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  * @package   OpenEMR
   9  * @link      https://www.open-emr.org
  10  * @author    Ray Magauran <magauran@MedFetch.com>
  11  * @copyright Copyright (c) 2016 Raymond Magauran <magauran@MedFetch.com>
  12  * @license   https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
  13  */
  14
  15 require_once(__DIR__ . "/../../globals.php");
  16 require_once("$srcdir/api.inc.php");
  17 require_once("$srcdir/forms.inc.php");
  18 require_once("$srcdir/lists.inc.php");
  19 require_once("$srcdir/options.inc.php");
  20 require_once("$srcdir/patient.inc.php");
  21 require_once("$srcdir/report.inc.php");
  22
  23 use OpenEMR\Services\FacilityService;
  24 use OpenEMR\Core\Header;
  25
  26 $facilityService = new FacilityService();
  27
  28 $form_name = "Eye Form";
  29 $form_folder = "eye_mag";
  30 require_once("php/" . $form_folder . "_functions.php");
  31
  32 $RX_expir = "+1 years";
  33 $CTL_expir = "+6 months";
  34 if (!$_REQUEST['pid'] && $_REQUEST['id']) {
  35     $_REQUEST['pid'] = $_REQUEST['id'];
  36 }
  37 if (!$_REQUEST['pid']) {
  38     $_REQUEST['pid'] = $_SESSION['pid'];
  39 }
  40
  41 $query = "select  *,form_encounter.date as encounter_date
  42                from forms,form_encounter,form_eye_base,
  43                 form_eye_hpi,form_eye_ros,form_eye_vitals,
  44                 form_eye_acuity,form_eye_refraction,form_eye_biometrics,
  45                 form_eye_external, form_eye_antseg,form_eye_postseg,
  46                 form_eye_neuro,form_eye_locking
  47                     where
  48                     forms.deleted != '1'  and
  49                     forms.formdir='eye_mag' and
  50                     forms.encounter=form_encounter.encounter  and
  51                     forms.form_id=form_eye_base.id and
  52                     forms.form_id=form_eye_hpi.id and
  53                     forms.form_id=form_eye_ros.id and
  54                     forms.form_id=form_eye_vitals.id and
  55                     forms.form_id=form_eye_acuity.id and
  56                     forms.form_id=form_eye_refraction.id and
  57                     forms.form_id=form_eye_biometrics.id and
  58                     forms.form_id=form_eye_external.id and
  59                     forms.form_id=form_eye_antseg.id and
  60                     forms.form_id=form_eye_postseg.id and
  61                     forms.form_id=form_eye_neuro.id and
  62                     forms.form_id=form_eye_locking.id and
  63                     forms.encounter=? and
  64                     forms.pid=? ";
  65
  66     $data = sqlQuery($query, array($_REQUEST['encounter'], $_REQUEST['pid']));
  67     $data['ODMPDD'] = $data['ODPDMeasured'];
  68     $data['OSMPDD'] = $data['OSPDMeasured'];
  69     $data['BPDD']   = (int) $data['ODMPDD'] + (int) $data['OSMPDD'];
  70     @extract($data);
  71
  72     $ODMPDD     = $ODPDMeasured;
  73     $OSMPDD     = $OSPDMeasured;
  74     $BPDD       = (int) $ODMPDD + (int) $OSMPDD;
  75
  76     $query      = "SELECT * FROM users where id = ?";
  77     $prov_data  = sqlQuery($query, array($data['provider_id']));
  78
  79     $query      = "SELECT * FROM patient_data where pid=?";
  80     $pat_data   = sqlQuery($query, array($data['pid']));
  81
  82     $practice_data = $facilityService->getPrimaryBusinessEntity();
  83
  84     $visit_date = oeFormatShortDate($data['encounter_date']);
  85
  86 if ($_REQUEST['mode'] == "update") {  //store any changed fields in dispense table
  87     $table_name = "form_eye_mag_dispense";
  88     $query = "show columns from " . $table_name;
  89     $dispense_fields = sqlStatement($query);
  90     $fields = array();
  91
  92     if (sqlNumRows($dispense_fields) > 0) {
  93         while ($row = sqlFetchArray($dispense_fields)) {
  94             //exclude critical columns/fields, define below as needed
  95             if (
  96                 $row['Field'] == 'id' ||
  97                 $row['Field'] == 'pid' ||
  98                 $row['Field'] == 'user' ||
  99                 $row['Field'] == 'groupname' ||
 100                 $row['Field'] == 'authorized' ||
 101                 $row['Field'] == 'activity' ||
 102                 $row['Field'] == 'date'
 103             ) {
 104                 continue;
 105             }
 106
 107             if (isset($_POST[$row['Field']])) {
 108                 $fields[$row['Field']] = $_POST[$row['Field']];
 109             }
 110         }
 111         $fields['RXTYPE'] = $RXTYPE;
 112         $insert_this_id = formUpdate($table_name, $fields, $_POST['id'], $_SESSION['userauthorized']);
 113     }
 114
 115     exit;
 116 } elseif ($_REQUEST['mode'] == "remove") {
 117     $query = "DELETE FROM form_eye_mag_dispense where id=?";
 118     sqlStatement($query, array($_REQUEST['delete_id']));
 119     echo xlt('Prescription successfully removed.');
 120     exit;
 121 } elseif ($_REQUEST['RXTYPE']) {  //store any changed fields
 122     $query = "UPDATE form_eye_mag_dispense set RXTYPE=? where id=?";
 123     sqlStatement($query, array($_REQUEST['RXTYPE'], $_REQUEST['id']));
 124     exit;
 125 }
 126
 127     formHeader("OpenEMR Eye: " . text($prov_data['facility']));
 128
 129 if ($_REQUEST['REFTYPE']) {
 130     $REFTYPE = $_REQUEST['REFTYPE'];
 131     if ($REFTYPE == "AR") {
 132         $RXTYPE = "Bifocal";
 133     }
 134
 135     if ($REFTYPE == "MR") {
 136         $RXTYPE = "Bifocal";
 137     }
 138
 139     if ($REFTYPE == "CTL") {
 140         $RXTYPE = "Bifocal";
 141     }
 142
 143     $id = $_REQUEST['id'];
 144     $table_name = "form_eye_mag";
 145     if (!$_REQUEST['encounter']) {
 146         $encounter = $_SESSION['encounter'];
 147     } else {
 148         $encounter = $_REQUEST['encounter'];
 149     }
 150
 151
 152
 153     if ($REFTYPE == "W") {
 154         //we have rx_number 1-5 to process...
