Final answer:
A medical examiner must inquire about eye conditions during an eye exam, potentially referring to a specialist for conditions like trachoma. Assessment of eye movement can reveal internuclear ophthalmoplegia leading to diplopia. Neurological checks complement these tests for an overall health assessment vital for driving safety.
Step-by-step explanation:
During a routine eye exam, a medical examiner should ask the driver about any history of eye conditions that could impair their ability to drive safely. If any issues are indicated, the medical examiner may request a specialist evaluation to further assess the driver's vision and eye health. This is critical, as about one out of two people eventually need some form of vision correction in their lifetime, and undiagnosed eye diseases can lead to vision loss. In particular, the examiner should check for signs of trachoma, which can cause severe eye irritation and even blindness, and seek specialist advice if needed.
Additional tests for drivers might include assessing eye movement to check for internuclear ophthalmoplegia, which leads to diplopia or double vision, by having the patient track a pen through their visual field. The examiner is watching for proper conjugate eye movement, ensuring both eyes move in synchronization. During a neurological assessment, a doctor might perform specific tasks such as having a patient smile, raise eyebrows, stick out their tongue, and shrug their shoulders to identify any deficiencies that may point to nerve damage or central nervous system disorders like a stroke, especially if the patient reports sensory issues like pins and needles or difficulty in feeling touch.