First-time patients often have questions about what to expect during an eye exam. To help you prepare, here are the five main tests performed during your first appointment.

Your doctor will begin by reviewing your medical history. Then, they will use pain-free eye drops to dilate your pupils.

Evaluation of Medical History

Whether you’re getting your first eye exam or last saw an optometrist a while ago, your visit will start with the doctor reviewing your medical history and current medications.

After that, an eye doctor near me will likely dilate your eyes using drops to get a closer look at the inner eye structure and retina. This may cause your vision to be more sensitive to light and make it harder to focus on objects for a few hours afterward.

Your doctor will also use a tonometer tool to measure the pressure inside your eye (aka eye or intraocular pressure). After numbing your eyes with drops, they’ll touch the front of each eye with a flat-tipped cone device that measures how much force is needed to flatten a small cornea area.

Visual Acuity Test

If you have ever been to an eye care specialist, chances are you have been given a visual acuity test. It’s the standard way to determine your visual acuity. It’s often the first thing your eye doctor will do during a comprehensive exam.


The eye care professional will have you stand about 20 feet away from a row of letters, numbers, or symbols and cover one eye. Then, they will ask you to read the rows of smaller and smaller letters until you can no longer accurately read them. The doctor will then record the line you could no longer see.

Another visual acuity test uses an eye chart with different sizes of capital E’s that face in various directions. It is commonly used for young children or adults who cannot read alphabetical letters and is known as the random E test.

Ocular Motility Test

The ocular motility test determines whether your eyes are properly aligned when looking in different directions. It is used to assess ocular muscle function and detect eye movement disorders. To perform the test, your healthcare provider will ask you to sit up straight and stare at a pen or object 12 to 16 inches from your face. They will then move the object up and down and side to side in a H pattern.

If your versions (binocular movements) are full and you have no complaints of diplopia, your ocular motility test is complete. However, if your test results show that one of your eyes is not moving properly, the doctor may have to perform more testing to find the problem.

Cover Test

A cover test is an objective method for measuring children’s ocular misalignment (strabismus and amblyopia). The clinician covers one eye with a cover (such as the palm of a hand or a paddle) while the patient focuses on a distant and near object. Upon removal of the occluder, the clinician watches for movement of the eyes. These movements are interpreted as the type and magnitude of the ocular deviation.


Your doctor may also perform a refraction examination, in which the eye doctor holds an instrument called a phoropter in front of your face and asks you to look through various lenses to see which is clearer. The results from this test are used to develop your final eyeglass and contact lens prescription.

External Exam

An external exam is an examination that is not administered by a student’s school or college faculties. Instead, these exams are arranged by outside examiners.

During the external exam, your doctor will inspect the alignment and position of your eyes. This is done by shining a light into your eyes and noting whether the reflection is symmetrical (the normal reflex is toward the center of the pupil). Your doctor will also evaluate the color of the conjunctiva, the sclera, the cornea, and the iris and check the extraocular movements of the eyes. This includes examining for abnormal bowing forward of the iris, which is called exophthalmos. The doctor will also look for a normal conjugate movement of the eyes and note any deviations, such as lid lag.