You’ve received the notice: it’s time for your annual eye exam. You start thinking of excuses—anything to avoid letting the eye doctor do that air-puff-test-thing. But maybe you’ve noticed your prescription isn’t quite right, you’re experiencing headaches or blurred vision, or your eyes have been pretty dry and itchy lately. Perhaps you can’t remember the last time you had your eyes checked. You decide to get it over with. What should you expect during the visit to your eye doctor?
When you arrive at the optometrist’s or ophthalmologist’s office you will be asked to provide or update your health information. Let your doctor know about any changes in vision or medical history, as well as any medications you’re taking
During a routine eye exam your optometrist will assess your eye health and vision quality with a series of tests and, if necessary, provide a prescription for the appropriate corrective lenses. These tests look for vision health concerns such as glaucoma, macular degeneration, and more.
Contact lens and eyeglasses exams are getting easier and easier. New advances in eye examination procedures provide the doctor with a starting point on the eyeglass prescription and a detailed analysis on the shape of the front of the eye. One such instrument is the autorefractor, a computer that estimates the prescription of the eye within a few seconds. The autorefractor test requires only that you sit still while the machine does its job. There are no puffs of air or bright lights—you look into the autorefractor and watch as an image moves in an out of focus. The test determines how light changes as it enters your eye, which then gives your eye doctor an estimate of your appropriate lens prescription.
Noncontact tonometry (NCT), the infamous ‘air puff’ test, is used to measure intraocular pressure, or the pressure inside your eye. This quick, routine eye test checks for damage to the optic nerve, which can cause glaucoma. A quick puff of air flattens your cornea in order to measure the pressure within your eye. Though the puff of air is often surprising, it causes minimal discomfort.
Many optometry offices no longer use the air puff test, and opt instead for alternatives. Goldmann tonometry is a common, and relatively unobtrusive, test that uses yellow dye and a blue light to measure the pressure in the eye. The eye is numbed with drops to minimize discomfort when a special prism is placed against your eye. The amount of force needed to flatten the cornea is measured to gauge the pressure within the eye.
These tests are helpful in detecting glaucoma but are not conclusive in ruling it out. Eye pressures can fluctuate during the course of a day and ideally pressures should be measured in the morning and again in the afternoon when there is concern about high pressure.
Visual Acuity Test
The easily-recognizable letter chart, called a LogMAR chart, is used in a visual acuity test. You will be asked to read the letters on each line to determine which is the smallest line you can see. The results are presented as a fraction—20/20 is considered normal, while 20/60 means the smallest line you can read at a distance of 20 feet can be read at 60 feet by a person with normal vision. Because the eye exam rooms are small, a mirror is used to make the eye chart appear as if it were 20 feet away.
In order to determine how well your eyes work together, your eye doctor will use an occluder to cover one eye at a time. You will be asked to focus on an object in the distance while the optometrist covers one eye, then the other, to observe fixation, alignment, movement, cooperation, and more.
Refraction determines the appropriate prescription lenses to provide normal 20/20 vision. You will look into a phoropter, a large mask-like object that contains hundreds of lens combinations. Your eye doctor will flip through a series of lens options and ask which is clearer, or if they are about the same. Your answers will help determine common eye conditions like nearsightedness, farsightedness, or astigmatism, and can help diagnose additional vision concerns.
This test focuses a single beam of light shaped like a slit into your eye. This lamp provides a magnified view of the structures within your eyes. The retina, cornea, iris, and fluid within the eye are all examined during this part of your appointment. One lens is used to view the front of your eye, and another for the back.
Visual Field Test
Visual field testing is done with a sophisticated computerized instrument which allows the doctor to test the sensitivity of the retina and optic nerve. This test is valuable in assisting the early detection of many eye diseases including glaucoma, optic neuritis, macular degeneration and some neurologic lesions.
Dilation of the eye is a procedure that allows the doctor to temporarily open the pupil in order to view the back of the eye. This procedure is helpful in evaluating for glaucoma, macular degeneration, diabetes, retinal detachment and many other diseases.
Drops are placed in your eyes to widen the pupil, letting more light into your eyes. After about twenty minutes, when your pupils are fully dilated, the eye doctor will examine the retina and other tissue at the back of your eye with a magnifying glass.
You may notice blurry vision and sensitivity to light until the drops wear off, usually within a few hours. Bring sunglasses to wear after the test to alleviate discomfort, and consider finding someone to drive after your appointment.
If an abnormal result is found during any routine tests, further testing may be necessary. It is recommended that you have an eye exam every 1-2 years. Though it may not be the most comfortable hour of your year, it’s important to stay current in order to discover and correct any vision concerns early.
Picking Your Glasses
And finally, the fun part—choosing the perfect frames for your new prescription. With so many options, how do you pick the best eyeglasses? Check out the face shape guide to decide which styles may work for you, and explore these top picks from our team of professionals.
How to Prepare for an Eye Exam
You need to do more than just make an appointment for an eye exam or eyeglasses examination. You also need to gather information to help your optometrist assess your eye health and vision, and provide you with good vision solutions for your varied lifestyle. Write down your answers to these questions and give the information to your optometrist when you go for your exam.
- What chronic health conditions, such as high blood pressure, diabetes or allergies do you or any close family members have? Your eyes can be affected by your general health.
- What eye health problems, like glaucoma, run in your family?
- What prescription and non-prescription medications are you taking? Drugs sometimes can affect your eyes and vision.
- How do you use your eyes for work? Make note of the tasks that you do, how long and how often you do them, the distance between your eyes and each task, and details about your work environment. Such information helps the optometrist determine the exact prescription and any special lens design needed to give you sharp, comfortable vision on the job.
- What are your hobbies and sports? Your optometrist can help you decide whether or not you need a special pair of eyeglasses or safety glasses for your hobby or sport.
- What problems are you having with your eyes? Some symptoms are blurred vision, difficulty changing focus from far to near and visa versa, squinting, double vision, seeing floaters or flashes of light, headaches, difficulty seeing at night or in dim light, burning or itching or tired eyes.
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