 155         $query = "select * from form_eye_mag_wearing where ENCOUNTER=? and FORM_ID=? and PID=? and RX_NUMBER=?";
 156         $wear = sqlStatement($query, array($encounter,$_REQUEST['form_id'],$_REQUEST['pid'],$_REQUEST['rx_number']));
 157         $wearing = sqlFetchArray($wear);
 158         $ODSPH = $wearing['ODSPH'];
 159         $ODAXIS = $wearing['ODAXIS'];
 160         $ODCYL = $wearing['ODCYL'];
 161         $OSSPH = $wearing['OSSPH'];
 162         $OSCYL = $wearing['OSCYL'];
 163         $OSAXIS = $wearing['OSAXIS'];
 164         $COMMENTS = $wearing['COMMENTS'];
 165         $ODMIDADD = $wearing['ODMIDADD'];
 166         $ODADD2 = $wearing['ODADD'];
 167         $OSMIDADD = $wearing['OSMIDADD'];
 168         $OSADD2 = $wearing['OSADD'];
 169         @extract($wearing);
 170         if ($wearing['RX_TYPE'] == '0') {
 171             $Single = "checked='checked'";
 172             $RXTYPE = "Single";
 173         } elseif ($wearing['RX_TYPE'] == '1') {
 174             $Bifocal = "checked='checked'";
 175             $RXTYPE = "Bifocal";
 176         } elseif ($wearing['RX_TYPE'] == '2') {
 177             $Trifocal = "checked='checked'";
 178             $RXTYPE = "Trifocal";
 179         } elseif ($wearing['RX_TYPE'] == '3') {
 180             $Progressive = "checked='checked'";
 181             $RXTYPE = "Progressive";
 182         }
 183
 184         //do LT and Lens materials
 185     } elseif ($REFTYPE == "AR") {
 186         $ODSPH      = $data['ARODSPH'];
 187         $ODAXIS     = $data['ARODAXIS'];
 188         $ODCYL      = $data['ARODCYL'];
 189         $ODPRISM    = $data['ARODPRISM'];
 190         $OSSPH      = $data['AROSSPH'];
 191         $OSCYL      = $data['AROSCYL'];
 192         $OSAXIS     = $data['AROSAXIS'];
 193         $OSPRISM    = $data['AROSPRISM'];
 194         $COMMENTS   = $data['CRCOMMENTS'];
 195         $ODADD2     = $data['ARODADD'];
 196         $OSADD2     = $data['AROSADD'];
 197         $Bifocal    = "checked='checked'";
 198     } elseif ($REFTYPE == "MR") {
 199         $ODSPH      = $data['MRODSPH'];
 200         $ODAXIS     = $data['MRODAXIS'];
 201         $ODCYL      = $data['MRODCYL'];
 202         $ODPRISM    = $data['MRODPRISM'];
 203         $OSSPH      = $data['MROSSPH'];
 204         $OSCYL      = $data['MROSCYL'];
 205         $OSAXIS     = $data['MROSAXIS'];
 206         $OSPRISM    = $data['MROSPRISM'];
 207         $COMMENTS   = $data['CRCOMMENTS'];
 208         $ODADD2     = $data['MRODADD'];
 209         $OSADD2     = $data['MROSADD'];
 210         $Bifocal    = "checked='checked'";
 211     } elseif ($REFTYPE == "CR") {
 212         $ODSPH      = $data['CRODSPH'];
 213         $ODAXIS     = $data['CRODAXIS'];
 214         $ODCYL      = $data['CRODCYL'];
 215         $ODPRISM    = $data['CRODPRISM'];
 216         $OSSPH      = $data['CROSSPH'];
 217         $OSCYL      = $data['CROSCYL'];
 218         $OSAXIS     = $data['CROSAXIS'];
 219         $OSPRISM    = $data['CROSPRISM'];
 220         $COMMENTS   = $data['CRCOMMENTS'];
 221     } elseif ($REFTYPE == "CTL") {
 222         $ODSPH      = $data['CTLODSPH'];
 223         $ODAXIS     = $data['CTLODAXIS'];
 224         $ODCYL      = $data['CTLODCYL'];
 225         $ODPRISM    = $data['CTLODPRISM'];
 226
 227         $OSSPH      = $data['CTLOSSPH'];
 228         $OSCYL      = $data['CTLOSCYL'];
 229         $OSAXIS     = $data['CTLOSAXIS'];
 230         $OSPRISM    = $data['CTLOSPRISM'];
 231
 232         $ODBC       = $data['CTLODBC'];
 233         $ODDIAM     = $data['CTLODDIAM'];
 234         $ODADD      = $data['CTLODADD'];
 235         $ODVA       = $data['CTLODVA'];
 236
 237         $OSBC       = $data['CTLOSBC'];
 238         $OSDIAM     = $data['CTLOSDIAM'];
 239         $OSADD      = $data['CTLOSADD'];
 240         $OSVA       = $data['CTLOSVA'];
 241
 242         $COMMENTS   = $data['COMMENTS'];//in form_eye_mag_dispense there is no leading 'CTL_'
 243
 244         $CTLMANUFACTUREROD  = getListItemTitle('CTLManufacturer', $data['CTLMANUFACTUREROD']);
 245         $CTLMANUFACTUREROS  = getListItemTitle('CTLManufacturer', $data['CTLMANUFACTUREROS']);
 246         $CTLSUPPLIEROD      = getListItemTitle('CTLManufacturer', $data['CTLSUPPLIEROD']);
 247         $CTLSUPPLIEROS      = getListItemTitle('CTLManufacturer', $data['CTLSUPPLIEROS']);
 248         $CTLBRANDOD         = getListItemTitle('CTLManufacturer', $data['CTLBRANDOD']);
 249         $CTLBRANDOS         = getListItemTitle('CTLManufacturer', $data['CTLBRANDOS']);
 250     }
 251
 252     //Since we selected the Print Icon, we must be dispensing this - add to dispensed table now
 253     $table_name      = "form_eye_mag_dispense";
 254     $query           = "show columns from " . $table_name;
 255     $dispense_fields = sqlStatement($query);
 256     $fields          = array();
 257
 258     if (sqlNumRows($dispense_fields) > 0) {
 259         while ($row = sqlFetchArray($dispense_fields)) {
 260             //exclude critical columns/fields, define below as needed
 261             if (
 262                 $row['Field'] == 'id' ||
 263                 $row['Field'] == 'pid' ||
 264                 $row['Field'] == 'user' ||
 265                 $row['Field'] == 'groupname' ||
 266                 $row['Field'] == 'authorized' ||
 267                 $row['Field'] == 'activity' ||
 268                 $row['Field'] == 'RXTYPE' ||
 269                 $row['Field'] == 'REFDATE' ||
 270                 $row['Field'] == 'date'
 271             ) {
 272                 continue;
 273             }
 274             if (isset(${$row['Field']})) {
 275                 $fields[$row['Field']] = ${$row['Field']};
 276             }
 277         }
 278
 279         $fields['RXTYPE'] = $RXTYPE;
 280         $fields['REFDATE'] = $data['date'];
 281         $insert_this_id = formSubmit($table_name, $fields, $form_id, $_SESSION['userauthorized']);
 282     }
 283 }
 284
 285 if ($_REQUEST['dispensed']) {
 286     $query = "SELECT * from form_eye_mag_dispense where pid =? ORDER BY date DESC";
 287     $dispensed = sqlStatement($query, array($_REQUEST['pid']));
 288     ?><html>
 289     <title><?php echo xlt('Rx Dispensed History'); ?></title>
 290     <head>
 291
 292         <?php Header::setupHeader(['opener', 'pure', 'jscolor']); ?>
 293
 294         <link rel="stylesheet" href="../../forms/<?php echo $form_folder; ?>/css/style.css" type="text/css">
 295
 296         <style>
 297             .title {
 298                 font-size:1em;
 299                 position:absolute;
 300                 right:10px;
 301                 top:30px;
 302                 font-size: 1em;
 303             }
 304             .refraction {
 305                 width:95%;
 306                 display: -moz-stack;
 307                 vertical-align: middle;
 308                 min-height:unset;
 309             }
 310             .refraction td {
 311                 text-align:center;
 312                 font-size:12px;
 313                 width:0.9in;
 314                 vertical-align: text-middle;
 315                 text-decoration: unset;
 316             }
 317             table {
 318                 font-size: 1.0em;
 319                 padding: 12px;
 320                 color: black;
 321                 vertical-align: text-top;
 322             }
 323
 324             input[type=text] {
 325                 text-align: center;
 326                 width: 60px;
 327             }
 328
 329             .refraction b {
 330                 font-weight: bold;
 331             }
 332
 333             .refraction td.right {
 334                 text-align: right;
 335                 text-decoration: unset;
 336                 width: 0.7in;
 337                 vertical-align: middle;    font-size:12px;
 338             }
 339
 340             .refraction td.left {
 341                 vertical-align: middle;
 342                 text-align: left;
 343                 font-size:12px;
 344             }
 345
 346             .right {
 347                 text-align: right;
 348                 vertical-align: middle;}
 349
 350             .left {
 351                 vertical-align: middle;
 352                 text-align: left;
 353             }
 354
 355             .title {
 356                 font-size: 0.9em;
 357                 font-weight: normal;
 358             }
 359
 360             .bold {
 361                 font-weight: 600;
 362             }
 363
 364             input {
 365                 width: 60px;
 366             }
 367
 368             input[type="radio"] {
 369                 width: 15px;
 370             }
 371             .underline {
 372                 text-decoration:underline !important
 373             }
 374             #CTLODQUANTITY, #CTLOSQUANTITY {
 375                 width: 300px;
 376             }
 377         </style>
 378         <script language="JavaScript">
 379         <?php
 380         require_once("$srcdir/restoreSession.php");  ?>
 381
 382             function delete_me(delete_id) {
 383                 top.restoreSession();
 384                 var url = "../../forms/eye_mag/SpectacleRx.php";
 385                 $.ajax({
 386                            type: 'POST',
 387                            url: url,
 388                            data: {
 389                                mode: 'remove',
 390                                delete_id: delete_id,
 391                                dispensed: '1'
 392                            } // our data object
 393                        }).done(function (o) {
 394                     $('#RXID_' + delete_id).hide();
 395                     alert(o);
 396                 });
 397             }
 398
 399         </script>
 400     </head>
 401     <?php echo report_header($pid, "web"); ?>
 402     <div class="row">
 403         <div class="col-sm-8 offset-sm-2 text-center m-3">
 404             <table>
 405                 <tr>
 406                     <td colspan="2"><h4 class="underline"><?php echo xlt('Rx History'); ?></h4></td>
 407                 </tr>
 408                 <?php
 409                 if (sqlNumRows($dispensed) == 0) {
 410                     echo "<tr><td colspan='2' class='text-center p-3' style='font-size:1.2em;'>" . xlt('There are no Glasses or Contact Lens Presciptions on file for this patient') . "</td></tr>";
 411                 }
 412                 ?>
 413             </table>
 414             <?php
 415             while ($row = sqlFetchArray($dispensed)) {
 416                 $i++;
 417                 $Single = '';
 418                 $Bifocal = '';
 419                 $Trifocal = '';
 420                 $Progressive = '';
 421                 if ($row['RXTYPE'] == "Single") {
 422                     $Single = "checked='checked'";
 423                 }
 424
 425                 if ($row['RXTYPE'] == "Bifocal") {
 426                     $Bifocal = "checked='checked'";
 427                 }
 428
 429                 if ($row['RXTYPE'] == "Trifocal") {
 430                     $Trifocal = "checked='checked'";
 431                 }
 432
 433                 if ($row['RXTYPE'] == "Progressive") {
 434                     $Progressive = "checked='checked'";
 435                 }
 436
 437                 $row['date'] = oeFormatShortDate(date('Y-m-d', strtotime($row['date'])));
 438                 if ($row['REFTYPE'] == "CTL") {
 439                     $expir = date("Y-m-d", strtotime($CTL_expir, strtotime($row['REFDATE'])));
 440                 } else {
 441                     $expir = date("Y-m-d", strtotime($RX_expir, strtotime($row['REFDATE'])));
 442                 }
 443                 $expir_date = oeFormatShortDate($expir);
 444                 $row['REFDATE'] = oeFormatShortDate($row['REFDATE']);
 445
 446                 ?>
 447                     <div class="position-relative text-center mt-2 mb-2 mx-auto" id="RXID_<?php echo attr($row['id']); ?>">
