Introduction to Optometry
and the Optometric Exam
Walter Huang, OD
Yuanpei University
Department of Optometry
Optometry
Definition (Greek)


“Opto” = vision
“metry” = measurement of
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.”
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
The Primary Care Examination
Pretesting
Case history
Confrontational testing
Refraction
Visual functions testing
Ocular health check
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
Pretesting
This part of the exam can be performed by
technicians
Pretesting
Autorefraction
Non-contact tonometry (NCT)
Automated visual field (VF) test
Color vision test
Stereo vision test
Lensometry
Visual Field Test
Humphrey visual field test
Color Vision
Farnsworth-100 hue test
Stereo Vision Test
Stereo fly vision test
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
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
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
Refraction
Retinoscopy
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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
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
Ocular Health Check
Slit lamp examination
Direct ophthalmoscopy
Binocular indirect ophthalmoscopy

The examination of the physical health of the
eye
Slit Lamp Examination
Slit lamp biomicroscope
Dilated Fundus Examination