A lot happens during the eye exam. Where possible, you should schedule an entire day for the test. After all, once the pupil dilation takes place, you will need the rest of the day to rest. You cannot be productive much after that. Here is what happens:
This is what happens during eye pre-exam
Assuming that this is the first exam or you are changing doctors, you will undergo a lot of preliminaries. At this point, the doctor wants to understand the present and past state of your eyes. In some cases, this first part may take place under the watch of a technician or a clinical assistant. While it is a necessary stage, they are more than capable of handling the process. They will leave the technical details to the doctor, though.
This first part works as an assessment of any risk factors that you may have. It also gives them a glimpse as to any vision issues you may have had in the past or present.
They will ask you whether you are having any problems in the present. Maybe you want your eyes checked because you have noticed a change in your eyes. What is that change? When did it start? How are your eyes feeling? They will also delve into past eye problems. If you have had any, how did you resolve them? Are they a thing of the past?
Corrective eyewear will also be an item of discussion if you wear eyeglasses and contact lenses. Here, the person asking the questions will want to know when you started wearing the glasses or contacts.
They will also want to know the underlying problem being addressed. Is the eyewear prescriptive? If so, is it working? In some cases, you may have worn eyewear in the past but stopped. Why did you do so?
Health problems will also arise during this preliminary assessment. Some health issues put you at more risk of eye problems. Diabetes and high blood pressure are some examples of diseases that could threaten your vision. The doctor will want to know if you have any underlying health issues. Also, what treatments are you using, and have they had any side effects?
Your birth history is also essential. You should note that children born prematurely or with low birth weight are at more risk of eye complications. Other risk factors include if the mother suffered an infection during pregnancy and where the child has crossed eyes. The doctor will want to establish the possibility of birth-related complications.
Allergies are a known source of eye irritation, which, if not dealt with, could lead to more severe issues. The doctor will want to confirm or rule out the possibility of any allergies. They could conduct some allergy tests to ensure that your present and past issues do not owe to this.
Eye surgery and eye trauma contribute significantly to eye problems. In some cases, the eye problems you have could relate to such incidences. The doctor will ask you about these, as well as any treatment plans you are currently on owing to these.
Your family history of eye problems has a bearing on the possibility of eye issues in your case. Thus, the doctor will want to know if anyone in your family has suffered any issues. It helps to do some research before going to the doctor’s office.
Maybe someone in your family had macular degeneration, but you will not know until you ask about it. Having this knowledge enables the doctor to be on the lookout for any warning symptoms.
The history of systemic diseases in your family is also essential. Find out if anyone has suffered from conditions such as diabetes and heart disease in the past. These diseases attack several parts of the body, including the eyes.
At the end of this assessment, the doctor will have a rough idea as to your eye health. But they cannot make any recommendation without looking in your eye, in this case, in the literal sense.
This is what happens during the eye exam
During the exam, you will go through a series of questions that are similar to those asked during preliminaries. The difference here is that the doctor will perform some tests while undertaking the queries.
Your medical history will be of importance in this case. Also, the doctor will want to know why you are getting your eyes checked. Is it a routine exam, or do you have a cause for worry? Do you see well? The doctor will determine this by taking you through a visual acuity test. The result of this will influence the need or lack thereof of prescriptive eyewear.
During the procedure, the doctor will numb your eyes such that you do not experience discomfort. Dilation of the pupils may also be necessary to allow the doctor to see the eyes better. These processes aid the doctor in taking eye pressure as well as performing other tasks that would otherwise be impossible.
Below are some of the vision tests you might undergo during the exam. They work in testing your vision while ensuring that the eyes function as needed:
Eye muscle
In this exam, the doctor wants to check if the eye muscles in charge of movement are working as needed. They move an object around which you should follow with your eyes. All the while, they look out for any warning signs in the movement. These include weakness in the muscles, poor control, and incoordination, among others.
Visual acuity
Under this test, the doctor measures how well you can see by asking you to identify symbols on a chart. They could also direct you to a screen where letters are present. The letters get smaller at each stage, and the doctor tests each eye separately.
That way, the doctor can tell how well you can see from a distance. The next step involves handing you a card with the letters. You should read this from a close range, to test if you can see things close to you.
Refraction assessment
As light moves through your cornea and lens, it bends, in a process known as refraction. This refracted light makes its way to the retina where images get processed. In some cases, the refraction may not take place as it should, and this causes an error in focus at the back of the eye. When this happens, doctors refer to it as a refractive error.
In this case, you need correction, which could be in the form of eyewear or surgery. It ensures that refraction takes place as required such that you can see clearly.
The doctor will take you through a refraction assessment to check the extent of the error. That way, they can tell what kind of lens will provide you with the correction needed. In some cases, you may not require corrective eyewear.
