An accurate social and occupational history can uncover specific vision requirements of the patient’s profession. Certain occupations require that best vision be at a specific distance. For example, to avoid wearing glasses at the pulpit, a minister may desire that best uncorrected vision be at arm’s length. Military personnel, firefighters, or police officers may have restrictions on minimum UCVA and BCVA and on the type of refractive surgery allowed. Knowledge of a patient’s recreational activities may help guide the surgeon to the most appropriate refractive procedure or determine whether that patient is even a good candidate for refractive surgery. For example, a surface laser procedure may be preferable to a lamellar procedure for a patient who is active and at high risk of ocular trauma. Someone with highly myopic and presbyopic vision who is used to examining objects a few inches from the eyes without the use of glasses (eg, jeweler or stamp collector) may be dissatisfied with postoperative emmetropia. Tobacco and alcohol use should be documented.
Excerpted from BCSC 2020-2021 series: Section 13 - Refractive Surgery. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.