Our Eye Examination
A comprehensive eye exam includes a number of tests and procedures to examine and evaluate the health of your eyes and the quality of your vision. These tests range from simple ones, like having you read an eye chart, to complex tests, such as using a high-powered lens to examine the health of the tissues inside of your eyes. We use the latest technology and listen to your needs and explain all your options.
Here are some tests you are likely to encounter during a routine comprehensive eye exam:
In addition to enquiring about your ocular history and family history , your eyes are part of your body and can be affected by systemic conditions in the rest of the body. We will ask detailed questions about your overall health, medical conditions and medication usage.
This is the test your doctor uses to determine your exact eyeglass prescription. During a refraction, the doctor puts the phoropter in front of your eyes and shows you a series of lens choices. He or she will then ask you which of the two lenses in each choice (“1 or 2,” “A or B,” for example) make the letters on the wall chart look clearer.
Based on your answers, your doctor will determine the amount of nearsightedness, farsightedness and/or astigmatism you have, and the eyeglass lenses required to correct these vision problems (which are called refractive errors).
Your eye doctor also may use an autorefractor or aberrometer to help determine your glasses prescription. With both devices, a chin rest stabilizes your head while you typically look at a pinpoint of light or other image.
An autorefractor evaluates the way an image is focused on the retina, where vision processing takes place, without the need for you to say anything. This makes autorefractors especially useful when examining young children or people who may have difficulty with a regular (“subjective”) refraction. Automated refractions and subjective refractions are often used together during a comprehensive exam to determine your eyeglass prescription.
The slit lamp is an instrument that the eye doctor uses to examine the health of your eyes. Also called a biomicroscope, the slit lamp gives your doctor a highly magnified view of the structures of the eye, including the lens behind the pupil, in order to thoroughly evaluate them for signs of infection or disease.
The slit lamp is basically an illuminated binocular microscope that’s mounted on a table and includes a chin rest and head band to position the patient’s head properly. With the help of hand-held lenses, your doctor can also use the slit lamp to examine the retina (the light-sensitive inner lining of the back of the eye.)
Tonometry is the name for a variety of tests that can be performed to determine the pressure inside the eye. Elevated internal eye pressure can cause glaucoma, which is vision loss due to damage to the sensitive optic nerve in the back of the eye. Pressure is just one of several risk factors for glaucoma that we evaluate including various methods for evaluating the optic nerve and visual field testing.
The most common method used for tonometry is the “air puff” test. We offer the new generation air puff test that is very gentle and quiet.
Another popular way to measure eye pressure is with an instrument called an applanation tonometer, which is usually attached to a slit lamp. For this test, a yellow eye drop is placed in your eyes. Your eyes will feel slightly heavy when the drops start working. This is not a dilating drop – it is simply a numbing agent combined with a yellow dye. Then the doctor will have you stare straight ahead in the slit lamp while he or she gently rests the bright-blue glowing probe of the tonometer on the front of each eye and manually measures the intraocular pressure. Like the air puff test, applanation tonometry is painless and takes just a few seconds.
Your comprehensive exam includes the use of dilating drops. These medicated eye drops enlarge your pupil so your doctor can get a better view of the internal structures in the back of the eye. Dilating the pupil allows us to check for glaucoma, optic nerve disease, retinal disease or abnormalities, and systemic diseases such as high blood pressure, high cholesterol, and diabetes. Dilating drops usually take about 20 minutes to start working. When your pupils are dilated, you will be sensitive to light, because more light is getting into your eye. You may also notice difficulty reading or focusing on close objects. These effects can last up to several hours, depending on the strength of the drops used.
Dilation is very important for people with risk factors for eye disease, because it allows for a more thorough evaluation of the health of your eyes.
The colour photograph, taken by means of a specialized retinal camera, shows detailed images of the various structures of the retina including the optic nerve, blood vessels, nerve fiber layer, and the macula. It can show abnormalities that may threaten normal vision.
This new technology can greatly aid our ability to accurately diagnose and document many diseases. It also provides a baseline for comparison with previous and future visits, which aids in monitoring disease progression and response to therapy.
Visual Field Testing
Our comprehensive examination includes a computerized screening of your peripheral vision with an Auto Perimeter. This test checks the integrity of the retina and optic nerve. It helps to diagnose or rule out pathology affecting the retina or neurological disorders (ie. multiple sclerosis and pituitary tumors). If a defect is found with this screening Auto Perimeter, we will perform additional testing to determine the exact cause of the defect so we can determine how to fix the actual problem.
These are the most common tests performed during a standard comprehensive eye exam. Depending on your particular needs, we may perform additional tests or schedule them to be performed at a later date.