Preliminary Examination

To enable proper diagnosis of patients’ ocular ailments, a detailed preliminary investigation is a must. The sequential preliminary eye examination of a patient by an optometrist is as follows:

Preliminary Investigation
1 Introduction 14 Subjective Acceptance
2 Chief complaints 15 Binocular Balancing
3 History of present complaints 16 Near point of convergence
4 Review of systems 17 Near point of accommodation
5 Past Medical History 18 Determination of Near Addition
6 Recent Investigations 19 Extra Ocular Motility
7 Medication 20 Cover Test
8 Family History 21 Pupillary evaluation
9 Social History 22 Colour vision
10 Drug Allergy 23 Anterior segment Evaluation using Slit lamp Biomicroscope
11 Last spectacle Prescription 24 Intra ocular Pressure using Applanation Tonometer
12 Vision Check for Distance and Near 25 Dilatation Orders
13 Retinoscopy
Example:

  • Diabetic patients are referred to the Medical retina clinic.
  • Symptomatic Myopes and patients with myopia of > 3 DS are referred for a detailed fundus evaluation with medical retina clinic.
  • Patients requiring cataract surgery are referred to the cataract and IOL clinic.
  • Patients with increased IOP, narrow angles, occludable angles or any glaucomatous cupping are referred to glaucoma department.
  • Patients with any neurological problem, pupillary abnormalities or disc pallor are referred to neuro ophthalmology clinic.
  • Patients interested in contact lenses are referred to the contact lens clinic.
  • Patients requiring detailed binocular vision assessment are referred to the orthoptics clinic.