Comprehensive Eye Examination
Comprehensive annual eye and vision examinations should be a part of everyone's regular health care. Many eye and vision problems have no obvious signs or symptoms. As a result, individuals are often unaware that problems exist. Early diagnosis and treatment of eye and vision problems are important for maintaining good vision and eye health, and when possible, preventing vision loss.
Patient History
A patient history helps to determine any symptoms the individual is experiencing, when they began, the presence of any general heath problems, medications taken and occupational or environmental conditions that may be affecting vision. We will ask about any eye or vision problems you may be having and about your overall health. We will also ask about any previous eye or health conditions of yours and your family members.
Visual Acuity
Reading charts are often used to measure visual acuity. Visual acuity measurements evaluate how clearly each eye is seeing. As part of the testing, you are asked to read letters on distance and near reading charts. The results of visual acuity testing are written as a fraction such as 20/40.
When testing distance vision, the top number in the fraction is the standard distance at which testing is done, twenty feet. The bottom number is the smallest letter size you were able to read. A person with 20/40 visual acuity would have to get within 20 feet of a letter that should be seen at 40 feet in order to see it clearly. Normal distance visual acuity is 20/20.
Preliminary Tests
Preliminary testing may include evaluation of specific aspects of visual function and eye health such as depth perception, color vision, eye muscle movements, peripheral or side vision, and the way your pupils respond to light.
Keratometry
This test measures the curvature of the cornea, the clear outer surface of the eye, by focusing a circle of light on the cornea and measuring its reflection. This measurement is particularly critical in determining the proper fit for contact lenses.
Refraction
Determining refractive error with a phoropter and retinoscope Refraction is conducted to determine the appropriate lens power needed to compensate for any refractive error (nearsightedness, farsightedness, or astigmatism). Using an instrument called a phoropter, we will place a series of lenses in front of your eyes and measures how they focus light using a hand held lighted instrument called a retinoscope. The doctor may choose to use an automated instrument that automatically evaluates the focusing power of the eye. The power is then refined by patient's responses to determine the lenses that allow the clearest vision.
This testing may be done without the use of eye drops to determine how the eyes respond under normal seeing conditions. In some cases, such as for patients who can't respond verbally or when some of the eyes focusing power may be hidden, eye drops are used. The drops temporarily keep the eyes from changing focus while testing is done.
Eye Focusing, Eye Teaming, and Eye Movement Testing
Assessment of accommodation, ocular motility and binocular vision determines how well the eyes focus, move and work together. In order to obtain a clear, single image of what is being viewed, the eyes must effectively change focus, move and work in unison. This testing will look for problems that keep your eyes from focusing effectively or make using both eyes together difficult.
Eye Health Evaluation
Tonometry measures eye pressure. Elevated pressure in the eye signals an increased risk for glaucoma. External examination of the eye includes evaluation of the cornea, eyelids, conjunctiva and surrounding eye tissue using bright light and magnification.
Evaluation of the lens, retina and posterior section of the eye may be done through a dilated pupil to provide a better view of the internal structures of the eye.
Measurement of pressure within the eye (tonometry) is performed. Normal eye pressures range from 10 to 21 millimeters of mercury (mm Hg), averaging about 14 to 16 mm Hg. Anyone with eye pressure greater than 22 mm Hg is at an increased risk of developing glaucoma, although many people with normal pressure also develop glaucoma.
Supplemental testing
Additional testing may be needed based on the results of the previous tests to confirm or rule out possible problems, to clarify uncertain findings, or to provide a more in-depth assessment.
Pachymetry
Pachymetry is a simple, quick painless test to measure the thickness of the cornea. Having this measurement allows the doctor to get a better understanding of your eye pressure readings. Pachymetry is an integral part of the Glaucoma examination. It is also a very important piece of information for patients who are considering LASIK surgery and to monitor the progression of certain corneal conditions such as Fuchs Endothelial dystrophy.
Refractive Surgery Evaluation
Laser eye surgeries correct for nearsightedness, farsightedness, and astigmatism. During your refractive surgery evaluation, we will ask you a few questions and perform various tests to determine if you are a good candidate for surgery. If you are determined to be a good candidate, we will work with an eye surgeon to determine the best type of refractive surgery for you. After the surgery is complete, we will evaluate the progress of the surgery, and make sure no complications have occurred.
In addition to measuring your visual acuity, refraction, eye coordination and visual skills, we also take the time to thoroughly evaluate your eye health including cataract, glaucoma and retinal evaluation. Drops are routinely used during the exam for enhanced testing and viewing.