Eye Exam Form Template
Streamline Your Eye Exams with Our Proven Form Template
Struggling to keep track of detailed eye examination results? This eye exam form template helps you efficiently document vision tests and assessments, ensuring better patient care. Benefit from organized data collection, improved reporting accuracy, and time savings on paperwork, all while maintaining compliance with medical standards for documentation. Start using our live template to simplify your documentation process today.
When to use this form
Use this template for new patient intake, annual checkups, or urgent complaints like sudden floaters, eye pain, or a broken pair of glasses. It works for clinics, school screenings, and mobile outreach, so you collect the same history, acuity, and exam findings every time. When you issue or update a prescription, attach an Eye prescription form. If the patient uses multiple medications or eye drops, pair the visit with a Medication reconciliation form to catch interactions that affect vision or pressure. For complex cases or referrals, summarize outcomes with a Case report form. The result: faster visits, fewer omissions, and clear next steps for follow-up or treatment.
Must Ask Eye Exam Questions
- What symptoms or vision changes are you experiencing, and when did they start?
Timing and triggers help you triage urgency and choose the right tests. Clear detail guides decisions like dilation, imaging, or same-day referral.
- Do you wear glasses or contact lenses, and how old is your current prescription?
This sets a baseline for refraction and reveals over- or under-correction. It also flags contact lens comfort or safety issues that affect fit and eye health.
- Are you taking any medications, supplements, or eye drops? Please include doses and timing.
Many drugs change vision, pupil size, or eye pressure, so the plan must account for them. To keep this list accurate between visits, maintain a Medication log form.
- Do you have a history of eye disease, surgery, injury, or a family history of glaucoma or macular degeneration?
Past events and genetics shape risk and screening intervals. They also guide tests such as OCT, visual fields, or dilation.
- How do you use your eyes each day (screen time, night driving, sports, or hazardous work)?
Visual demands inform lens type, coatings, and safety eyewear. They also determine follow-up timing and practical workplace recommendations.
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