 448                         <i class="float-right fas fa-times"
 449                            onclick="delete_me('<?php echo attr(addslashes($row['id'])); ?>');"
 450                            title="<?php echo xla('Remove this Prescription from the list of RXs dispensed'); ?>"></i>
 451                         <div class="table-responsive">
 452                             <table class="table mt-1 mb-1 mx-auto">
 453                                 <tr>
 454                                     <td class="text-right align-middle font-weight-bold" style="width:250px;">
 455                                         <?php echo xlt('RX Print Date'); ?>:
 456                                     </td>
 457                                     <td>&nbsp;&nbsp;<?php echo text($row['date']); ?></td>
 458                                 </tr>
 459                                 <tr>
 460                                     <td class="text-right align-middle font-weight-bold">
 461                                         <?php echo xlt('Visit Date'); ?>:
 462                                     </td>
 463                                     <td>&nbsp;&nbsp;<?php echo text($row['REFDATE']); ?></td>
 464                                 </tr>
 465                                 <tr>
 466                                     <td class="text-right align-middle font-weight-bold">
 467                                         <?php echo xlt('Expiration Date'); ?>:
 468                                     </td>
 469                                     <td>&nbsp;&nbsp;<?php echo text($expir_date); ?></td>
 470                                 </tr>
 471
 472                                 <tr>
 473                                     <td class="text-right align-middle font-weight-bold"><?php echo xlt('Refraction Method'); ?>:</td>
 474                                     <td>&nbsp;&nbsp;<?php
 475                                     if ($row['REFTYPE'] == "W") {
 476                                         echo xlt('Duplicate Rx -- unchanged from current Rx{{The refraction did not change, New Rx=old Rx}}');
 477                                     } elseif ($row['REFTYPE'] == "CR") {
 478                                         echo xlt('Cycloplegic (Wet) Refraction');
 479                                     } elseif ($row['REFTYPE'] == "MR") {
 480                                         echo xlt('Manifest (Dry) Refraction');
 481                                     } elseif ($row['REFTYPE'] == "AR") {
 482                                         echo xlt('Auto-Refraction');
 483                                     } elseif ($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" class="text-center"> <?php
 493                                     if ($row['REFTYPE'] != "CTL") { ?>
 494                                                 <table id="SpectacleRx" name="SpectacleRx" class="refraction" style="top:0px;">
 495                                                     <tr class="font-weight-bold">
 496                                                         <td></td>
 497                                                         <td></td>
 498                                                         <td class="center font-weight-bold underline"><?php echo xlt('Sph{{Sphere}}'); ?></td>
 499                                                         <td class="center font-weight-bold underline"><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 500                                                         <td class="center font-weight-bold underline"><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
 501                                                         <td rowspan="5" class="text-right align-middle font-weight-bold underline" colspan="2"
 502                                                             style="min-width:100px;">
 503                                                             <?php echo xlt('Rx Type'); ?><br/><br/>
 504                                                             <?php echo xlt('Single'); ?>
 505                                                             <input type="radio" disabled <?php echo text($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($Progressive); ?>><br/>
 512                                                         </td>
 513                                                     </tr>
 514                                                     <tr>
 515                                                         <td class="font-weight-bold text-right" rowspan="2"><?php echo xlt('Distance'); ?></td>
 516                                                         <td class="font-weight-bold"><?php echo xlt('OD{{right eye}}'); ?></td>
 517                                                         <td><?php echo text($row['ODSPH']); ?></td>
 518                                                         <td><?php echo text($row['ODCYL']); ?></td>
 519                                                         <td><?php echo text($row['ODAXIS']); ?></td>
 520                                                         <td><?php echo text($row['ODPRISM']); ?></td>
 521                                                     </tr>
 522                                                     <tr>
 523                                                         <td class="font-weight-bold"><?php echo xlt('OS{{left eye}}'); ?></td>
 524                                                         <td><?php echo text($row['OSSPH']); ?></td>
 525                                                         <td><?php echo text($row['OSCYL']); ?></td>
 526                                                         <td><?php echo text($row['OSAXIS']); ?></td>
 527                                                         <td><?php echo text($row['OSPRISM']); ?></td>
 528                                                     </tr>
 529                                                     <tr class="NEAR">
 530                                                         <td class="text-nowrap" rowspan="2"><span class="font-weight-bold text-decoration-none"><?php echo xlt('ADD'); ?>
 531                                                                 :<br/><?php echo xlt("Mid{{Middle segment in a trifocal glasses prescription}}"); ?>
 532                                                                 /<?php echo xlt("Near"); ?></span></td>
 533                                                         <td class="font-weight-bold"><?php echo xlt('OD{{right eye}}'); ?></td>
 534                                                         <td class="WMid"><?php echo text($row['ODMIDADD']); ?></td>
 535                                                         <td class="WAdd2"><?php echo text($row['ODADD2']); ?></td>
 536                                                     </tr>
 537                                                     <tr class="NEAR">
 538                                                         <td class="font-weight-bold"><?php echo xlt('OS{{left eye}}'); ?></td>
 539                                                         <td class="WMid"><?php echo text($row['OSMIDADD']); ?></td>
 540                                                         <td class="WAdd2"><?php echo text($row['OSADD2']); ?></td>
 541                                                     </tr>
 542                                                     <tr>
 543                                                         <td colspan="2" class="up" class="font-weight-bold text-right align-top"
 544                                                             style="top:0px;"><?php echo xlt('Comments'); ?>
 545                                                             :
 546                                                         </td>
 547                                                         <td colspan="4" class="up text-left"></td>
 548                                                         <?php echo text($row['CRCOMMENTS']); ?>
 549                                                         </td>
 550                                                     </tr>
 551                                                 </table>
 552                                                 <?php
 553                                     } else {
 554                                         if (!empty($row['ODADD']) || !empty($row['OSADD'])) {
 555                                             $adds = 1;
 556                                         } else {
 557                                             $adds = '';
 558                                         }
 559                                         ?>
 560                                                 <table id="CTLRx" name="CTLRx" class="refraction">
 561                                                     <tr>
 562                                                         <td colspan="4"
 563                                                             class="font-weight-bold text-left align-middle text-uppercase text-top" style="display: flex;
 564                                                 align-items:top"><u><?php echo xlt('Right Lens'); ?></u>
 565                                                         </td>
 566                                                     </tr>
 567                                                     <tr class="font-weight-bold underline">
 568                                                         <td></td>
 569                                                         <td><?php echo xlt('Sph{{Sphere}}'); ?></td>
 570                                                         <td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 571                                                         <td><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
 572                                                         <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
 573                                                         <td><?php echo xlt('Diam{{Diameter}}'); ?></td>
 574                                                 <?php
 575                                                 if ($adds) {
 576                                                     ?>
 577                                                                 <td><?php echo xlt('ADD'); ?></td>
 578                                                         <?php }
 579                                                 ?>
 580                                                     </tr>
 581                                                     <tr>
 582                                                         <td></td>
 583                                                         <td><?php echo text($row['ODSPH']); ?></td>
 584                                                         <td><?php echo text($row['ODCYL']); ?></td>
 585                                                         <td><?php echo text($row['ODAXIS']); ?></td>
 586                                                         <td><?php echo text($row['ODBC']); ?></td>
 587                                                         <td><?php echo text($row['ODDIAM']); ?></td>
 588                                                         <?php
 589                                                         if ($adds) {
 590                                                             ?>
 591                                                                 <td><?php echo text($row['ODADD']); ?></td>
 592                                                             <?php } ?>
 593                                                     </tr>
 594                                                     <tr>
 595                                                         <td colspan="2" class="text-right align-middle font-weight-bold">
 596                                                             <?php echo xlt('Brand'); ?>: <br />
 597                                                             <?php echo xlt('Quantity'); ?>: <br />
