="prism" id="ODMPDD" name="ODMPDD"
1039                                                          value="<?php echo attr($ODMPDD); ?>"></td>
1040                                 <td name="W_wide"><input type="text" class="prism" id="ODMPDN" name="ODMPDN"
1041                                                          value="<?php echo attr($ODMPDN); ?>"></td>
1042                                 <td name="W_wide" rowspan="2" style="vertical-align:middle;"><input type="text"
1043                                                                                                     class="prism"
1044                                                                                                     id="BPDD"
1045                                                                                                     name="BPDD"
1046                                                                                                     value="<?php echo attr($BPDD); ?>">
1047                                 </td>
1048                                 <td name="W_wide" rowspan="2" style="vertical-align:middle;"><input type="text"
1049                                                                                                     class="prism"
1050                                                                                                     id="BPDN"
1051                                                                                                     name="BPDN"
1052                                                                                                     value="<?php echo attr($BPDN); ?>">
1053                                 </td>
1054                                 <td colspan="2">   <?php
1055                                     echo generate_select_list("LENS_MATERIAL", "Eye_Lens_Material", "$LENS_MATERIAL", '', ' ', '', 'restoreSession;submit_form();', '', array('style' => 'width:120px'));
1056                                     ?>
1057                                 </td>
1058                             </tr>
1059                             <tr>
1060                                 <td name="W_wide" style="text-align:right;font-weight:bold;"
1061                                     colspan="2"><?php echo xlt('OS{{left eye}}'); ?></td>
1062                                 <td name="W_wide"><input type="text" class="prism" id="OSMPDD" name="OSMPDD"
1063                                                          value="<?php echo attr($OSMPDD); ?>"></td>
1064                                 <td name="W_wide"><input type="text" class="prism" id="OSMPDN" name="OSMPDN"
1065                                                          value="<?php echo attr($OSMPDN); ?>"></td>
1066                             </tr>
1067                             <tr class="dispense_data">
1068                                 <td colspan="9" class="center">
1069                                     <xhr/>
1070                                 </td>
1071                             </tr>
1072                             <tr style="font-weight:bold;text-align:center;">
1073                                 <td colspan="3"><?php echo xlt('Lens Treatments'); ?>
1074                                 </td>
1075                             </tr>
1076                             <tr style="text-align:left;vertical-align:top;">
1077                                 <td colspan="5" style="font-weight:bold;text-align:left;">
1078                                     <?php echo generate_lens_treatments($W, $LENS_TREATMENTS); ?>
1079                                 </td>
1080                             </tr>
1081                             <tr class="dispense_data">
1082                                 <td colspan="9" class="center">
1083                                     <hr/>
1084                                 </td>
1085                             </tr>
1086
1087                         </table>&nbsp;<br/><br/><br/>
1088                         <?php
1089                     } else { ?>
1090                         <table id="CTLRx" name="CTLRx" class="refraction">
1091                             <tr>
1092                                 <td class="right bold underline"><?php echo xlt('Right Lens'); ?></td>
1093                             </tr>
1094                             <tr>
1095                                 <td colspan="2" class="right bold"><?php echo xlt('Manufacturer'); ?>:</td>
1096                                 <td colspan="2" class="left"><?php echo text($CTLMANUFACTUREROD); ?></td>
1097                                 <td class="right bold"><?php echo xlt('Brand'); ?>:</td>
1098                                 <td colspan="2" class="left"><?php echo text($CTLBRANDOD); ?></td>
1099                             </tr>
1100                             <tr class="bold" style="line-height:0.3em;font-size:0.6em;">
1101                                 <td><?php echo xlt('SPH{{Sphere}}'); ?></td>
1102                                 <td><?php echo xlt('CYL{{Cylinder}}'); ?></td>
1103                                 <td><?php echo xlt('AXIS{{Axis of a glasses prescription}}'); ?></td>
1104                                 <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
1105                                 <td><?php echo xlt('DIAM{{Diameter}}'); ?></td>
1106                                 <td><?php echo xlt('ADD{{Bifocal Add}}'); ?></td>
