Introduction to Optometry and the Optometric Exam

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Introduction to Optometry and the Optometric Exam

• Walter Huang, OD
• Yuanpei University
• Department of Optometry

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Optometry

• Definition (Greek)
• Opto vision
• metry measurement of

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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.

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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

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The Primary Care Examination

• Pretesting
• Case history
• Confrontational testing
• Refraction
• Visual functions testing
• Ocular health check

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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

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Pretesting

• This part of the exam can be performed by
  technicians

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Pretesting

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

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Visual Field Test

• Humphrey visual field test

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Color Vision

• Farnsworth-100 hue test

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Stereo Vision Test

• Stereo fly vision test

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Case History

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

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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

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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

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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

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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

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Ocular Health Check

• Slit lamp examination
• Direct ophthalmoscopy
• Binocular indirect ophthalmoscopy
• The examination of the physical health of the eye

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Slit Lamp Examination

• Slit lamp biomicroscope

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Dilated Fundus Examination