 598                                                             <?php echo xlt('Supplier'); ?>: </td>
 599                                                         <td colspan="5" class="text-left align-middle align-middle align-top" style="padding-left:10px;">
 600                                                             <?php echo text($row['CTLBRANDOD']); ?>
 601                                                             <?php
 602                                                             if (!empty($row['CTLMANUFACTUREROD'])) {
 603                                                                 echo "(" . text($row['CTLMANUFACTUREROD']) . ")";
 604                                                             } ?>
 605                                                             <br />
 606                                                             <?php echo text($row['CTLODQUANTITY']); ?><br />
 607                                                             <?php echo text($row['CTLSUPPLIEROD']); ?>
 608                                                         </td>
 609                                                     </tr>
 610                                                     <tr>
 611                                                         <td colspan="7">
 612                                                             <hr />
 613                                                         </td>
 614                                                     </tr>
 615                                                     <tr>
 616                                                         <td colspan="4"
 617                                                             class="font-weight-bold text-left align-middle text-uppercase text-top d-flex align-items-start">
 618                                                             <u><?php echo xlt('Left Lens'); ?></u>
 619                                                         </td>
 620                                                     </tr>
 621                                                     <tr class="font-weight-bold underline">
 622                                                         <td></td>
 623                                                         <td><?php echo xlt('Sph{{Sphere}}'); ?></td>
 624                                                         <td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 625                                                         <td><?php echo xlt('Axis{{Axis in a glasses prescription}}'); ?></td>
 626                                                         <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
 627                                                         <td><?php echo xlt('Diam{{Diameter}}'); ?></td>
 628                                                         <?php
 629                                                         if ($adds) {
 630                                                             ?>
 631                                                                 <td><?php echo xlt('ADD'); ?></td>
 632                                                             <?php }
 633                                                         ?>
 634                                                     </tr>
 635                                                     <tr>
 636                                                         <td></td>
 637                                                         <td><?php echo text($row['OSSPH']); ?></td>
 638                                                         <td><?php echo text($row['OSCYL']); ?></td>
 639                                                         <td><?php echo text($row['OSAXIS']); ?></td>
 640                                                         <td><?php echo text($row['OSBC']); ?></td>
 641                                                         <td><?php echo text($row['OSDIAM']); ?></td>
 642                                                         <?php
 643                                                         if ($adds) {
 644                                                             ?>
 645                                                                 <td><?php echo text($row['OSADD']); ?></td>
 646                                                                 <?php
 647                                                         } ?>
 648                                                     </tr>
 649                                                     <tr>
 650                                                         <td colspan="2" class="text-right align-middle font-weight-bold">
 651                                                             <?php echo xlt('Brand'); ?>: <br />
 652                                                             <?php echo xlt('Quantity'); ?>: <br />
 653                                                             <?php echo xlt('Supplier'); ?>: </td>
 654                                                         <td colspan="5" class="text-left align-middle align-top" style="padding-left:10px;"><?php echo text($row['CTLBRANDOS']); ?>
 655                                                             <?php
 656                                                             if (!empty($row['CTLMANUFACTUREROS'])) {
 657                                                                 echo "(" . text($row['CTLMANUFACTUREROS']) . ")";
 658                                                             } ?>
 659                                                             <br />
 660                                                             <?php echo text($row['CTLOSQUANTITY']); ?><br />
 661                                                             <?php echo text($row['CTLSUPPLIEROS']); ?>
 662                                                         </td>
 663                                                     </tr>
 664                                                     <?php if (!empty($row['COMMENTS'])) { ?>
 665                                                         <tr><td colspan="7"><hr /></td></tr>
 666                                                         <tr>
 667                                                             <td colspan="3" class="font-weight-bold text-right align-middle"><?php echo xlt('Comments'); ?>:
 668                                                             </td>
 669                                                             <td colspan="3" class="text-left align-middle" style="padding-left:10px;top:0px;">
 670                                                                 <?php echo text($row['COMMENTS']); ?>
 671                                                             </td>
 672                                                         </tr>
 673                                                     <?php } ?>
 674                                                 </table>
 675
 676                                                 <?php
 677                                     } ?>
 678                                     </td>
 679                                 </tr>
 680                             </table>
 681                         </div>
 682                         <hr>
 683
 684                     </div>
 685                     <?php
 686             } ?>
 687         </div>
 688     </div>
 689     </body>
 690         </html>
 691         <?php
 692         exit;
 693 }
 694
 695     ob_start();
 696 ?>
 697 <html>
 698 <head>
 699     <?php Header::setupHeader([ 'opener', 'jquery-ui', 'jquery-ui-redmond', 'pure', 'jscolor' ]); ?>
 700     <link rel="stylesheet" href="../../forms/<?php echo $form_folder; ?>/css/style.css">
 701
 702     <style>
 703         .title {
 704             font-size:1em;
 705             position:absolute;
 706             right:10px;
 707             top:30px;
 708             font-size: 1em;
 709         }
 710         .refraction {
 711             width:95%;
 712             display: -moz-stack;
 713             vertical-align: middle;
 714             min-height:unset;
 715         }
 716         .refraction td {
 717             text-align:center;
 718             font-size:12px;
 719             padding:5;
 720             width:0.35in;
 721             vertical-align: text-middle;
 722             text-decoration: unset;
 723         }
 724         table {
 725             font-size: 1.0em;
 726             padding: 12px;
 727             color: black;
 728             vertical-align: text-top;
 729         }
 730
 731         input[type=text] {
 732             text-align: center;
 733             width: 60px;
 734             padding: 0.2em 0.4em !important;
 735         }
 736
 737         .refraction b {
 738             font-weight: bold;
 739         }
 740
 741         .refraction td.right {
 742             text-align: right;
 743             text-decoration: unset;
 744             width: 0.7in;
 745             vertical-align: middle;    font-size:12px;
 746         }
 747
 748         .refraction td.left {
 749             vertical-align: middle;
 750             text-align: left;
 751             font-size:12px;
 752         }
 753
 754         .right {
 755             text-align: right;
 756             vertical-align: middle;}
 757
 758         .left {
 759             vertical-align: middle;
 760             text-align: left;
 761         }
 762
 763         .title {
 764             font-size: 0.9em;
 765             font-weight: normal;
 766         }
 767
 768         .bold {
 769             font-weight: 600;
 770         }
 771
 772         input {
 773             width: 60px;
 774         }
 775
 776         input[type="radio"] {
 777             width: 15px;
 778         }
 779         .underline {
 780             text-decoration:underline !important
 781         }
 782         #CTLODQUANTITY, #CTLOSQUANTITY {
 783             width: 300px;
 784             text-align: left;
 785             padding-left: 10px !important;
 786         }
 787         hr {
 788             margin:1px;
 789         }
 790         label {
 791             font-size:12px;
 792         }
 793
 794     </style>
 795     <!-- jQuery library -->
 796
 797     <script language="JavaScript">
 798         <?php require_once("$srcdir/restoreSession.php"); ?>
 799         function pick_rxType(rxtype, id) {
 800             var url = "../../forms/eye_mag/SpectacleRx.php";
 801             var formData = {
 802                 'RXTYPE': rxtype,
 803                 'id': id
 804             };
 805             top.restoreSession();
 806             $.ajax({
 807                        type: 'POST',
 808                        url: url,
 809                        data: formData
 810                    });
 811             if (rxtype == 'Trifocal') {
 812                 $("[name$='MIDADD']").show();
 813                 $("[name$='ADD2']").show();
 814             } else if (rxtype == 'Bifocal') {
 815                 $("[name$='MIDADD']").hide().val('');
 816                 $("[name$='ADD2']").show();
 817             } else if (rxtype == 'Progressive') {
 818                 $("[name$='MIDADD']").hide().val('');
 819                 $("[name$='ADD2']").show();
 820             } else if (rxtype == "Single") {
 821                 $("[name$='MIDADD']").hide().val('');
 822                 $("[name$='ADD2']").hide().val('');
 823             }
 824         }
 825
 826         function submit_form() {
 827             var url = "../../forms/eye_mag/SpectacleRx.php?mode=update";
 828             formData = $("form#Spectacle").serialize();
 829             top.restoreSession();
 830             $.ajax({
 831                        type: 'POST',
 832                        url: url,
 833                        data: formData
 834                    });
 835         }
 836
 837         //add sph and cyl, flip cyl sign, rotate axis 90.
