The history of Ophthalmic microscopes dates back as far as surgery began. The early beginnings of Ophthalmic microscopes started with the frequency of use of binocular loupes in general surgery; paralleled by the increasing use of these was the development of new and finer instruments leading to specializations in the field, more advanced techniques, and better instrumentation. As early as 1949, other specialties encountered surgical problems requiring an increased technical accuracy and better visualization of the operative field, thus began to use higher magnification and finer instruments. Surgeons demanded higher magnification and movability thus the head-supported loupe arose. Even more, other variations of a basic instrument designed as a culposcope in 1949 were invented to suit surgeons needs.
           
Although some ophthalmologists showed little interest at that time in Ophthalmic microscopes, mainly because of the skills required to operate such, specialization in the field showed the potential use of Ophthalmic microscopes in ophthalmic surgeries. Advances in magnification and ease in the use of these new equipments gave way to microtechniques in surgery and attracted more and more surgeons into instrumentation. The details in surgeries such as for cataracts made surgeons begin to desire the improvement of Ophthalmic microscopes. Soon studies of optics resulted in the advancement of features; higher resolution, continuous zoom, and higher accuracy. Effects of the rapidly growing technology gave birth to numerous changes in the Ophthalmic microscopes used by ophthalmic surgeons; incorporation of a display device, motorized motion, eye protection filters, integrated slit lamps, and many more features can now consistent in present day ophthalmic microscopes.

Nowadays ophthalmic microscopes come in different forms and sizes, with varying functions and purposes—usually surgical. Medical advancements in microscopy, and the incorporation of advanced computers into these devices, take medical science engineering next to what we can call  “rocket science.” Let us look at some of the common features of an ophthalmic microscope.
           
Basically, ophthalmic microscopes are composed of the main optic device; a slit lamp for example, is an instrument consisting of a microscope combined with a rectangular light source, used for examination of the cornea, aqueous humor, retina of the eye, etc. –it is sometimes referred to as a biomicroscope; a keratoscope may also be included. Ophthalmic microscopes are marked with lines or circles for used in examining the curvature of the cornea's meridian. Stereoscopic inverters or stereoscopic observers provide three-dimensional images of the cornea by projecting the image using high resolution prisms at different angles. Usually, an ophthalmic microscope is viewed through binocular eyepieces with adjustable angles for ease. Magnification can range from 4x up to 25x in operations but never usually any higher because the image usually becomes unrecognizable and the instruments may obstruct the view. Illumination is usually brought about by halogen lights mounted close to the optic device. The optic device is then attached to a mounting system wherein it is made up of a base stand and a carrying arm complete with movable joints carrying the main optic device; although in some cases, the arm is mounted onto a wall or a ceiling.

Ophthalmic microscopes may also be in the form of a mount-type; a wall unit has the suspending arm mounted onto a wall, extending the range of the optic device's sight. The automatic balancing arms can be controlled by the surgeon manually or through a joystick or a foot pedal; this would ensure balance and accuracy. A ceiling unit is similar to the wall unit but the arm is mounted from the ceiling. Finally, a stand eye scope is one where the optic device is held up by a base stand and extended by mechanical arms and joints controlled in the same way mentioned.

Technological breakthroughs in imagery and digital video recordings have been incorporated in these machines; digital cameras now record operational procedures in high resolution video formats. It is often used in studies and experiments, and in some occasions for storing operative data. Digitized image projection through high resolution monitors are also often features of the present machines. They enable second hand opinions for surgeries during operations from other co-surgeons, and in some cases, an assistant microscope is present for actual viewing. Dual eyepiece system is sometimes added as a feature in surgeries wherein two doctors are facing each other or one is positioned on either side of the surgeon.  The arms movements are usually soft and accurate to avoid the device from getting in the way of the surgeons instruments; some even features computer-controlled balancing system for some stand eye microscopes. Back up lamps and back up power supplies removes the complexity surgeons losing focus in critical situations brought up by malfunctions. Even more, some high-tech ophthalmic microscopes also come in with auto focusing features and manual overrides for fine tunings.