The traditional approach to office evaluation of patients being considered for cataract surgery begins with obtaining a history of significant visual symptoms followed by visual function testing and refraction, IOP measurement, slit lamp examination – hopefully including 90 D lens examination of the macula and optic nerve – and, finally, dilated pupil retinal examination with the indirect ophthalmoscope. If the visual function, visual complaints and slit lamp examination verify the need for cataract surgery; the next step is an array of tests to determine lens implant power, axis, and other parameters. In my view, OCT should also be performed in all patients.