• Case history; reason for examination, patient medical and eye history, current medications, etc.
• Recording of monocular (one eye) and binocular (both eyes) visual acuities at far and near, with and without present correction
• Pupil responses (Neurological Integrity)
• External examination findings (Biomicroscopy)
• Internal examination findings (Ophthalmoscopy)
• Present prescription (when applicable)
• Retinoscopy (when applicable)
• Subjective refraction
• Phorometry/Binocular testing at far and near
• Tonometry
• Diagnosis/Prognosis
• Specific recommendations

• Keratometry
• Diagnostic lens testing (when applicable)
• Additional external examination (biomicroscopy) with and without contact lenses
• Series of follow-up visits to ensure compliance with maintenance and wearing schedules.

Dilation
Dilation is the enlargement of the pupil diameter, which allows the doctor to observe the internal eye more completely. It is not always part of a provider's standard examination procedure, but providers may perform dilation if any of the following conditions exist:

• Diabetes
• Myopia (nearsightedness) over 6 diopters
• Hypertension (high blood pressure)
• Retinal disease
• Sudden changes in vision
• Flashes or floaters
• Family or personal health history that predicts future ocular complications
• State law requiring dilation

Prescription
Prescriptions are often written following an examination to correct one of the following conditions:

• Myopia
  Myopia ("nearsightedness") is a condition in which light refracted into the eye focuses at a point in front of the retina. Myopic individuals can see objects clearly at near and have trouble seeing at far. Myopia is correctable with eyeglasses or contact lenses. Myopic correcting lenses are concave, or thinner in the center than on the edge.
• Hyperopia
  Hyperopia ("farsightedness") is a condition in which light refracted into the eye focuses at a point behind the retina. Hyperopic individuals can see objects clearly at far and have trouble seeing at near. Hyperopia is correctable with eyeglasses or contact lenses. Hyperopic correcting lenses are convex, or thicker in the center than on the edge.
• Presbyopia
  Presbyopia is the loss of focus ability due to the natural aging process. It is correctable with bifocal or trifocal lenses that reduce the need for the eye to focus when changing from far to near vision.
• Astigmatism
  Astigmatism is a condition in which an asymmetric cornea results in different visual irregularities in different parts of the eye. It is correctable with eyeglass lenses that are ground to a different thickness and curvature. Toric soft contact lenses or rigid contact lenses can also correct some cases of astigmatism.

Ophthalmologist
An ophthalmologist is a medical doctor (MD) or osteopath (DO) who specializes in the treatment of the eye and visual system. In addition to providing routine eye care, ophthalmologists can diagnose and treat eye disease using medical or surgical techniques.

Optometrist
An optometrist is an eyecare professional who has completed four years of optometry school after graduating from college. Optometrists specialize in examination, diagnosis, and treatment of conditions of the visual system, including prescribing and fitting eyeglasses and contact lenses. Optometrists are not authorized to use surgical techniques to treat eye disease.

Opticians

• Dispensing optician
  A dispensing optician helps the patient with the selection of frames, and also measures, adjusts, and fits eyewear using prescriptions supplied by an optometrist or ophthalmologist.
• Laboratory optician
  A laboratory optician can manufacture eyewear using prescriptions supplied by an optometrist or ophthalmologist.
• Optometric technician
  An optometric technician performs the same duties as a dispensing optician, but has also had two years of formal training or has passed the National Optometric Registration Exam for technicians.

DPA certification
Diagnostic pharmaceutical agent (DPA) certification is granted to optometrists who have demonstrated capability to diagnose eye disease. State licensing agencies serve as the certifying body for DPA certification.

TPA certification
Therapeutic pharmaceutical agent (TPA) certification is granted to optometrists who have demonstrated capability to diagnose and treat eye disease. In addition, TPA certified optometrists can prescribe certain medications to treat eye disease. State licensing agencies serve as the certifying body for TPA certification.

Standard bifocal lenses
Bifocal lenses are uncoated, plastic lenses that correct both for distance and near vision in individuals with presbyopia. The top of the lens corrects for distance vision. In the lower part of the lens, there is a visible semicircle ground into the lens that corrects for near vision.

Trifocal lenses
Trifocal lenses are uncoated, plastic lenses that correct for vision at three distances. The top of the lens corrects for distance vision. In the lower part of the lens, there is a visible semicircle ground into the lens that corrects for near vision. Just above this semicircle is an additional lens segment that corrects for distances of about an arm's length away.

Lenticular lenses
Lenticular lenses are designed to treat eye conditions that are more serious than simply myopia, hyperopia, presbyopia, or astigmatism. They are often prescribed after cataract surgery for patients without intraocular implants.

Progressive lenses
Commonly called "no-line bifocals", progressive lenses are bifocal or trifocal lenses that have an invisible corridor of increasing power that leads from the distance portion of the lens down to the reading portion.

