1. Visual Acuity:

A. check each eye separately

B. indicate whether checking distance or near vision

C. indicate whether checking with correction (glasses or contacts) or without correction

example: "VA 20/30, 20/60 (dist, cc)" means the visual acuity is 20/30 in the right eye and 20/60 in the left eye when viewing the distance eye chart with glasses on

2. Intraocular Pressure:

A. use tonopen if available, otherwise you can use palpation (compare firmness of one eye vs the other, or you could use your own eye as the control)

B. normal IOP is 10-21 mmHg

** do not check pressure if there is a corneal abrasion, corneal ulcer, or suspected ruptured globe

3. Confrontation Visual Fields:

A. check one eye at a time

B. hold up either 1,2,or 5 fingers in the four quadrants: upper right, upper left, lower right, lower left

C. you are looking for dramatic (not subtle) visual field defects: homonymous hemianopsia, homonymous quadrantanopsia, bitemporal hemianopsia, or and altitudinal defect

4. Extraocular movements:

A. ask the patient to follow your finger without moving their head - up, down, left, and right - and note if one or both eyes are able to move or if there is a restriction

5. Pupils:

A. perform the swinging flashlight test to look for a relative afferent pupillary defect (APD) https://www.youtube.com/watch?v=WrNYqNH3b3A

If the requesting provider can at least attempt to convey these five pieces of information, and provide a basic ocular HPI (onset, duration, pain, new vs recurrent, associated symptoms, past ocular medical/surgical history), the ophthalmologist will have a significantly easier time triaging the call and can more accurately assist the provider in creating a plan for the patient.