Introduction to Optometry and the Optometric Exam

1. Introduction to Optometry and the Optometric Exam Walter Huang, OD Yuanpei University Department of Optometry

2. Optometry • Definition (Greek) • “Opto” = vision • “metry” = measurement of

3. Optometrist • American Optometric Assocation (AOA) Definition • “a primary health care professional who examines, diagnoses, treats and manages diseases, injuries, and disorders of the visual system, the eye and associated structures as well as identify related systemic conditions affecting the eye.”

4. Optometry in the USA • Close to 100 years in history • Four-year post-graduate program with the option of completing an additional one-year residency program in a specialty area • Specialty areas include: primary care, cornea and contact lenses, ocular disease, low vision, pediatrics, and vision therapy • National boards examinations and state boards examinations are required for licensing

5. The Primary Care Examination • Pretesting • Case history • Confrontational testing • Refraction • Visual functions testing • Ocular health check

6. The Primary Care Examination • The collection of data, both objective and subjective, allows the clinician to form a diagnosis (Dx) and a treatment (Tx) plan for the patient

7. Pretesting • This part of the exam can be performed by technicians

8. Pretesting • Autorefraction • Non-contact tonometry (NCT) • Automated visual field (VF) test • Color vision test • Stereo vision test • Lensometry

9. Visual Field Test • Humphrey visual field test

10. Color Vision • Farnsworth-100 hue test

11. Stereo Vision Test • Stereo fly vision test

12. Case History • The goal of case history is to obtain an understanding of the patient’s problems and needs • It consists of a series of questions to learn about the patient, the purpose for the visit, and the patient’s ocular history and health history

13. Case History • Case history is the most important part of the exam because it guides the exam by helping to narrow down the list of tests that the clinician must do for the remainder of the exam • It offers a good opportunity for the clinician to get to know the patient as a person and build trust with the patient

14. Confrontational Testing • Visual acuity (VA) – distance and near • Cover test (CT) – distance and near • Near point of accommodation (NPA) • Near point of convergence (NPC) • Pupillary distance (PD) • Extraocular motility (EOM) testing • Pupil testing • Confrontational visual field • Keratometry

15. Refraction • Retinoscopy • The objective measurement of refractive error • It provides a good starting point for the monocular subjective refraction • It is for patients (e.g., pediatric patients) who cannot be relied upon to provide good responses • Monocular subjective refraction • The subjective measurement of refractive error • Binocular balance

16. Visual Functions Testing • Testing is done in free space or behind the phoropter • Often done when patients have specific problems related to these aspects of vision • Binocular vision • Phoria • Vergence • Accommodation

17. Ocular Health Check • Slit lamp examination • Direct ophthalmoscopy • Binocular indirect ophthalmoscopy • The examination of the physical health of the eye

18. Slit Lamp Examination • Slit lamp biomicroscope

19. Dilated Fundus Examination