Polycarbonate lenses
Polycarbonate lenses are made of a material similar to standard plastic, but are lighter in weight and thinner than uncoated plastic lenses. They offer protection from surface abrasions like scratch resistant coated plastic lenses, and they do not shatter like glass or standard plastic lenses.

Photochromic lenses
Photochromic lenses are light sensitive glass lenses. The glass contains silver halide crystals that darken when exposed to ultraviolet (UV) light and become clear when removed from the light. In their darkened state, photochromic lenses offer protection from potentially damaging UV rays.

Transition lenses
Transition lenses are light sensitive plastic lenses, which makes them lighter in weight than photochromic glass lenses. They become darker when exposed to ultraviolet light and lighten when removed from the light. Transition lenses resist UV radiation both when light and dark, and the lenses are scratch resistant.

Scratch resistant coated lenses
Scratch resistant coated lenses offer protection from most surface abrasions. The coating is included as a part of polycarbonate lenses, but available as an option that is applied to the surface of standard plastic lenses after the lenses are ground.

Glass lenses
Glass lenses are generally heavier than plastic lenses and resist scratching better than uncoated plastic lenses.

Extended wear contact lenses
Extended wear contact lenses are usually soft contact lenses, but are designed to be worn for 24 hours or more at a time. Some lenses are FDA approved for up to 30 days of continuous wear, but most doctors recommend removing and cleaning the lenses at least weekly. Extended wear lenses have replacement schedules that vary significantly by the specific type of lens and length of continuous wear.

Disposable contact lenses
Disposable contact lenses are soft contact lenses, either daily wear or extended wear, that are replaced on a 7 to 30 day cycle. Wearers generally purchase a supply of disposable lenses that will last six months to one year.

Hard contact lenses
Hard contact lenses are made from a rigid plastic resin, polymethylemethacrylate (PMMA). The lenses are more durable and easier to handle than soft contact lenses, but many people may find them uncomfortable. PMMA does not absorb water, and does not allow for the transmission of oxygen through the lens to the eye. Hard contact lenses should be removed daily.

Rigid gas permeable contact lenses
Rigid gas permeable (RGP) contact lenses are made of a non-absorbent material that is oxygen permeable. RGP lenses are durable and easy to handle like hard contact lenses, but more comfortable to wear, though usually not as comfortable as soft contact lenses. Most RGP lenses are used for daily wear, but some lenses can be worn for extended periods of time.

Medically necessary contact lenses
Following certain surgeries, soft contact lenses are sometimes prescribed to act as a replacement for the front covering of the eye that has been removed or disturbed. These contact lens prescriptions are medically necessary, and are generally addressed differently than elective contact lenses in managed vision care policies. Medically necessary contact lenses can also be prescribed for the treatment of certain eye diseases, including keratonocus.

Toric lenses
Toric lenses are either hard or soft contact lenses used to treat astigmatism, which cannot be corrected with traditional spherical contact lenses.

Tinted contact lenses
Many soft and disposable contact lenses have a visibility tint, usually bluish, that makes them easier to see. This visibility tint makes the lenses easier to handle and easier to find if the wearer drops them. There is generally no additional charge for lenses with a visibility tint. Contact lenses can also be tinted to change or enhance the color of the wearer's eye. The lenses are generally made with a clear center so that the wearer's perception of color is not affected. Since these lenses are more complicated to manufacture, they are generally more expensive than clear contact lenses.

PRK
Photorefractive keratectomy (PRK) was one of the first laser refractive surgery procedures performed to correct vision defects. In PRK, the outermost layer of the eye is removed, and then a laser beam is used to reshape the cornea. PRK can be used to correct myopia, hyperopia, and astigmatism, and results are fairly predictable. The removal of the outermost layer of the eye can result in significant discomfort, long recovery time, and the need for steroid drops to reduce inflammation in many patients. PRK was introduced in the early 1990's.

RK
Radial keratotomy (RK) was introduced in the 1980's as a surgical technique to correct myopia. RK involves surgical scarring of the peripheral cornea to change the curvature of the cornea. Small incisions are made at even intervals around the surface of the eye. As the incisions heal, scar tissue develops and causes the cornea to reflect light at different angles. RK outcomes are often unpredictable and rely heavily on the individual surgeon performing the procedure. It also introduces the possibility for serious eye damage and compromises the integrity of the eye. Since the introduction of the laser refractive procedures, RK has rarely been performed in the United States.

AK
Astigmatic keratotomy (AK) is a variation of RK that corrects astigmatism. In AK, incisions are made in the eye at angles instead of at even intervals. AK, like RK, is rarely performed in the United States due to the significant potential for complications and the introduction of laser refractive procedures.