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


Chief complaints

History of present complaints

Past Medical History

Recent Investigations


Family History

Social History

Drug Allergy

Last spectacle Prescription

Vision Check for Distance and Near


Subjective Acceptance

Binocular Balancing

Near point of convergence

Determination of Near Addition

Extra Ocular Motility

Cover Test

Pupillary evaluation

Colour vision

Anterior segment Evaluation using Slit lamp Biomicroscope

Intra ocular Pressure using Applanation Tonometer

Dilatation Orders.

This preliminary examination is followed by a detailed posterior segment (fundus) evaluation by the Ophthalmologist. Based on the correlation of all the clinical findings, diagnosis of the ocular ailment (if any) is arrived at and managed accordingly.

Referral to the ophthalmology or optometric specialties is done as required.

Like as below example :-

Diabetic and Htn. patients are referred to the Medical retina department.
Symptomatic Myopes and patients with myopia of > 3 DS are referred for a detailed fundus evaluation with medical retina department.

Patients requiring cataract surgery are referred to the cataract and IOL department

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 department.

Patients interested in contact lenses are referred to the contact lens clinic.

Patients requiring detailed binocular vision assessment are referred to the orthoptics clinic.