How does the test work? Well, the doctor can use a computerized refractor, which should determine the eyewear you can use. The other technique goes by the name retinoscopy. Here, the doctor shines a light into your eye. They then pay attention to the light your retina reflects through your pupil.
From here, the doctor asks you to look through a device with different lenses. As they move through the combinations, you get to see what gives you the clearest vision. And they use this in assessing what eyewear could work for you.
Perimetry
Under this exam, the doctor examines what you can see on your sides, provided you do not move your eyes. This exam puts your overall vision to the test and can work in showing if your peripheral vision is at its best. Tests work as follows:
Confrontation
In this exam, the doctor sits in front of you, asking you to cover one eye while looking straight ahead. You should not move your eyes even if you see anything moving around you. The doctor then waves a hand around you. Each time you see this movement, you should tell your doctor.
Manual testing
In this variation, you sit near a screen and focus on an object at the center. The doctor then moves an object into your side vision. Once you see it, you should tell the doctor.
Automated
This test is more or less like the manual one, only that this time, the motions are automated. You sit in front of a screen which has blinking lights. Every time you notice a blink, there is a button you should press.
The doctor may administer one or more of these visual field tests. Suppose you cannot see on one side, they can diagnose what the problem is. Glaucoma patients often start by experiencing a loss in their peripheral vision. If this is the case, the doctor can examine the eyes and put you on a treatment plan. This way, you can avoid loss in your central vision.
Color vision
You have heard of people saying that they are color blind. Well, there is only one way to know for sure. It involves taking this test where you should distinguish varying colors. Your doctor will present you with tests featuring multiple colors. If you can see colors well, you will not have trouble picking out shapes and numbers in the tests.
People with color deficiencies find it challenging to pick out some patterns. Other than this test, your doctor may administer other exams.
Slit-lamp
Under this test, the doctor uses a microscope that lights up the front of your eye using light. It is useful in checking for eye health in parts such as the cornea, lens, eyelids, and other such parts.
Sometimes, the doctor uses a dye to stain the tear film. That way, if there is any damage to the front part of the eye, the light will illuminate this. Do not worry about the dye. Your tears will wash it away within a short time.
Ophthalmoscopy
This test also goes by the name funduscopy or retinal exam. It works in examining the back of the eye, including parts such as the retina and the optic disk. For this test, you will undergo pupil dilation to allow the doctor to see the back of the eye. Without this dilation, the pupils will decrease in size in the absence of light.
The test starts with pupil dilation, after which you wait a while in the waiting room. Once the drops have taken effect, the doctor can then use one or more of the following tests:
Direct
Here, the doctor shines a light to the back of the eye through the pupil. In some cases, you may not need dilation given the strength of the light. The doctor uses an ophthalmoscope for this.
Indirect
You can rest in many positions for this exam, including seated or lying down. The doctor uses a mounted light to check your retina and other parts of the eye at the back. It allows the doctor to view these parts in three dimensions, allowing for accuracy.
Glaucoma screening
You are at high risk of developing glaucoma if you have high eye pressure. Your doctor will thus measure the fluid pressure in your eyes, which also goes by the name intraocular pressure (IOP). Where the pressure remains high for extended periods, damage to the optic nerve can occur, threatening your vision. The doctor will use the following tests:
Applanation
In this test, the doctor will administer anesthetic eye drops to your eyes before using a dye on them. They will use a tonometer on your cornea as they determine how much pressure is necessary to flatten part of it. With anesthesia, you will not experience much discomfort. The doctor will follow these movements using a slit lamp.
Noncontact
Here, you will not come to contact with any instruments. The use of anesthesia will, thus, not be necessary. The doctor will direct air onto the surface of your eyes. It works in estimating the pressure in the eyes. The puff of air is sudden and can be unnerving, but it will not hurt you.
After administering these tests, the doctor can tell if you have elevated eye pressure. Where this is the case, the doctor will use a pachometer to measure the thickness of the cornea. Sometimes, doctors use anesthesia on the eyes before placing probes on their surface. It takes a few seconds to get a reading of the dimensions.
Your age and other risk factors may point to the need for more specialized tests.
This is what happens post eye exam
At the end of the above tests, the doctor will be in a position to assess the state of your eyes. They will also talk to you about your risk of eye diseases and preventative measures you could use.
Normal eye exams yield standard results. They include normal vision, absence of eye disorders, good peripheral vision, and normal external eye structures. You should also see the colors.
Where this is not the case, the doctor will provide you with possible treatment plans, including the use of eyewear. In some cases, it might be necessary for you to undergo other tests to check for any underlying health conditions.
