Ophthalmologic Exam

Check your patient's eye health and record their results using our ophthalmologic exam templates. Click here for a copy and a guide on how to use it.

By Patricia Buenaventura on Jul 15, 2024.


Fact Checked by Nate Lacson.

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Ophthalmologic Exam PDF Example
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What is an Ophthalmologic Exam?

An , also known as an ophthalmic exam, comprehensive eye exam, or routine eye exam, is a series of tests to check a patient’s vision and health. The frequency a patient undergoes an exam is mainly determined by age and eye health. Usually, the ophthalmologic exam consists of the doctor asking or checking the following:

  • Complete eye and family history
  • Vision problems, corrective methods, and current medications
  • Overall health

Depending on the doctor, the document where the doctor records all the results they obtain from their ophthalmologic exam will vary.

If you’re an optometrist or ophthalmologist who has been writing results on an empty clinical note and are looking for a template where you can write your findings, we have the template just for you. On it, you can find the following:

  • Essential information like the exam date, patient’s name, address, email, phone number, patient’s signature, and physician’s name.
  • Sections where you can write the case history, examination results, and recommendations

Want a copy of our template? Read the section below for instructions on how to download and use it.

Check out this video on eye charts to find out more about these assessments:

How Does it Work?

Step One. Download the Template

Access and download a copy of our printable ophthalmologic exam template by doing either of the following:

  • Clicking the "Download Template" or "Use this Template" button above
  • Searching "Ophthalmologic Exam" on Carepatron's template library on our website or app

Step Two. Conduct the Tests

After completing the required basic information, it's time to conduct the test. As the expert, you would know best which and in what order to do the series of assessments.

Step Three. Record Results and Proceed with Recommendations

After every test, it's best to record the results immediately to avoid forgetting. If you observe anything that's not within normal range and can diagnose the patient without further testing, you can proceed with recommendations. Remember to record your recommendations in case you or fellow practitioners use this as a reference.

When Would You Use This Template

Medical health practitioners can use our downloadable ophthalmologic exam template when conducting an eye exam. When discussing when one must conduct an eye exam, however, it depends on the patient’s condition, circumstance, symptom, or risk factor. To help you out, here’s a list of the types of patients who will benefit from an ophthalmologic exam:

  • Wears contact lenses
  • Have an eye injury or eye surgery like refractive surgery
  • Taking medication that has side effects that may affect their eyes
  • Works in occupations or participates in activities that affect one’s eyesight or health
  • Have a history - personal and family - of eye disease
  • Have chronic health conditions, like diabetes, whose complications can affect one’s eyesight
  • Whose family and friends with 20/20 vision recommend that the patient undergo an optic exam

According to research, even if the patient has no vision or eye health concerns, they must still go to an optometrist or ophthalmologist for their regular eye check-up.


Easy to Use

Since the template is designed to record results, the sections are adequately labeled, making the template easy to navigate through and use. And if you follow the instruction in our “How Does it Work?” section, you can effortlessly grab a copy of the template.

Early Detection and Prevention

Conduct the ophthalmology exam with the help of our free ophthalmologic exam template. You can detect any abnormalities you find early on and prevent any potential complications or disease from progressing or worsening.

Establish Baselines for Comparison

Let’s say your patient needs further medical care, is post-surgery, is taking medication for their eyes, or is using glasses/contacts to help them with their vision; you can use our template to establish baselines for comparison before the treatment. That way, you can assess if the treatment is effective.

Fully Digital

Because our template is fully digital, you can access it on any gadget you have on hand and fill it out on your local PDF editor or Carepatron. Moreover, you don’t have to worry about physical storage if you save it on a secure EHR like Carepatron.

Research and Evidence

Though few studies prove an ophthalmologic exam template’s usefulness, there are benefits to using one, as seen in the “Benefits” section above. Ultimately, it’s up to you as the one conducting the test to determine how to make the most out of our template or whether or not using one will be helpful to you. 

Who uses Ophthalmologic Exams?
Who uses Ophthalmologic Exams?

Commonly asked questions

Who uses Ophthalmologic Exams?

Medical practitioners most likely to use our ophthalmologic exam templates are ophthalmologists and optometrists.

When do you use Ophthalmologic Exams?

You use the ophthalmologic exams template while conducting the eye test to either gather new information or to compare the results obtained with the previous ones.

What does Ophthalmologic Exam assess?

Generally, ophthalmologic exams or ophthalmic exams measure a patient’s vision or eye health.

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