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.

November is National Diabetes Month

If you are one of more than 25 million Americans with diabetes, you may already know the importance of watching your diet and keeping track of your blood sugar. But did you know it’s also important to have regular eye exams?

In the United States, diabetic eye disease is the leading cause of vision loss among working-age adults. Diabetic retinopathy is the most common form of this disease, and affects about 28.5 percent of Americans with diabetes age 40 and older. That’s more than 7 million people, and the number is expected to reach more than 11 million by the year 2030.

The condition can creep up quietly. It gradually weakens small blood vessels in and around the retina, the light-sensing layer of tissue at the back of the eye. If the disease progresses, these vessels may rupture and leak blood into the eye; they can also spread and grow on the surface of the retina and cause scarring.

Typically, diabetic retinopathy has no symptoms until it reaches an advanced stage. But the disease can be detected early through a comprehensive dilated eye exam. In this procedure, an eye professional will put drops in your eye to dilate (widen) the pupil, which allows a closer look at the retina.

The good news is that with early detection, timely treatment, and appropriate follow-up, the risk of severe vision loss from diabetic retinopathy can be reduced by 95 percent. There are several effective treatment options including laser surgery and injections of anti-VEGF drugs. These drugs block the actions of a protein that can cause abnormal blood vessels to grow and leak fluid.

November is National Diabetes Month. If you have diabetes, it’s a good time to remember these health tips:

  • Get a comprehensive dilated eye exam at least once a year.
  • Control your blood sugar, blood pressure and cholesterol levels. By controlling your diabetes, you’ll reduce your risk of diabetic eye disease.
  • Talk to your eye care professional about diabetic retinopathy.
  • Learn more about diabetic eye disease from the National Eye Institute, part of the National Institutes of Health.
  • Learn more about preventing and managing diabetes from the National Diabetes Education Program.