1107                                 <td><?php echo xlt('ACUITY'); ?></td>
1108                             </tr>
1109                             <tr>
1110                                 <td><input type=text id="CTLODSPH" name="CTLODSPH" value="<?php echo attr($ODSPH); ?>">
1111                                 </td>
1112                                 <td><input type=text id="CTLODCYL" name="CTLODCYL" value="<?php echo attr($ODCYL); ?>">
1113                                 </td>
1114                                 <td><input type=text id="CTLODAXIS" name="CTLODAXIS"
1115                                            value="<?php echo attr($ODAXIS); ?>"></td>
1116                                 <td><input type=text id="CTLODBC" name="CTLODBC" value="<?php echo attr($ODBC); ?>">
1117                                 </td>
1118                                 <td><input type=text id="CTLODDIAM" name="CTLODDIAM"
1119                                            value="<?php echo attr($ODDIAM); ?>"></td>
1120                                 <td><input type=text id="CTLODADD" name="CTLODADD" value="<?php echo attr($ODADD); ?>">
1121                                 </td>
1122                                 <td><input type=text id="CTLODVA" name="CTLODVA" value="<?php echo attr($ODVA); ?>">
1123                                 </td>
1124                             </tr>
1125                             <tr>
1126                                 <td colspan="8">
1127                                     <hr/>
1128                                 </td>
1129                             </tr>
1130                             <tr>
1131                                 <td class="right bold underline"><?php echo xlt('Left Lens'); ?></td>
1132                             </tr>
1133                             <tr>
1134                                 <td colspan="2" class="right bold"><?php echo xlt('Manufacturer'); ?>:</td>
1135                                 <td colspan="2" class="left"><?php echo text($CTLMANUFACTUREROS); ?></td>
1136                                 <td class="right bold"><?php echo xlt('Brand'); ?>:</td>
1137                                 <td colspan="2" class="left"><?php echo text($CTLBRANDOS); ?></td>
1138                             </tr>
1139                             <tr class="bold" style="line-height:0.3em;font-size:0.6em;">
1140                                 <td><?php echo xlt('SPH{{Sphere}}'); ?></td>
1141                                 <td><?php echo xlt('CYL{{Cylinder}}'); ?></td>
1142                                 <td><?php echo xlt('AXIS{{Axis of a glasses prescription}}'); ?></td>
1143                                 <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
1144                                 <td><?php echo xlt('DIAM{{Diameter}}'); ?></td>
1145                                 <td><?php echo xlt('ADD{{Bifocal Add}}'); ?></td>
1146                                 <td><?php echo xlt('ACUITY'); ?></td>
1147                             </tr>
1148                             <tr>
1149                                 <td><input type=text id="CTLOSSPH" name="CTLOSSPH" value="<?php echo attr($OSSPH); ?>">
1150                                 </td>
1151                                 <td><input type=text id="CTLOSCYL" name="CTLOSCYL" value="<?php echo attr($OSCYL); ?>">
1152                                 </td>
1153                                 <td><input type=text id="CTLOSAXIS" name="CTLOSAXIS"
1154                                            value="<?php echo attr($OSAXIS); ?>"></td>
1155                                 <td><input type=text id="CTLOSBC" name="CTLOSBC" value="<?php echo attr($OSBC); ?>">
1156                                 </td>
1157                                 <td><input type=text id="CTLOSDIAM" name="CTLOSDIAM"
1158                                            value="<?php echo attr($OSDIAM); ?>"></td>
1159                                 <td><input type=text id="CTLOSADD" name="CTLOSADD" value="<?php echo attr($OSADD); ?>">
1160                                 </td>
1161                                 <td><input type=text id="CTLOSVA" name="CTLOSVA" value="<?php echo attr($OSVA); ?>">
1162                                 </td>
1163                             </tr>
1164                             <?php if ($COMMENTS > '') { ?>
1165                                 <tr>
1166                                     <td colspan="8">
1167                                         <hr/>
1168                                     </td>
1169                                 </tr>
1170                                 <tr>
1171                                     <td class="right bold red" colspan="2"
1172                                         style="vertical-align:top;"><?php echo xlt('Comments'); ?>:</u></td>
1173                                     <td colspan="6" class="left">
1174                                         <textarea cols="30" rows="4"><?php echo text($COMMENTS); ?></textarea>
1175                                     </td>
1176                                 </tr>
1177                             <?php } ?>
1178                         </table>
1179                         <?php
1180                     } ?>
1181                 </td>
1182             </tr>
1183             <tr>
1184                 <td style="margin:25px auto;text-align:center;">
1185                     <?php
