What Is Typically Listed on a Vision Exam Form?


Quick Answer

A vision exam form usually lists the patient's name, age and contact details in the first section. The second section, completed by the examining doctor, lists the patient's ocular and medical history including possible drug allergies. There is a third section that lists actual eye examination results.

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Full Answer

An eye examination looks at visual acuity, eye pressure and eye movements and coordination. The vision exam form requires the examining doctor to fill in results of an external exam, internal exam, pupillary reflex, binocular function, color vision and glaucoma evaluation. Some forms require a basic examination while others may be more detailed. A doctor fills a diagnosis and recommendation section after interpreting the results of the eye exam.

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