HPI: 43 yo Female w/ ocular history which includes only mild myopia, presents for annual refraction exam. Upon questioning, patient states she has been experiencing dry eyes and mild ocular irritation. In addition, family members have told her that her eyes "look different". She denies double vision

PMH: None

POHx: myopia

Medications: None

Allergies: NKDA

SocHx: No tobacco, EtOH or recreational drug use

ROS: Pt does note increased anxiety, slight tremor, increased sweating, unintentional weight loss and palpitations which have appeared and gradually worsened over the past year.