1186                     $signature = $GLOBALS["webserver_root"] . "/interface/forms/eye_mag/images/sign_" . attr($_SESSION['authUserID']) . ".jpg";
1187                     if (file_exists($signature)) {
1188                         ?>
1189                         <span style="position:relative;padding-left:40px;">
1190                                 <img src='<?php echo $web_root; ?>/interface/forms/eye_mag/images/sign_<?php echo attr($_SESSION['authUserID']); ?>.jpg'
1191                                      style="width:240px;height:85px;border-block-end: 1pt solid black;margin:5px;"/>
1192                                     </span><br/>
1193
1194                         <?php
1195                     } ?>
1196
1197                     <?php echo xlt('Provider'); ?>
1198                     : <?php echo text($prov_data['fname']); ?> <?php echo text($prov_data['lname']);
1199                     if ($prov_data['suffix']) {
1200                         echo ", " . $prov_data['suffix'];
1201                     } ?><br/>
1202                     <small><?php echo xlt('e-signed'); ?> <input type="checkbox" checked="checked"></small>
1203                 </td>
1204             </tr>
1205         </table>
1206     </div>
1207 </form>
1208
1209 </body>
1210 <script>
1211     $(document).ready(function () {
1212         $('.header').click(function () {
1213             var $this = $(this);
1214             $(this).nextUntil('tr.header').slideToggle(100).promise().done(function () {
1215                 $this.find('span').html(function (_, value) {
1216                     return value == '<i class="fa fa-plus-square-o"></i>' ? '<i class="fa fa-minus-square-o"></i>' : '<i class="fa fa-plus-square-o"></i>';
1217                 });
1218             });
1219         });
1220         <?php
1221         if (!$detailed) {
1222             echo "$('.header').trigger('click');";
1223         } ?>
1224
1225         $("input[name$='PD']").blur(function () {
1226             //make it all caps
1227             var str = $(this).val();
1228             str = str.toUpperCase();
1229             $(this).val(str);
1230         });
1231         $('input[name$="SPH"]').blur(function () {
1232             var mid = $(this).val();
1233             if (mid.match(/PLANO/i)) {
1234                 $(this).val('PLANO');
1235                 return;
1236             }
1237             if (mid.match(/^[\+\-]?\d{1}$/)) {
1238                 mid = mid + ".00";
1239             }
1240             if (mid.match(/\.[27]$/)) {
1241                 mid = mid + '5';
1242             }
1243             if (mid.match(/\.\d$/)) {
1244                 mid = mid + '0';
1245             }
1246             //if near is +2. make it +2.00
1247             if (mid.match(/\.$/)) {
1248                 mid = mid + '00';
1249             }
1250             if ((!mid.match(/\./)) && (mid.match(00 | 25 | 50 | 75))) {
1251                 var front = mid.match(/(\d{0,2})(00|25|50|75)/)[1];
1252                 var back = mid.match(/(\d{0,2})(00|25|50|75)/)[2];
1253                 if (front == '') front = '0';
1254                 mid = front + "." + back;
1255             }
1256             if (!mid.match(/\./)) {
1257                 var front = mid.match(/([\+\-]?\d{0,2})(\d{2})/)[1];
1258                 var back = mid.match(/(\d{0,2})(\d{2})/)[2];
1259                 if (front == '') front = '0';
1260                 if (front == '-') front = '-0';
1261                 mid = front + "." + back;
1262             }
1263             if (!mid.match(/^(\+|\-){1}/)) {
1264                 mid = "+" + mid;
1265             }
1266             $(this).val(mid);
1267         });
1268
1269         $("input[name$='ADD'],input[name$='ADD2']").blur(function () {
1270             var add = $(this).val();
1271             add = add.replace(/=/g, "+");
1272             //if add is one digit, eg. 2, make it +2.00
1273             if (add.match(/^\d{1}$/)) {
1274                 add = "+" + add + ".00";
1275             }
1276             //if add is '+'one digit, eg. +2, make it +2.00
1277             if (add.match(/^\+\d{1}$/)) {
1278                 add = add + ".00";
1279             }
1280             //if add is 2.5 or 2.0 make it 2.50 or 2.00
1281             if (add.match(/\.[05]$/)) {
1282                 add = add + '0';
1283             }
1284             //if add is 2.2 or 2.7 make it 2.25 or 2.75
1285             if (add.match(/\.[27]$/)) {
1286                 add = add + '5';
1287             }
1288             //if add is +2. make it +2.00
1289             if (add.match(/\.$/)) {
1290                 add = add + '00';
1291             }
1292             if ((!add.match(/\./)) && (add.match(/(0|25|50|75)$/))) {
1293                 var front = add.match(/([\+]?\d{0,1})(00|25|50|75)/)[1];
1294                 var back = add.match(/([\+]?\d{0,1})(00|25|50|75)/)[2];
1295                 if (front == '') front = '0';
1296                 add = front + "." + back;
1297             }
1298             if (!add.match(/^(\+)/) && (add.length > 0)) {
1299                 add = "+" + add;
1300             }
1301             $(this).val(add);
1302             if (this.id == "ODADD2") $('#OSADD2').val(add);
1303             if (this.id == "ODMIDADD") $('#OSMIDADD').val(add);
1304             if (this.id == "CTLODADD") $('#CTLOSADD').val(add);
1305         });
1306
1307         $("input[name$='AXIS']").blur(function () {
1308             // Make this a 3 digit leading zeros number.