 838         function reverse_cylinder() {
 839             var Rsph = $('#ODSPH').val();
 840             var Rcyl = $('#ODCYL').val();
 841             var Raxis = $('#ODAXIS').val();
 842             var Lsph = $('#OSSPH').val();
 843             var Lcyl = $('#OSCYL').val();
 844             var Laxis = $('#OSAXIS').val();
 845             if (Rsph == '' && Rcyl == '' && Lsph == '' && lcyl == '') return;
 846             if ((!Rcyl.match(/SPH/i)) && (Rcyl > '')) {
 847                 if (Rsph.match(/plano/i)) Rsph = '0';
 848                 Rsph = Number(Rsph);
 849                 Rcyl = Number(Rcyl);
 850                 Rnewsph = Rsph + Rcyl;
 851                 if (Rnewsph == 0) Rnewsph = "PLANO";
 852                 Rnewcyl = Rcyl * -1;
 853                 if (Rnewcyl > 0) Rnewcyl = "+" + Rnewcyl;
 854                 if (parseInt(Raxis) < 90) {
 855                     Rnewaxis = parseInt(Raxis) + 90;
 856                 } else {
 857                     Rnewaxis = parseInt(Raxis) - 90;
 858                 }
 859                 if (Rnewcyl == '0') Rnewcyl = "SPH";
 860                 if (Rnewsph == '0') {
 861                     Rnewsph = "PLANO";
 862                     if (Rnewcyl == "SPH") Rnewcyl = '';
 863                 }
 864                 $("#ODSPH").val(Rnewsph);
 865                 $("#ODCYL").val(Rnewcyl);
 866                 $("#ODAXIS").val(Rnewaxis);
 867                 $('#ODAXIS').trigger('blur');
 868                 $('#ODSPH').trigger('blur');
 869                 $('#ODCYL').trigger('blur');
 870             }
 871             if ((!Lcyl.match(/SPH/i)) && (Lcyl > '')) {
 872                 if (!Lsph.match(/\d/)) Lsph = '0';
 873                 Lsph = Number(Lsph);
 874                 Lcyl = Number(Lcyl);
 875                 Lnewsph = Lsph + Lcyl;
 876                 Lnewcyl = Lcyl * -1;
 877                 if (Lnewcyl > 0) Lnewcyl = "+" + Lnewcyl;
 878                 if (parseInt(Laxis) < 90) {
 879                     Lnewaxis = parseInt(Laxis) + 90;
 880                 } else {
 881                     Lnewaxis = parseInt(Laxis) - 90;
 882                 }
 883
 884                 if (Lnewcyl == '0') Lnewcyl = "SPH";
 885                 if (Lnewsph == '0') {
 886                     Lnewsph = "PLANO";
 887                     if (Lnewcyl == "SPH") Lnewcyl = '';
 888                 }
 889
 890                 $("#OSSPH").val(Lnewsph);
 891                 $("#OSCYL").val(Lnewcyl);
 892                 $("#OSAXIS").val(Lnewaxis);
 893                 $('#OSAXIS').trigger('blur');
 894                 $('#OSSPH').trigger('blur');
 895                 $('#OSCYL').trigger('blur');
 896             }
 897         }
 898     </script>
 899 </head>
 900 <body>
 901 <?php echo report_header($pid, "web");  ?>
 902 <br/><br/>
 903 <?php
 904 if ($REFTYPE == "CTL") {
 905     $expir = date("Y-m-d", strtotime($CTL_expir, strtotime($data['date'])));
 906 } else {
 907     $expir = date("Y-m-d", strtotime($RX_expir, strtotime($data['date'])));
 908 }
 909     $expir_date = oeFormatShortDate($expir);
 910 ?>
 911 <p><span class="font-weight-bold"><?php echo xlt('Expiration Date'); ?>: </span>
 912     &nbsp;&nbsp;     <?php echo text($expir_date); ?>
 913 </p>
 914
 915 <form method="post" action="<?php echo $rootdir; ?>/forms/<?php echo text($form_folder); ?>/SpectacleRx.php?mode=update"
 916       id="Spectacle" class="eye_mag pure-form text-center" name="Spectacle">
 917     <!-- start container for the main body of the form -->
 918     <input type="hidden" name="REFDATE" id="REFDATE" value="<?php echo attr($data['date']); ?>">
 919     <input type="hidden" name="RXTYPE" id="RXTYPE" value="<?php echo attr($RXTYPE); ?>">
 920     <input type="hidden" name="REFTYPE" value="<?php echo attr($REFTYPE); ?>"/>
 921     <input type="hidden" name="pid" id="pid" value="<?php echo attr($pid); ?>">
 922     <input type="hidden" name="id" id="id" value="<?php echo attr($insert_this_id); ?>">
 923     <input type="hidden" name="encounter" id="encounter" value="<?php echo attr($encounter); ?>">
 924
 925     <div style="width: 650px;">
 926         <table class="mx-auto">
 927             <tr>
 928                 <td>
 929                     <?php
 930                     if ($REFTYPE != "CTL") { ?>
 931                             <table id="SpectacleRx" name="SpectacleRx" class="refraction bordershadow"
 932                                    style="min-width:610px;top:0px;">
 933                                 <tr class="font-weight-bold text-center">
 934                                     <td><i name="reverse" id="reverse" class="fa fa-gamepad fa-2x"></i></td>
 935                                     <td></td>
 936                                     <td><?php echo xlt('Sph{{Sphere}}'); ?></td>
 937                                     <td><?php echo xlt('Cyl{{Cylinder}}'); ?></td>
 938                                     <td><?php echo xlt('Axis{{Axis of a glasses prescription}}'); ?></td>
 939                                     <td rowspan="5" class="text-right align-middle font-weight-bold" colspan="1" >
 940                                         <span class="font-weight-bold underline"><?php echo xlt('Rx Type'); ?></span>
 941                                         <br/><br/>
 942                                         <span id="SingleVision_span" name="SingleVision_span">
 943                                             <label for="RXTYPE_Single"><?php echo xlt('Single'); ?></label>
 944                                             <input type="radio"
 945                                                    onclick="pick_rxType('Single',<?php echo attr_js($insert_this_id); ?>);"
 946                                                    value="Single" id="RXTYPE_Single" name="RXTYPE"
 947                                                    <?php echo attr($Single); ?> />
 948                                         </span>
 949                                         <br/>
 950                                         <span id="Bifocal_span" name="Bifocal_span">
 951                                             <label for="RXTYPE_Bifocal"><?php echo xlt('Bifocal'); ?></label>
 952                                             <input type="radio"
 953                                                    onclick="pick_rxType('Bifocal',<?php echo attr_js($insert_this_id); ?>);"
 954                                                    value="Bifocal" id="RXTYPE_Bifocal" name="RXTYPE" <?php echo attr($Bifocal); ?> />
 955                                         </span>
 956                                         <br/>
 957                                         <span id="Trifocal_span" name="Trifocal_span">
 958                                             <label for="RXTYPE_Trifocal"><?php echo xlt('Trifocal'); ?></label>
 959                                             <input type="radio"
 960                                                    onclick="pick_rxType('Trifocal',<?php echo attr_js($insert_this_id); ?>);"
 961                                                    value="Trifocal" id="RXTYPE_Trifocal"
 962                                                    name="RXTYPE" <?php echo attr($Trifocal); ?>>
 963                                         </span>
 964                                         <br/>
 965                                         <span id="Progressive_span">
 966                                             <label for="RXTYPE_Progressive">
 967                                                 <?php echo xlt('Prog.{{Progressive lenses}}'); ?>
 968                                             </label>
 969                                             <input type="radio"
 970                                                    onclick="pick_rxType('Progressive',<?php echo attr_js($insert_this_id); ?>);"
 971                                                    value="Progressive" id="RXTYPE_Progressive"
 972                                                    name="RXTYPE" <?php echo attr($Progressive); ?>>
 973                                         </span>
 974                                         <br/>
 975                                     </td>
 976                                     <td></td>
 977                                 </tr>
 978                                 <tr class="center">
 979                                     <td rowspan="2" colspan="1" class="text-right align-middle font-weight-bold"><?php echo xlt('Distance'); ?>: </td>
 980                                     <td class="text-right align-middle font-weight-bold"><?php echo xlt('OD{{right eye}}'); ?></td>
 981                                     <td><input type="text" id="ODSPH" name="ODSPH" value="<?php echo attr($ODSPH); ?>"></td>
 982                                     <td><input type="text" id="ODCYL" name="ODCYL" value="<?php echo attr($ODCYL); ?>"></td>
 983                                     <td><input type="text" id="ODAXIS" name="ODAXIS" value="<?php echo attr($ODAXIS); ?>">
 984                                     </td>
 985                                 </tr>
 986                                 <tr class="center">
 987                                     <td name="W_wide" class="text-right align-middle font-weight-bold"><?php echo xlt('OS{{left eye}}'); ?></td>
 988                                     <td><input type="text" id="OSSPH" name="OSSPH" value="<?php echo attr($OSSPH); ?>"></td>
 989                                     <td><input type="text" id="OSCYL" name="OSCYL" value="<?php echo attr($OSCYL); ?>"></td>
 990                                     <td><input type="text" id="OSAXIS" name="OSAXIS" value="<?php echo attr($OSAXIS); ?>">
 991                                     </td>
 992                                 </tr>
 993                                 <tr class="NEAR center">
 994                                     <td rowspan="2" colspan="1" class="text-right align-middle font-weight-bold text-nowrap"><?php echo xlt('ADD'); ?>:<br/>
 995                                         <?php echo xlt("Mid{{Middle segment in a trifocal glasses prescription}}"); ?>
 996                                         /<?php echo xlt("Near"); ?></td>
 997                                     <td class="text-right align-middle font-weight-bold"><?php echo xlt('OD{{right eye}}'); ?></td>
 998                                     <td name="COLADD1"><input type="text" id="ODMIDADD" name="ODMIDADD"
 999                                                               value="<?php echo attr($ODMIDADD); ?>"></td>
