Many neuro-ophthalmologists insist on a lengthy, detailed examination of the patient. The present author prefers a concise, problem-solving oriented approach, attempting to elicit the patient’s major concerns and problems. Why are you here today? What questions can I answer for you that will make your wait worthwhile? What bothers you most? Questions like these allow determination of exactly what concerns the patient and why he/she has been referred to your office. A patient’s answers might include, ‘My vision is not as sharp as it used to be’, ‘I see double’, or ‘I have headaches’. These leads allow the patient’s major concerns to be focused on instead of wasting time searching elsewhere. There is a place for the extensive neuro-ophthalmologic examination but in the present author’s opinion the majority of neuro-ophthalmic consultations can be handled quickly in an efficient, problem-solving manner. The long drawn-out examination may be saved for obscure, difficult cases. If you know what you are doing and what you are looking for, a brief, problem-oriented history and examination is usually effective.