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Physical examination procedures
9.1 Blood pressure measurement Hypertension, the most common cause of mortality in the developed world, is a major contributing factor in stroke, myocardial infarction, coronary artery disease, heart failure, abdominal aortic aneurysm, and peripheral arterial disease. , Hypertension affects about…
Variations in appearance of the normal eye
The vast majority of patients examined in optometry practice have normal, healthy eyes. This chapter presents information about some of the subtle variations that occur in the normal eye and presents changes that commonly occur with normal ageing. To discriminate…
Ocular health assessment
7.1 Examination of the anterior segment and ocular adnexa This includes the eyelids, eyelashes, conjunctiva, tear layer, cornea, anterior chamber, iris, crystalline lens, and anterior vitreous. 7.1.1 The evidence base: When and how to assess the anterior segment and adnexa…
Assessment of binocular vision and accommodation
Tests of accommodation and binocular vision are presented together in this chapter because, from a problem-oriented examination viewpoint, it is frequently not obvious whether a patient’s signs and symptoms are primarily accommodative or binocular in origin. Core or ‘entrance’ tests…
Contact lens assessment
Patient preference for contact lenses over glasses is common owing to perceived conveniences (i.e., no spectacle fogging, can see better in rain, can wear off-the-shelf sunglasses) as well as improvements in appearance and abilities in sports. There is a relatively…
Refraction and prescribing
4.1 Focimetry (vertometry or lensometry) The instrument used to measure lens power , optical centres, and any prism in glasses has been known by a variety of trade names including refractionometer, dioptrescope, and ultimeter, but currently the most commonly used…
Assessment of visual function
3.1 Distance visual acuity Visual acuity (VA), which is a measure of the patient’s ability to resolve fine detail, is the most commonly used measurement of visual function. Distance and reading VAs are used to assess the adequacy of glasses…
Communication skills
2.1 Turning anxious patients into satisfied ones 2.1.1 Patient satisfaction is linked to good communication skills The research literature consistently indicates that patient satisfaction is linked with clinicians having good communication skills: being able to explain diagnoses, prognoses, treatment, and…
Evidence-based eye examinations
1.1 Several tests are widely used because of tradition and not evidence Evidence-based optometry means integrating individual clinical expertise with the best currently available evidence from the research literature. For the majority of primary eye care procedures described, the evidence…