First Look: First Eye Exam
Do you find it difficult to read without squinting or feeling like your eyes are straining? Do you sometimes get a headache as you’re deep into your favorite book? Are you finding it more and more difficult to drive at night? If you answered yes to any of these questions, the chances are you should probably get an eye exam. Let’s take a look at the process and shed some light on the process of obtaining great vision.
Eye exams are very important and should be done on a regular basis and not just when a problem is noticed. Children should have their first eye exam at six months old, three years of age, and right before first grade. These exams are usually done during yearly checkups, as well as through preschool eye screenings. Your child will also get have their eyes examined through grade school on through high school through eye screenings as well. Adults are encouraged to have an eye exam every two years and then annually after the age of 60, as eyesight may start to degrade.
Your doctor may also recommend getting your eyes test more frequently if you have been diagnosed with high blood pressure, diabetes, are taking medications that may affect eyesight, or if you work at a job that leaves you staring at a computer screen through most of your day.
So now that you may have determined that you need or want to get an exam, what do you do now? First things first, contact an optometrist. During the initial call, you’ll probably be asked about any symptoms you’ve been having and your general reason for calling. Once the appointment is set, your journey towards great vision begins.
Before Your Exam
Before you go in for your exam, it is a good idea to be prepared to discuss family history, medications you are taking, any questions you may have, and the reason why you’re in for an eye exam in the first place. Making a list of medications, brief medical history, and any questions you have on a note card or on your phone is a great idea. You’ll not only be asked this information for the office paperwork, but you’ll also be discussing this information with your doctor.
During Your Exam
Once your paperwork has been complete, the testing begins. Your eye exam may take anywhere from half an hour to an hour to evaluate the health and vision of your eyes. The following tests will be done to determine just the spectrum of your vision care needs.
Eye Muscle Movement Test: In this test, your doctor will ask you to visually track an object moving in different directions to determine your range of motion, as well as making sure your eyes are properly aligned.
Eye Cover Test: This test is determine how well your eyes work together. As you stare at a small target some distance away, the doctor will cover and uncover each eye to observe how much your eyes move, watching for an eye that turns away from the target (strabismus). The test may be repeated with a target close to you.
External exam and pupillary reactions: The doctor will watch the reactions of your pupils to light and objects at close distance. At the same time, the doctor will check the exterior eye, looking at things such as the condition of the white of the eyes and the position of your eyelids.
Visual acuity test: You’ll sit in front of an eye chart, with letters that get smaller as you read down each line. You cover each eye in turn and, using the other eye, read aloud, going down the chart, until you can’t read the letters anymore.
Retinoscopy: The eye doctor may shine a light in your eyes and flip lenses in a machine (phoropter) that you look through while staring at a large target, such as a big “E,” or the doctor may use an automated machine (refractor) for the same purpose. By checking the way light reflects from your eyes, the doctor gets an approximate idea of the lens prescription you need now.
Refraction testing: For your exact lens prescription, the eye doctor may use the results of the computerized refractor, or he or she may fine-tune the prescription manually by asking you to respond to questions such as, “Which is better, this or that?” while flipping back and forth between different lenses. If you don’t need corrective lenses, you won’t have this test.
Slit lamp (biomicroscope): The slit lamp magnifies and lights up the front of your eye. The eye doctor uses it to detect several eye diseases and disorders by examining your cornea, iris, lens, and anterior chamber.
Retinal examination (ophthalmoscopy): Using an ophthalmoscope and pupil dilation, the eye doctor examines the back of your eyes: retina, retinal blood vessels, vitreous, and optic nerve head.
Glaucoma testing: This tests whether the fluid pressure inside your eyes is within a normal range. Painless and taking just a few seconds, the test can be done several ways.
The tonometer test: This is the most accurate. With drops numbing your eyes, you stare directly ahead. The eye doctor barely touches the front surface of each eye with an instrument called an applanation tonometer or Tonopen to measure the pressure.
The “puff of air” or non-contact tonometer test: While you focus on a target, you get a small “puff” of air in each eye. Resistance to the air puff indicates the pressure.
Pachymetry: This test uses ultrasound to measure corneal thickness. Thin corneas can lead to falsely low pressure readings and thick corneas can lead to falsely high pressure readings. This test is done just once to create a baseline for future testing. Pachymetry may be needed if you are being considered for corneal surgery.
Pupil dilation (enlargement): With your pupils fully enlarged, the eye doctor will examine the inside of your eyes with different instruments and lights. The pupil-enlarging drops for this part of your eye exam start to work after about 20-30 minutes, making your eyes more sensitive to light and blurring your vision. These effects may last for several hours or longer so it’s important to bring a pair of sunglasses to your exam for the ride home.
Visual field test (perimetry): Your visual field is the area you can see in front of you without moving your eyes. Using one of three tests, the eye doctor “maps” what you see at the edges (periphery) of your visual field, using this map in diagnosing your eye condition.
After Your Exam
After your eye exam is complete and all testing is complete, your doctor will determine where you fall on the eye health spectrum and discuss his / her findings based on the information gathered. Depending on the data, your doctor will discuss the best course of action and treatment plan to get you seeing the world clearly and correctly.