A thorough eye examination consists of a variety of standard tests designed to measure visual acuity and other vision faculties, as well as observe the health of the eye and check for common eye diseases. There is no pain or discomfort associated with an exam, and they typically take less than an hour.
General eye exams can diagnose a variety of eye conditions early on and are the best way to preserve good vision. For children, strabismus (crossed eye) and amblyopia (lazy eye) can often be diagnosed and treated in early childhood, avoiding life-long vision impairment. Also, rare eye conditions from birth (like congenital cataracts) can be diagnosed and treated. For all ages, refraction tests can determine whether prescription eyewear would be beneficial, and what power is necessary. Furthermore, many debilitating eye diseases can be diagnosed before noticeable symptoms occur, potentially making the difference between minor damage and major vision loss.
Eye exams are recommended regularly throughout all phases of one’s life. In the first three years, infants should have their vision checked as part of regular pediatric checkups. Between age three and six, an eye exam every year or two is recommended. Throughout childhood and the teenage years, exams should be scheduled as necessary. It is recommended that all healthy adults have a dilated eye exam annually, especially those who wear glasses or contacts. Additionally, for people with a family history of eye problems, those monitoring a diagnosed eye disease, or those with high-risk conditions such as diabetes, it is very important to have eye exams every six to twelve months.
Common tests and evaluations during an eye exam include:
- Introductory interview: An Ophthalmic technician will ask basic questions about the patient's medical history and eye health history.
- Visual acuity: A common means of measuring visual acuity is the Snellen chart. This is a large card or projection with progressively smaller horizontal lines of random block letters. The test determines how well the patient can discern detail at a given distance. Patients taking this test will cover one eye and then read aloud the letters of each row, starting from the top. The smallest row that can be accurately read indicates the patient’s visual acuity in that eye.
- Tonometry: This test measures intraocular pressure, which can be a sign of glaucoma if pressure is abnormally high. Internal eye pressure is measured either with a puff of air at the cornea or brief direct contact with the cornea, to measure how easily it is pushed inward.
- Pupil exam: The patient’s pupils will be examined for equal size and regular shape. Dr. D will test how they react to light and objects at various distances.
- Eye muscle health and mobility: Eye movement is checked in six directions (corresponding to the six extraocular muscles), as well as by tracking a moving object, such as a pen.
- Visual field: The patient will cover one eye at a time, and with the other eye gazing straight ahead, identify objects or fingers being held up in the patient's peripheral vision.
- Refraction: This test is used to find the best corrected vision, if necessary, for prescription eye wear or contacts. A technician will try various lenses in front of each eye, as the patient focuses on a chart at a distance or up-close, to help determine the best power of correction.
- Color vision: A technician will show the patient a series of images with symbols embedded in color dots or patterns. Based upon the patient’s ability to identify the symbols, certain types of colorblindness can be diagnosed or ruled out.
- Dilation: The patient's eyes will be dilated using special eye drops as a part of most regular exams. This allows a better view into the back sections of the eye.
- External examination: Dr. D will examine all outward visible parts of the eye and surrounding tissue.
- Ophthalmoscopy: This test is often done with an ophthalmoscope, a handheld instrument with a light and magnifying lenses. Alternatively, Dr. D may use other means, such as a slit lamp, which affords a more three-dimensional view. Ophthalmoscopy aims to inspect the retina and surrounding internal eye. This test can help diagnose problems with the retina or detachment of the retina, and monitor diseases like glaucoma and diabetes. An opacity in the eye can indicate a cataract. Dilation of the pupils with eye drops gives a wider view of the internal eye.
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