DICOM PS3.16 2025e - Content Mapping Resource

Optometry and Ophthalmology Templates 

TID 2020 Spectacle Prescription Report

The Spectacle Prescription Report is a structured report used to represent the prescription for a patient. Usually a prescription is for both eyes, but sometimes just one. The Spectacle Prescription Report defines a refractive correction relative to which visual acuity may be measured subjectively, and thus may be referenced by a Visual Acuity Measurements Storage SOP Instance.

Type:

Extensible

Order:

Significant

Root:

Yes

Table TID 2020. Spectacle Prescription Report

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

EV (111671, DCM, "Spectacle Prescription Report")

1

M

Root node

2

>

CONTAINS

CONTAINER

EV (111688, DCM, "Right Eye Rx")

1

UC

IF Right Spectacle Lens is prescribed

3

>>

CONTAINS

INCLUDE

DTID 2021 “Template for Spectacle Prescription Details”

1

M

4

>

CONTAINS

CONTAINER

EV (111689, DCM, "Left Eye Rx")

1

UC

IF Left Spectacle Lens is prescribed

5

>>

CONTAINS

INCLUDE

DTID 2021 “Template for Spectacle Prescription Details”

1

M

6

>

CONTAINS

NUM

EV (111679, DCM, "Distance Pupillary Distance")

1

U

UNITS = EV (mm, UCUM, "mm")

7

>

CONTAINS

NUM

EV (111680, DCM, "Near Pupillary Distance")

1

U

UNITS = EV (mm, UCUM, "mm")

8

>

CONTAINS

TEXT

EV (121106, DCM, "Comment")

1

U


DICOM PS3.16 2025e - Content Mapping Resource