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Neurologic eye conditions (If checked, complete # 12 below) Tumors and neoplasms (If checked, complete # 13 below) Other eye conditions (If checked, complete # 14 below) For each checked answer, complete the appropriate section (2-14) below: 2. Anatomical loss of eyelids, brows, lashes . a. Indicate condition and side affected (check all that ... ................
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