The history and examination permit accurate diagnosis of most eye disorders, without need for laboratory or imaging studies. The essential ocular exam includes assessment of the visual acuity, pupil reactions, eye movements, eye alignment, visual fields, and intraocular pressure. The lids, conjunctiva, cornea, anterior chamber, iris, and lens are examined with a slit lamp. The fundus is viewed with an ophthalmoscope.

Acute visual loss or double vision in a pt with quiet, uninflamed eyes often signifies a serious ocular or neurologic disorder and should be managed emergently (Chap. 41). Ironically, the occurrence of a red eye, even if painful, has less dire implications as long as visual acuity is spared.