How to examine the eyes
Other platforms explain it with text and video. In VMS you practice it on the patient.
The eye exam starts with vision: acuity is the vital sign of the eye. Then pupils, fields, movements and the back of the eye.
Step by step
Prepare
Clean your hands, introduce yourself and get consent. Ask about pain, redness, vision loss, flashes and floaters. [1]
Visual acuity
Snellen chart at 20 feet (6 m), one eye at a time, with glasses. Use a pinhole if vision is reduced. Record as 20/x. [1]
Outside of the eye
Eyelids, lashes, conjunctiva, sclera color and tearing. [1]
Pupils
Size, shape, direct and consensual reaction, accommodation, and the swinging flashlight test. [1]
Visual fields and movements
Confrontation test for fields; follow your finger in an H shape; corneal light reflex for alignment. [1]
Fundoscopy
Dim room. Your right eye for their right eye. Find the red reflex from about 15 inches, then follow it in to the optic disc, vessels and macula. [1]
Red flags
Sudden vision loss, a painful red eye, new flashes and floaters, and a fixed dilated pupil need urgent care. [2]
Common errors
- Testing acuity without the patient's glasses.
- Doing fundoscopy in a bright room.
- Missing the red reflex check in children.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- NCCPA PANCE Content Blueprint
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint. VMS is not affiliated with these organizations. Updated: 2026-10-11.