Refractive surgery patient preparation is a partnership between technical staff, optometrists and surgeons. There are many optometrists now who specialise in this area and some, if not all, of their working day involves preoperative examination and counselling of prospective refractive surgery patients as well as postoperative care. There are many more optometrists whose working day involves refraction and contact lens fitting and possibly diabetic and glaucoma shared care. None of us practise in isolation without ever needing to interface with colleagues whose areas of expertise differ from our own. Our patients will be glad of our professional advice when they are initially considering refractive surgery. This article will outline those areas the optometrist will consider and those examinations the refractive optometrist will usually perform. An overview of current refractive procedures will be given. Detailed descriptions of techniques and their associated complications are beyond the scope of this review; however, there are many publications and research articles to which the optometrist may refer if wishing to delve deeper.