Contribute to the registry

This form records your practice, never an individual case. All answers are chosen from menus.

No patient data is collected here. Do not mention age, dates, initials or any individual history.

What you receive immediately. At the end, the full summary of your contribution is displayed: keep it or print it. Contribution after contribution, you build a structured record of your own practice.
What you receive afterwards. Contributions are aggregated across all participating centres. The quarterly synthesis is sent to registered contributors only — it is not published on the site. You see your own data; you receive everyone's, because you take part.

Molecule concerned Molecule Context of use

What you observe Ocular phenotype observed Frequency among your treated patients Most frequent time to onset Confidence in your estimate

CTCAE grading

The term is your clinical judgement: the tool does not guess it. The grade is computed from the official CTCAE v5.0 definitions.

Reported event (CTCAE term) Best-corrected visual acuity of the worse eye Loss from baseline Impact

What you do

Prophylaxis you use — chaque élément est indépendant.

Preservative-free artificial tears Topical corticosteroids Vasoconstrictors (apraclonidine, brimonidine…) Cold packs Contact lens avoidance Usual management of the event Reversibility observed

Your details — for sending onlyFull nameProfessional email addressSpecialty Practice setting

Submit

Your data. Name, email address, specialty and institution are collected by Pr Eric E. Gabison, data controller, for three purposes: to enrich and correct this tool, to send you the quarterly synthesis of the registry, and to contact you about your contribution where relevant. Basis: your consent, withdrawable at any time. Retention: three years after our last exchange. No transfer, no commercial use. You have rights of access, rectification, erasure, objection and portability, and may lodge a complaint with the CNIL.

I have read the above, I confirm that I am reporting no patient data, and I consent to my data being processed for this purpose.

egabison@for.paris

These observations stay in this browser, on this computer. They are sent to no one — not to the site, not to me. Clearing browsing data would delete them for good: export regularly.

Contribute to the registry

Summary of your contribution

My private register

Summary of your contribution