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Sankara Nethralaya
Sankara Nethralaya
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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
Introduction
Chief complaints
History of present complaints
Review of systems
Past Medical History
Recent Investigations
Medication
Family History
Social History
Drug Allergy
Last spectacle Prescription
Vision Check for Distance and Near
Retinoscopy
Subjective Acceptance
Binocular Balancing
Near point of convergence
Near point of accommodation
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,

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.