1309             // we are not translating text to numbers, just numbers to
1310             // a 3 digit format with leading zeroes as needed.
1311             // assume the end user KNOWS there are only numbers presented and
1312             // more than 3 digits is a mistake...
1313             // (although this may change with topographic answer)
1314             var axis = $(this).val();
1315             var group = this.name.replace("AXIS", "CYL");
1316             ;
1317             var cyl = $("#" + group).val();
1318             if ((cyl > '') && (cyl != 'SPH')) {
1319                 if (!axis.match(/\d\d\d/)) {
1320                     if (!axis.match(/\d\d/)) {
1321                         if (!axis.match(/\d/)) {
1322                             axis = '0';
1323                         }
1324                         axis = '0' + axis;
1325                     }
1326                     axis = '0' + axis;
1327                 }
1328             } else {
1329                 axis = '';
1330             }
1331             $(this).val(axis);
1332         });
1333         $("[name$='CYL']").blur(function () {
1334             var mid = $(this).val();
1335             var group = this.name.replace("CYL", "SPH");
1336             ;
1337             var sphere = $("#" + group).val();
1338             if (((mid.length == 0) && (sphere.length > 0)) || (mid.match(/sph/i))) {
1339                 $(this).val('SPH');
1340                 var axis = this.name.replace("CYL", "AXIS");
1341                 $("#" + axis).val('');
1342                 return;
1343             } else if (sphere.length > 0) {
1344                 if (mid.match(/^[\+\-]?\d{1}$/)) {
1345                     mid = mid + ".00";
1346                 }
1347                 if (mid.match(/^(\d)(\d)$/)) {
1348                     mid = mid[0] + '.' + mid[1];
1349                 }
1350                 //if mid is 2.5 or 2.0 make it 2.50 or 2.00
1351                 if (mid.match(/\.[05]$/)) {
1352                     mid = mid + '0';
1353                 }
1354                 //if mid is 2.2 or 2.7 make it 2.25 or 2.75
1355                 if (mid.match(/\.[27]$/)) {
1356                     mid = mid + '5';
1357                 }
1358                 //if mid is +2. make it +2.00
1359                 if (mid.match(/\.$/)) {
1360                     mid = mid + '00';
1361                 }
1362                 if (mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)) {
1363                     var front = mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)[1];
1364                     var back = mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)[2];
1365                     if (front == '') front = '0';
1366                     mid = front + "." + back;
1367                 }
1368                 if (!mid.match(/^(\+|\-){1}/) && (sphere.length > 0)) {
1369                     //Since it doesn't start with + or - then give it '+'
1370                     mid = "+" + mid;
1371                 }
1372                 $(this).val(mid);
1373             }
1374         });
1375         $("input,textarea,text,checkbox").change(function () {
1376             submit_form($(this));
1377         });
1378         $("#reverse").click(function () {
1379             //alert('Start');
1380             reverse_cylinder('');
1381             //alert('Finish');
1382
1383         });
1384         $("input[name$='SPH'],input[name$='CYL']").on('keyup', function (e) {
1385             if (e.keyCode == '61' || e.keyCode == '74') {
1386                 now = $(this).val();
1387                 now = now.replace(/=/g, "+").replace(/^j/g, "J");
1388                 $(this).val(now);
1389             }
1390         });
1391
1392     });
1393 </script>
1394 </html>
1395
1396 <?php
1397 $content = ob_get_clean();
1398 echo $content;
1399 exit;
1400 ?>