What is A Comprehensive Eye Exam?

Periodic eye and vision examinations are an important part of preventive health care. Many eye and vision problems have no obvious signs or symptoms, so you might not know a problem exists. Early diagnosis and treatment of eye and vision problems can help prevent vision loss.

Each patient’s signs and symptoms, along with your optometrist’s professional judgment, will determine what tests your optometrist conducts. A comprehensive adult eye and vision examination may include, but is not limited to, the following tests.

Patient History
The doctor will ask about any eye or vision problems you are currently having and about your overall health. In addition, a patient history will include when your eye or vision symptoms began, medications you are taking, and any work-related or environmental conditions that may be affecting your vision. The doctor will also ask about any previous eye or health conditions you and your family members have experienced.

Visual Acuity
Visual acuity measurements evaluate how clearly each eye is seeing. Reading charts are often used to measure visual acuity. As part of the testing, you will read letters on charts at a distance and near.

The results of visual acuity testing are written as a fraction, such as 20/40. The top number in the fraction is the standard distance at which testing is done (20 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 to see a letter that should be seen clearly at 40 feet. Normal distance visual acuity is 20/20.

Preliminary Tests
An optometrist may first want to look at specific aspects of your visual function and eye health. Preliminary tests can include evaluations of 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
Refraction determines the lens power you need to compensate for any refractive error (nearsightedness, farsightedness or astigmatism). Using an instrument called a phoropter, your optometrist places a series of lenses in front of your eyes. He or she then measures how these lenses focus light using a handheld lighted instrument called a retinoscope. Your doctor may choose to use an instrument that automatically evaluates the focusing power of the eye. The lens power is then refined based your input on the lenses that give you the clearest vision.

Eye Health Evaluation
Your optometrist may need to perform additional tests based on the results of the previous tests. These tests can help confirm or rule out possible problems, clarify uncertain findings or provide a more in-depth assessment.

At the completion of the examination, your optometrist will evaluate all the test results to determine a diagnosis. He or she will discuss with you any visual or eye health problems and explain treatment options. In some cases, your optometrist may refer you to another optometrist or other health care provider for consultation or treatment.

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.

At the completion of the examination, your optometrist will assess and evaluate the results of the testing to determine a diagnosis and develop a treatment plan. He or she will discuss with you the nature of any visual or eye health problems found and explain available treatment options. In some cases, referral for consultation with, or treatment by, another optometrist or other health care provider may be indicated.

Is Corrective Laser Surgery Right For You?

You’ve worn glasses or contacts forever, and frankly, you’re tired of the hassle. You want to see clearly from the second you wake up in the morning till the moment you drift to sleep at night. The most common way to achieve this is by corrective laser surgery, often called Lasik. But if you’re considering corrective laser surgery, you probably have some questions like, “Will I be laid up for days?” “Will it hurt?” And: “What are the odds it’ll work?” Before you go under the laser, here are a few things you should know.

How is corrective laser surgery done?
After your eye surgeon applies numbing drops, they make an incision in the cornea and lifts a thin flap. Then a laser reshapes the corneal tissue underneath, and the flap is replaced.

Who can get the procedure?
Corrective laser surgery is used to treat the common vision problems nearsightedness, farsightedness, and astigmatism. To find out if you’re a good candidate for the surgery, see an eye doctor for a comprehensive eye exam.

Corrective laser surgery can also be used to fix presbyopia—that effect of aging that makes it harder to focus close-up—but you need to have one eye corrected for near vision and the other for distance.

Also know that as you get older, your vision may continue to get worse, so you may need another corrective laser surgery procedure or glasses down the road.

What’s the success rate?
According to the AAO, 90% of corrective laser surgery patients end up with vision somewhere between 20/20 and 20/40.

There’s chance you will still need to use corrective lenses sometimes: Still, 80% of the survey respondents reported feeling “completely” or “very satisfied” with their procedure.

According to the FDA, results are usually not as good in people who have very large refractive errors. Make sure you discuss your expectations with your eye doctor to see if they’re realistic.

What are the risks?
While the thought of a laser boring into your eye may seem, well, terrifying, the procedure is overwhelmingly safe, the risk of problems is about 1%.

That said, it’s important to weigh the risks against the benefits, as the potential complications can be debilitating. The FDA has a list on its site, including severe dry eye syndrome, and a loss in vision that cannot be fixed with eyewear or surgery. Some patients develop symptoms like glare, halos, and double vision that make it especially tough to see at night or in fog.

One thing you don’t have to worry about: Flinching or blinking during the procedure. A device will keep your eyelids open, while a suction ring prevents your eye from moving.

How long will I be out of commission?
You will need someone to drive you home after the procedure, but you can go back to work the very next day.

How much will this cost?
The cost can range from $299 per eye to more than $4,000 per eye. Geography, technology, and the surgical experience of the doctor all factor into the price. Insurance companies don’t typically cover the surgery, but you can use tax-free funds from your FSA, HSA, or HRA account to pay for it.

How do I get started?
Schedule a comprehensive eye exam with your eye doctor to make sure you are a candidate for corrective laser surgery first. Your eye doctor will discuss your options with you and refer you to the best clinic in your area.