Assess functional vision by having the patient read a label or identify objects at near and distance with their usual correction; note each eye if able.
Inspect the external eye in good light for redness, discharge, lid or lash changes, and conjunctival or scleral abnormality.
Assess pupils grossly for size, equality, and direct reaction to light; refer detailed extraocular and field testing to Neurological.
Characterize any visual change fully — sudden versus gradual, painful versus painless, and any associated symptoms — because the pattern distinguishes an emergency.
Observe eye-drop or ointment administration — hand hygiene, lower-lid technique, not touching the tip to the eye, and waiting between drops.
Confirm the availability and condition of glasses and low-vision aids and observe their use.
Ask the date of the last dilated eye exam in diabetic and hypertensive patients and reinforce the surveillance schedule.
For a chemical exposure or sudden painless loss, treat or escalate immediately rather than completing a full exam.