1000                                     <td class="WAdd2"><input type="text" id="ODADD2" name="ODADD2"
1001                                                              value="<?php echo attr($ODADD2); ?>"></td>
1002                                 </tr>
1003                                 <tr class="NEAR center">
1004                                     <td class="text-right align-middle font-weight-bold"><?php echo xlt('OS{{left eye}}'); ?></td>
1005                                     <td name="COLADD1">
1006                                         <input type="text" id="OSMIDADD" name="OSMIDADD" value="<?php echo attr($OSMIDADD); ?>"></td>
1007                                     <td class="WAdd2">
1008                                         <input type="text" id="OSADD2" name="OSADD2" value="<?php echo attr($OSADD2); ?>"></td>
1009                                 </tr>
1010                                 <tr>
1011                                     <td colspan="2" class="center font-weight-bold"><?php echo xlt('Comments'); ?>: </td>
1012                                     <td colspan="4">
1013                                     <textarea class="w-100" style="height:3em;" id="CRCOMMENTS"
1014                                               name="CRCOMMENTS"><?php echo text($COMMENTS); ?></textarea>
1015                                     </td>
1016                                 </tr>
1017                                 <!-- start Dispense data -->
1018                                 <tr class="header closeButton">
1019                                     <td colspan="9" class="right">
1020                                                 <span><?php
1021                                                 if (
1022                                                     $ODHPD || $ODHBASE || $ODVPD || $ODVBASE || $ODSLABOFF || $ODVERTEXDIST ||
1023                                                         $OSHPD || $OSHBASE || $OSVPD || $OSVBASE || $OSSLABOFF || $OSVERTEXDIST ||
1024                                                         $ODMPDD || $ODMPDN || $OSMPDD || $OSMPDN || $BPDD || $BPDN ||
1025                                                         $LENS_MATERIAL || $LENS_TREATMENTS
1026                                                 ) {
1027                                                     $detailed = '1';
1028                                                     ?><i class="fa fa-minus-square-o"></i><?php
1029                                                 } else {
1030                                                     $detailed = '0';
1031                                                     ?><i class="fa fa-plus-square-o"></i><?php
1032                                                 }
1033                                                 ?>
1034                                                 </span>
1035                                     </td>
1036                                 </tr>
1037                                 <tr>
1038                                     <td colspan="7">
1039                                         <hr/>
1040                                     </td>
1041                                 </tr>
1042                                 <tr class="dispense_data" style="font-weight:bold;text-align:center;">
1043                                     <td name="W_wide" colspan="1"></td>
1044                                     <td name="W_wide"
1045                                         title="<?php echo xla('Horizontal Prism Power'); ?>"><?php echo xlt('Horiz Prism{{abbreviation for Horizontal Prism Power}}'); ?></td>
1046                                     <td name="W_wide"
1047                                         title="<?php echo xla('Horizontal Prism Base'); ?>"><?php echo xlt('Horiz Base{{abbreviation for Horizontal Prism Base}}'); ?></td>
1048                                     <td name="W_wide"
1049                                         title="<?php echo xla('Vertical Prism Power'); ?>"><?php echo xlt('Vert Prism{{abbreviation for Vertical Prism Power}}'); ?></td>
1050                                     <td name="W_wide"
1051                                         title="<?php echo xla('Vertical Prism Base'); ?>"><?php echo xlt('Vert Base{{abbreviation for Vertical Prism Base}}'); ?></td>
1052                                     <td name="W_wide"
1053                                         title="<?php echo xla('Slab Off'); ?>"><?php echo xlt('Slab Off'); ?></td>
1054                                     <td name="W_wide"
1055                                         title="<?php echo xla('Vertex Distance'); ?>"><?php echo xlt('Vert Distance{{abbreviation for Vertex Distance}}'); ?></td>
1056                                 </tr>
1057                                 <tr class="dispense_data">
1058                                     <td name="W_wide" style="text-align:right;font-weight:bold;"
1059                                         colspan="1"><?php echo xlt('OD{{right eye}}'); ?></td>
1060                                     <td name="W_wide"><input type="text" class="prism" id="ODHPD" name="ODHPD"
1061                                                              value="<?php echo attr($ODHPD); ?>"></td>
1062                                     <td name="W_wide"><input type="text" class="prism" id="ODHBASE" name="ODHBASE"
1063                                                              value="<?php echo attr($ODHBASE); ?>"></td>
1064                                     <td name="W_wide"><input type="text" class="prism" id="ODVPD" name="ODVPD"
1065                                                              value="<?php echo attr($ODVPD); ?>"></td>
1066                                     <td name="W_wide"><input type="text" class="prism" id="ODVBASE" name="ODVBASE"
1067                                                              value="<?php echo attr($ODVBASE); ?>"></td>
1068                                     <td name="W_wide"><input type="text" class="prism" id="ODSLABOFF" name="ODSLABOFF"
1069                                                              value="<?php echo attr($ODSLABOFF); ?>"></td>
1070                                     <td name="W_wide"><input type="text" class="prism" id="ODVERTEXDIST" name="ODVERTEXDIST"
1071                                                              value="<?php echo attr($ODVERTEXDIST); ?>"></td>
1072                                 </tr>
1073                                 <tr class="dispense_data">
1074                                     <td name="W_wide" style="text-align:right;font-weight:bold;"
1075                                         colspan="1"><?php echo xlt('OS{{left eye}}'); ?></td>
1076                                     <td name="W_wide"><input type="text" class="prism" id="OSHPD" name="OSHPD"
1077                                                              value="<?php echo attr($OSHPD); ?>"></td>
1078                                     <td name="W_wide"><input type="text" class="prism" id="OSHBASE" name="OSHBASE"
1079                                                              value="<?php echo attr($OSHBASE); ?>"></td>
1080                                     <td name="W_wide"><input type="text" class="prism" id="OSVPD" name="OSVPD"
1081                                                              value="<?php echo attr($OSVPD); ?>"></td>
1082                                     <td name="W_wide"><input type="text" class="prism" id="OSVBASE" name="OSVBASE"
1083                                                              value="<?php echo attr($OSVBASE); ?>"></td>
1084                                     <td name="W_wide"><input type="text" class="prism" id="OSSLABOFF" name="OSSLABOFF"
1085                                                              value="<?php echo attr($OSSLABOFF); ?>"></td>
1086                                     <td name="W_wide"><input type="text" class="prism" id="OSVERTEXDIST" name="OSVERTEXDIST"
1087                                                              value="<?php echo attr($OSVERTEXDIST); ?>"></td>
1088                                 </tr>
1089                                 <tr class="dispense_data">
1090                                     <td colspan="7" class="center">
1091                                         <hr/>
1092                                     </td>
1093                                 </tr>
1094                                 <tr class="dispense_data" style="font-weight:bold;text-align:center;">
1095                                     <td></td>
1096                                     <td name="W_wide"
1097                                         title="<?php echo xla('Monocular Pupillary Diameter - Distance'); ?>"><?php echo xlt('MPD-D{{abbreviation for Monocular Pupillary Diameter - Distance}}'); ?></td>
1098                                     <td name="W_wide"
1099                                         title="<?php echo xla('Monocular Pupillary Diameter - Near'); ?>"><?php echo xlt('MPD-N{{abbreviation for Monocular Pupillary Diameter - Near}}'); ?></td>
1100                                     <td name="W_wide"
1101                                         title="<?php echo xla('Binocular Pupillary Diameter - Distance'); ?>"><?php echo xlt('BPD-D{{abbreviation for Binocular Pupillary Diameter - Distance}}'); ?></td>
1102                                     <td name="W_wide"
1103                                         title="<?php echo xla('Binocular Pupillary Diameter - Near'); ?>"><?php echo xlt('BPD-N{{abbreviation for Binocular Pupillary Diameter - Near}}'); ?></td>
1104
1105                                     <td colspan="2">Lens Material:</td>
1106                                 </tr>
1107                                 <tr>
1108                                     <td name="W_wide" style="text-align:right;font-weight:bold;"
1109                                         colspan="1"><?php echo xlt('OD{{right eye}}'); ?></td>
1110                                     <td name="W_wide"><input type="text" class="prism" id="ODMPDD" name="ODMPDD"
1111                                                              value="<?php echo attr($ODMPDD); ?>"></td>
1112                                     <td name="W_wide"><input type="text" class="prism" id="ODMPDN" name="ODMPDN"
1113                                                              value="<?php echo attr($ODMPDN); ?>"></td>
1114                                     <td name="W_wide" rowspan="2" style="vertical-align:middle;"><input type="text"
