Presbyope has not clear vision with elderly changes. To introduce the essential preliminary examination for presbyope, we performed preliminary tests in 190 elderly patients with case history, slitlamp examination, pinhole test, Hirschberg test, pursuit, stereopsis, pupil reaction, Worth-4 dot test, Amsler grid test, dominant eye test. To perform an examination, the case history is clitical as it guides the whole examination. Chief complaints were epiphora, decreased visual acuity, floaters, hyperemia, eye pain, etc. From the information gained in the case history, we deduced a list of tentative diagnosis. Throughout the examination we decided whether additional tests. The 18.9% of patients didn't have improve visual acuity in pinhole test. Cause of reduced visual acuity in pinhole test was opaque of refractive media such as cataract or pterygium. In 44.7% of patients, stereoauity falls below 40s of arc. The 6.8% of patients have suppression of right or left eye. The 28.9% of patients have metamorphopsia or scotomas in Amsler chart test. Therefore, pinhole visual acuity helps to differentiate ocular pathology from lack of refractive media clarity. Amsler chart is also useful for monitoring age related maculopathy. We suggest that Jones dye test for tear drainage, pinhole test, Amsler grid test and Worth-4 dot test are essential for presbyope.