Visus writes: on routine

From time immemorial optometry students have worked hard to build up a 'routine' and before the days of OSCEs, were even examined in 'routine'. Why? What's routine about an eye examination, aren't they individually tailored to the needs of the patient?

I'm often asked if I routinely dilate. Quite honestly, it's a daft question and misses the point of the clinical examination. For one thing there is always a balance of convenience against benefit and outcome but more importantly it's a matter of asking why you are doing things. In my opinion, we do not dilate to enlarge the pupil, we dilate because we need a comprehensive examination of the ocular fundus or other structures because a smaller pupil does not permit the view we need with the piece of equipment we want to use.