1115                                                                                                         class="prism"
1116                                                                                                         id="BPDD"
1117                                                                                                         name="BPDD"
1118                                                                                                         value="<?php echo attr($BPDD); ?>">
1119                                     </td>
1120                                     <td name="W_wide" rowspan="2" style="vertical-align:middle;"><input type="text"
1121                                                                                                         class="prism"
1122                                                                                                         id="BPDN"
1123                                                                                                         name="BPDN"
1124                                                                                                         value="<?php echo attr($BPDN); ?>">
1125                                     </td>
1126                                     <td colspan="2">   <?php
1127                                         echo generate_select_list("LENS_MATERIAL", "Eye_Lens_Material", "$LENS_MATERIAL", '', ' ', '', 'restoreSession;submit_form();', '', array('style' => 'width:120px'));
1128                                     ?>
1129                                     </td>
1130                                 </tr>
1131                                 <tr>
1132                                     <td name="W_wide" style="text-align:right;font-weight:bold;"
1133                                         colspan="1"><?php echo xlt('OS{{left eye}}'); ?></td>
1134                                     <td name="W_wide"><input type="text" class="prism" id="OSMPDD" name="OSMPDD"
1135                                                              value="<?php echo attr($OSMPDD); ?>"></td>
1136                                     <td name="W_wide"><input type="text" class="prism" id="OSMPDN" name="OSMPDN"
1137                                                              value="<?php echo attr($OSMPDN); ?>"></td>
1138                                 </tr>
1139                                 <tr style="font-weight:bold;text-align:center;">
1140                                     <td colspan="3"><?php echo xlt('Lens Treatments'); ?>
1141                                     </td>
1142                                 </tr>
1143                                 <tr style="text-align:left;vertical-align:top;">
1144                                     <td colspan="4" class="bold left">
1145                                         <?php echo generate_lens_treatments($W, $LENS_TREATMENTS); ?>
1146                                     </td>
1147                                 </tr>
1148                             </table>&nbsp;<br/><br/><br/>
1149                             <?php
1150                     } else {
1151                         if (!empty($ODADD) || !empty($OSADD)) {
1152                             $adds = 1;
1153                         } else {
1154                             $adds = '';
1155                         }
1156                         ?>
1157                             <table id="CTLRx" name="CTLRx" class="refraction bordershadow">
1158                                 <tr class="bold center">
1159                                     <td class="right bold underline"><?php echo xlt('Right Lens'); ?></td>
1160                                 </tr>
1161                                 <tr>
1162                                     <td colspan="2" class="right bold text-uppercase"><?php echo xlt('Brand'); ?>:</td>
1163                                     <td colspan="4" class="left"><?php echo text($CTLBRANDOD); ?> <?php if ($CTLMANUFACTUREROD) {
1164                                         echo "(" . text($CTLMANUFACTUREROD) . ")";} ?></td>
1165                                 </tr>
1166                                 <tr class="bold">
1167                                     <td><?php echo xlt('SPH{{Sphere}}'); ?></td>
1168                                     <td><?php echo xlt('CYL{{Cylinder}}'); ?></td>
1169                                     <td><?php echo xlt('AXIS{{Axis of a glasses prescription}}'); ?></td>
1170                                     <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
1171                                     <td><?php echo xlt('DIAM{{Diameter}}'); ?></td>
1172                                 <?php
1173                                 if ($adds) {
1174                                     ?>
1175                                             <td><?php echo xlt('ADD{{Bifocal Add}}'); ?></td>
1176                                         <?php } ?>
1177                                 </tr>
1178                                 <tr>
1179                                     <td><input type=text id="CTLODSPH" name="CTLODSPH" value="<?php echo attr($ODSPH); ?>">
1180                                     </td>
1181                                     <td><input type=text id="CTLODCYL" name="CTLODCYL" value="<?php echo attr($ODCYL); ?>">
1182                                     </td>
1183                                     <td><input type=text id="CTLODAXIS" name="CTLODAXIS"
1184                                                value="<?php echo attr($ODAXIS); ?>"></td>
1185                                     <td><input type=text id="CTLODBC" name="CTLODBC" value="<?php echo attr($ODBC); ?>">
1186                                     </td>
1187                                     <td><input type=text id="CTLODDIAM" name="CTLODDIAM"
1188                                                value="<?php echo attr($ODDIAM); ?>"></td>
1189                                     <?php
1190                                     if ($adds) {
1191                                         ?>
1192                                             <td><input type=text id="CTLODADD" name="CTLODADD" value="<?php echo attr($ODADD); ?>">
1193                                             </td>
1194                                         <?php } ?>
1195                                 </tr>
1196                                 <tr>
1197                                     <td colspan="2" class="right bold text-uppercase"><?php echo xlt('Quantity:'); ?></td>
1198                                     <td colspan="4" class="left"><input id="CTLODQUANTITY" name="CTLODQUANTITY" value="<?php echo attr($CTLODQUANTITY); ?>" type="text" class="left" /></td>
1199                                 </tr>
1200                                 <tr>
1201                                     <td colspan="7">
1202                                         <hr />
1203                                     </td>
1204                                 </tr>
1205                                 <tr>
1206                                     <td class="right bold large underline"><?php echo xlt('Left Lens'); ?></td>
1207                                 </tr>
1208                                 <tr>
1209                                     <td colspan="2" class="right bold text-uppercase"><?php echo xlt('Brand'); ?>:</td>
1210                                     <td colspan="4" class="left"><?php echo text($CTLBRANDOS); ?> <?php if ($CTLMANUFACTUREROS) {
1211                                         echo "(" . text($CTLMANUFACTUREROS) . ")";} ?></td>
1212                                 </tr>
1213                                 <tr class="bold" style="line-height:0.3em;font-size:0.6em;">
1214                                     <td><?php echo xlt('SPH{{Sphere}}'); ?></td>
1215                                     <td><?php echo xlt('CYL{{Cylinder}}'); ?></td>
1216                                     <td><?php echo xlt('AXIS{{Axis of a glasses prescription}}'); ?></td>
1217                                     <td><?php echo xlt('BC{{Base Curve}}'); ?></td>
1218                                     <td><?php echo xlt('DIAM{{Diameter}}'); ?></td>
1219                                     <?php
1220                                     if ($adds) {
1221                                         ?>
1222                                             <td><?php echo xlt('ADD{{Bifocal Add}}'); ?></td>
1223                                         <?php } ?>
1224                                 </tr>
1225                                 <tr>
1226                                     <td><input type=text id="CTLOSSPH" name="CTLOSSPH" value="<?php echo attr($OSSPH); ?>">
1227                                     </td>
1228                                     <td><input type=text id="CTLOSCYL" name="CTLOSCYL" value="<?php echo attr($OSCYL); ?>">
1229                                     </td>
1230                                     <td><input type=text id="CTLOSAXIS" name="CTLOSAXIS"
1231                                                value="<?php echo attr($OSAXIS); ?>"></td>
1232                                     <td><input type=text id="CTLOSBC" name="CTLOSBC" value="<?php echo attr($OSBC); ?>">
1233                                     </td>
1234                                     <td><input type=text id="CTLOSDIAM" name="CTLOSDIAM"
1235                                                value="<?php echo attr($OSDIAM); ?>"></td>
1236                                     <?php
1237                                     if ($adds) {
1238                                         ?>
1239                                             <td><input type=text id="CTLOSADD" name="CTLOSADD" value="<?php echo attr($OSADD); ?>"></td>
1240                                         <?php } ?>
1241                                 </tr>
1242                                 <tr>
1243                                     <td colspan="2" class="right bold text-uppercase"><?php echo xlt('Quantity:'); ?></td>
1244                                     <td colspan="4" class="left"><input id="CTLOSQUANTITY" name="CTLOSQUANTITY" value="<?php echo attr($CTLOSQUANTITY); ?>" type="text" class="left" /></td>
1245                                 </tr>
1246
1247                                 <?php if ($CTL_COMMENTS > '') { ?>
1248                                     <tr>
1249                                         <td colspan="7">
1250                                             <hr />
