History

The VR surgeon should never rely on the referring physician’s or a nurse’s notes but personally ask the patient about his current complains, past ocular and systemic history, current general condition etc.

Certain conditions such as vitreous floaters may be difficult for the VR surgeon to visualize, which makes asking the proper questions especially pertinent

External inspection

This is crucial mostly in cases of injury, but can reveal other abnormalities such as hypopyon or cataract^a

Visual functions (VA, reading ability, Amsler)

The VA must be taken in both, not just in the affected eye

In many macular conditions (see Sect. 50.​1) the patient’s difficulty reading with the affected eye or the abnormalities found on the Amsler test, especially if these can be compared to a normal fellow eye’s, are more important than the VA level^b

Slit lamp/60–90 D lenses^c

While such lenses provide a small field of view, they have high magnification and resolution, allowing the surgeon to detect minor abnormalities in a three-dimensional view. The eye’s external surface, the anterior chamber and the tissues surrounding/constituting it, the vitreous/cavity, the posterior retina, the optic disc, and to a certain extent the choroid can and should be examined

This method is often employed in determining whether a PVD is present. Unfortunately, what is diagnosed as PVD often proves to be vitreoschisis (see the comments below, under ultrasonography)

The exact location of the retinal break in an eye with RD is much less important to determine if PPV, not SB, is planned (see below and Sect. 54.​5.​1)

Slit lamp/three-mirror and/or 170° lens^d

The former lens has a very small field of view but allows the surgeon to visualize the chamber angle and the peripheral retina as well. Enlarging the field of the lens reduces its resolution