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Procedures to include in an examination in routine practice

You should select additional procedures to those in the routine eye examination, according to the patient’s clinical need. You should normally: 
  1. assess the optic nerve head. This would include assessing the size of the disc
  2. measure the IOP. See paragraph A239.
If a patient refuses to consent to tonometry after you have explained the reason for this procedure, you should record the patient’s reason for refusal. You should use your professional judgement to decide how best to manage the patient.
The examination may also include an assessment of the central visual field using perimetry with threshold control. Where necessary, you should repeat visual field assessment to obtain a meaningful result.
If the patient is at risk from glaucoma, you should assess the anterior eye and angle, for example by slit lamp – Van Herick technique. You should also look for signs of pigment dispersion syndrome (PDS) and pseudoexfoliation (PEX).