Various embodiments relate to systems and methods for performing eye examinations using an HMD that is able to present an image to each eye individually and then to both eyes simultaneously. Because the HMD, rather than a patient, controls conditions (e.g., glare, brightness) during the examination, test results are more likely to be accurate and reliable. In some embodiments, the HMD employs voice recognition to replicate the conversational exchange that would typically occur between the patient and the ophthalmologist or optometrist. The HMD may also be configured to change the visual environment experienced by the patient during testing. Further yet, the HMD, or another distinct computing system, may be configured to identify abnormal test results in real-time and, in some embodiments, the examination is modified accordingly. For example, tests scheduled to be performed during the examination can be modified or removed and new tests can be added.