A case history is a detailed record of a patient’s medical history, symptoms, and treatment plan. For eye care, it includes:

Key components:

1. Chief complaint: Patient’s main issue (e.g., blurred vision)
2. History of present illness: Symptoms, duration, severity
3. Medical history: Systemic conditions, medications
4. Ocular history: Previous eye issues, surgeries
5. Family history: Relevant eye conditions
6. Social history: Lifestyle, occupation, habits
7. Medications: Current medications, allergies

Purpose:

1. Accurate diagnosis
2. Personalized treatment plan
3. Monitoring progress