In our last post we went through some of the most common preliminary testing you may get before your eye examination with your doctor. Today we are going to take a brief look at the actual examination your optometrist will be doing. As every person has their own unique differences, so too will every doctor with their exam process, so again, this is a general guideline of what is likely to happen during your eye examination.
Taking History and Review of Preliminary test results
Although the technicians who do pretesting will probably ask a fairly thorough medical history, your doctor is likely to go over it again with you, especially if it is your first visit to them. They will take special note of any new changes in your health or medications at this time, as these things can also have an effect on your eyes and vision. They may ask for not only your medical history, but any family medical history that may be pertinent, as there are many eye diseases that could also be hereditary. In these cases, your doctor may ask to see you back at a more regular frequency so they can monitor for any of these possibly inherited eye issues. Your optometrist will also at this time review all the preliminary tests that the technician had done earlier, and if there are any areas of concern with any particular test that was done, he will then know to be extra thorough during those portions of the exam testing.
Visual Acuities is a fancy way of saying your visual correction. This will be the testing to find out your actual lens prescription, and howsuccessful the correction can or will be. This is where you will hear discussion of 20/20 vision, but what does that even mean? 20/20 vision is basically perfect average vision as most of us know. The first number is a patient with perfect average vision and no needed correction and the second number is you. If you have 20/20 vision, it means that at 20 feet away you can see the same as someone else standing 20 feet from that object. If you have 20/10 vision, your eyes would be better than the perfect average, something you can see at 20 feet is something that the perfect average vision would have to see at 10 ft away. If you have 200/20 vision, it means you are struggling to see something at 20 feet, which the person with perfect average vision can see it at 200 ft away. During this testing, your optometrist is going to use the Phoropter, the fancy device that the doctor moves in front of your face with all the wheels and dials on it! This is a fairly complex machine, so I will not be going into the specifics of how to use it. Using the phoropter and different eye charts, the doctor will be able to pin down a good optical prescription for your needs.
The Optometrist will likely at some point use a paddle to do the Cover test. This is a pretty simple test where the doctor covers and un covers one eye at a time and watches your eyes response to this. This is a simple test that can indicate normal muscles movements for the eyes. If there is any muscle issue noted during this test it would be an indication of a phoria or tropia, also known as a lazy eye to the usual folk.
Intra Ocular Pressures
If the technicians do not check your eye pressures during pretesting then the doctor absolutely will check them during the exam, this step is never skipped no matter how healthy your eyes may be. High or low pressures in the eye can indicate some very serious eye diseases, and is one of the first indicators that the eye health has changed. The optometrist will use the most accurate method of obtaining Intra Ocular pressures by using the contact tonometer. This is that funny little cone that shines a blue light, and it will make contact lightly with the surface of the cornea to read the pressure behind it. Dont worry, you wont feel a thing! Your doctor will have numbed your eye surface before doing this test with you.
Light response test
Using a penlight, your doctor may flash a bright light in to your pupils one at a time. What you may not know is that when he is shining light into one of your pupils, he is actually watching the opposite pupil! This is another very simple but super important test as it can tell you that your pupils and light response time is normal. Many people who suffer form concussions or other head injuries may have an uneven pupil response time. Of most concern is if you shine a light into one eye and the other eye's pupil does nothing, this could be an indication of a serious issue, so this test should be performed at every eye examination you go to.
This is usually everyone's least favorite part of the exam, but also one of the most important - the dilation of your pupils. This is done with certain drops that relax the ciliary muscles of the eye (in the iris) which will greatly open up the pupils, but will also cause some blurriness and light sensitivity. Most people find the dilation will affect the near vision the most, but some sensitive people will find their vision is overall blurry in all distances. This is not unusual at all, and your vision will return to normal once those dilation drops have worn off. This can be anywhere from 1 - 6 hours depending on the strength of dilation drops used and the sensitivity of the patient. This portion of the exam is the most requested portion to exempt, but should not be neglected. The use of dilation drops will allow your optometrist to have a clear and full view of the inside and back area of your eye, so it is best if you allow your doctor to do this while you are having your exam. Even with all our fancy scans and technology, nothing is truly better than the doctor being able to clearly see in real time what is happening in your eyes right now!
Once again, this is not a finite and complete list of test you will do with your optometrist. Your doctor may have other additional tests that they would like to perform as well. This is a general guide to some of the most common test doctors will use while testing your eyes and vision. Stay tuned for next time, where we will touch on the next part of the process, sitting down with your optician to discuss glasses!