1251                                         </td>
1252                                     </tr>
1253                                     <tr>
1254                                         <td class="right bold red" colspan="2"
1255                                             style="vertical-align:top;"><?php echo xlt('Comments'); ?>:</u></td>
1256                                         <td colspan="4" class="left">
1257                                             <textarea cols="30" rows="4" id="COMMENTS" name="COMMENTS"><?php echo text($CTL_COMMENTS); ?></textarea>
1258                                         </td>
1259                                     </tr>
1260                                 <?php } ?>
1261                             </table>
1262                             <?php
1263                     } ?>
1264                 </td>
1265             </tr>
1266             <tr>
1267                 <?php
1268                     $signature = $GLOBALS["webserver_root"] . "/interface/forms/eye_mag/images/sign_" . attr($_SESSION['authUserID']) . ".jpg";
1269                 if (file_exists($signature)) {
1270                     ?>
1271                 <td class="center" style="margin:25px auto;">
1272                             <span style="position:relative;padding-left:40px;">
1273                                 <img src='<?php echo $web_root; ?>/interface/forms/eye_mag/images/sign_<?php echo attr($_SESSION['authUserID']); ?>.jpg'
1274                                      style="width:240px;height:85px;border-block-end: 1pt solid black;margin:5px;"/>
1275                                     </span><br/>
1276
1277                     <?php
1278                 } else {
1279                     ?>
1280                 <td class="center">
1281                     <hr style="border:solid 1px black;width:50%;margin:0.5in auto 0;" />
1282                     <?php
1283                 } ?>
1284
1285                     <?php echo xlt('Provider'); ?>
1286                     : <?php echo text($prov_data['fname']); ?> <?php echo text($prov_data['lname']);
1287                     if ($prov_data['suffix']) {
1288                         echo ", " . $prov_data['suffix'];
1289                     } ?><br/>
1290                     <small><?php echo xlt('e-signed'); ?> <input type="checkbox" checked="checked"></small>
1291                 </td>
1292             </tr>
1293
1294
1295         </table>
1296     </div>
1297 </form>
1298
1299 </body>
1300 <script>
1301     $(function () {
1302         $('.header').click(function () {
1303             var $this = $(this);
1304             $(this).nextUntil('tr.header').slideToggle(100).promise().done(function () {
1305                 $this.find('span').html(function (_, value) {
1306                     return value == '<i class="fa fa-plus-square-o"></i>' ? '<i class="fa fa-minus-square-o"></i>' : '<i class="fa fa-plus-square-o"></i>';
1307                 });
1308             });
1309         });
1310         <?php
1311         if (!$detailed) {
1312             echo "$('.header').trigger('click');";
1313         } ?>
1314
1315         $("input[name$='PD']").blur(function () {
1316             //make it all caps
1317             var str = $(this).val();
1318             str = str.toUpperCase();
1319             $(this).val(str);
1320         });
1321         $('input[name$="SPH"]').blur(function () {
1322             var mid = $(this).val();
1323             if (mid.match(/PLANO/i)) {
1324                 $(this).val('PLANO');
1325                 return;
1326             }
1327             if (mid.match(/^[\+\-]?\d{1}$/)) {
1328                 mid = mid + ".00";
1329             }
1330             if (mid.match(/\.[27]$/)) {
1331                 mid = mid + '5';
1332             }
1333             if (mid.match(/\.\d$/)) {
1334                 mid = mid + '0';
1335             }
1336             //if near is +2. make it +2.00
1337             if (mid.match(/\.$/)) {
1338                 mid = mid + '00';
1339             }
1340             if ((!mid.match(/\./)) && (mid.match(00 | 25 | 50 | 75))) {
1341                 var front = mid.match(/(\d{0,2})(00|25|50|75)/)[1];
1342                 var back = mid.match(/(\d{0,2})(00|25|50|75)/)[2];
1343                 if (front == '') front = '0';
1344                 mid = front + "." + back;
1345             }
1346             if (!mid.match(/\./)) {
1347                 var front = mid.match(/([\+\-]?\d{0,2})(\d{2})/)[1];
1348                 var back = mid.match(/(\d{0,2})(\d{2})/)[2];
1349                 if (front == '') front = '0';
1350                 if (front == '-') front = '-0';
1351                 mid = front + "." + back;
1352             }
1353             if (!mid.match(/^(\+|\-){1}/)) {
1354                 mid = "+" + mid;
1355             }
1356             $(this).val(mid);
1357         });
1358
1359         $("input[name$='ADD'],input[name$='ADD2']").blur(function () {
1360             var add = $(this).val();
1361             add = add.replace(/=/g, "+");
1362             //if add is one digit, eg. 2, make it +2.00
1363             if (add.match(/^\d{1}$/)) {
1364                 add = "+" + add + ".00";
1365             }
1366             //if add is '+'one digit, eg. +2, make it +2.00
1367             if (add.match(/^\+\d{1}$/)) {
1368                 add = add + ".00";
1369             }
1370             //if add is 2.5 or 2.0 make it 2.50 or 2.00
1371             if (add.match(/\.[05]$/)) {
1372                 add = add + '0';
1373             }
1374             //if add is 2.2 or 2.7 make it 2.25 or 2.75
1375             if (add.match(/\.[27]$/)) {
1376                 add = add + '5';
1377             }
1378             //if add is +2. make it +2.00
1379             if (add.match(/\.$/)) {
1380                 add = add + '00';
1381             }
1382             if ((!add.match(/\./)) && (add.match(/(0|25|50|75)$/))) {
1383                 var front = add.match(/([\+]?\d{0,1})(00|25|50|75)/)[1];
1384                 var back = add.match(/([\+]?\d{0,1})(00|25|50|75)/)[2];
1385                 if (front == '') front = '0';
1386                 add = front + "." + back;
1387             }
1388             if (!add.match(/^(\+)/) && (add.length > 0)) {
1389                 add = "+" + add;
1390             }
1391             $(this).val(add);
1392             if (this.id == "ODADD2") $('#OSADD2').val(add);
1393             if (this.id == "ODMIDADD") $('#OSMIDADD').val(add);
1394             if (this.id == "CTLODADD") $('#CTLOSADD').val(add);
1395         });
1396
1397         $("input[name$='AXIS']").blur(function () {
1398             // Make this a 3 digit leading zeros number.
1399             // we are not translating text to numbers, just numbers to
1400             // a 3 digit format with leading zeroes as needed.
1401             // assume the end user KNOWS there are only numbers presented and
1402             // more than 3 digits is a mistake...
1403             // (although this may change with topographic answer)
1404             var axis = $(this).val();
1405             var group = this.name.replace("AXIS", "CYL");
1406             ;
1407             var cyl = $("#" + group).val();
1408             if ((cyl > '') && (cyl != 'SPH')) {
1409                 if (!axis.match(/\d\d\d/)) {
1410                     if (!axis.match(/\d\d/)) {
1411                         if (!axis.match(/\d/)) {
1412                             axis = '0';
1413                         }
1414                         axis = '0' + axis;
1415                     }
1416                     axis = '0' + axis;
1417                 }
1418             } else {
1419                 axis = '';
1420             }
1421             $(this).val(axis);
1422         });
1423         $("[name$='CYL']").blur(function () {
1424             var mid = $(this).val();
1425             var group = this.name.replace("CYL", "SPH");
1426             ;
1427             var sphere = $("#" + group).val();
1428             if (((mid.length == 0) && (sphere.length > 0)) || (mid.match(/sph/i))) {
1429                 $(this).val('SPH');
1430                 var axis = this.name.replace("CYL", "AXIS");
1431                 $("#" + axis).val('');
1432                 return;
1433             } else if (sphere.length > 0) {
1434                 if (mid.match(/^[\+\-]?\d{1}$/)) {
1435                     mid = mid + ".00";
1436                 }
1437                 if (mid.match(/^(\d)(\d)$/)) {
1438                     mid = mid[0] + '.' + mid[1];
1439                 }
1440                 //if mid is 2.5 or 2.0 make it 2.50 or 2.00
1441                 if (mid.match(/\.[05]$/)) {
1442                     mid = mid + '0';
1443                 }
1444                 //if mid is 2.2 or 2.7 make it 2.25 or 2.75
1445                 if (mid.match(/\.[27]$/)) {
1446                     mid = mid + '5';
1447                 }
1448                 //if mid is +2. make it +2.00
1449                 if (mid.match(/\.$/)) {
1450                     mid = mid + '00';
1451                 }
1452                 if (mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)) {
1453                     var front = mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)[1];
1454                     var back = mid.match(/([\+\-]?\d{0,2})\.?(00|25|50|75)/)[2];
1455                     if (front == '') front = '0';
1456                     mid = front + "." + back;
1457                 }
1458                 if (!mid.match(/^(\+|\-){1}/) && (sphere.length > 0)) {
1459                     //Since it doesn't start with + or - then give it '+'
1460                     mid = "+" + mid;
1461                 }
1462                 $(this).val(mid);
1463             }
1464         });
1465         $("input,textarea,text,checkbox").change(function () {
1466             submit_form($(this));
1467         });
1468         $("#reverse").click(function () {
1469             //alert('Start');
1470             reverse_cylinder('');
1471             //alert('Finish');
1472
1473         });
1474         $("input[name$='SPH'],input[name$='CYL']").on('keyup', function (e) {
1475             if (e.keyCode == '61' || e.keyCode == '74') {
1476                 now = $(this).val();
1477                 now = now.replace(/=/g, "+").replace(/^j/g, "J");
1478                 $(this).val(now);
1479             }
1480         });
1481
1482     });
1483 </script>
1484 </html>
1485
1486 <?php
1487     $content = ob_get_clean();
1488     echo $content;
1489     exit;
1490 ?>