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.

Contact Lens Discomfort?

Ever feel like something’s not quite right with your contact lenses? If so, you’re not alone. Plenty of people who wear contacts experience contact lens discomfort at some point.

Episodes of contact lens discomfort usually does not mean you no longer are a good candidate for contact lenses or that you have to permanently stop wearing contacts. It’s likely that a simple change to your lenses, care products or daily habits will make your contact lenses much more comfortable.

Detection And Treatment Of Contact Lens Discomfort
To determine the specific causes of your contact lens discomfort and appropriate remedies, you need to see your optometrist. A visit to your eye doctor also will rule out the possibility that your discomfort indicates a more serious underlying problem.

Remove your contact lenses and visit your eye doctor if:

  • Eyes stinging, burning, itching (irritation), or other eye pain
  • Comfort is less than when lens was first placed on eye
  • Abnormal feeling of something in the eye (foreign body, scratched area)
  • Excessive watering (tearing) of the eyes
  • Unusual eye secretions
  • Redness of the eyes
  • Reduced sharpness of vision (poor visual acuity)
  • Blurred vision, rainbows, or halos around objects
  • Sensitivity to light (photophobia)
  • Dry eyes

Remember: If your eyes don’t feel good, look good, or see well, you need a checkup by an eye care professional. Sometimes a minor contact lens irritation, if left untreated, can develop into a more serious problem — occasionally one that can be sight-threatening.

Your eyes change, contacts lenses that worked for you before, may not work for you now. Ask your eye doctor about new types of contact lenses and/or cleaning solutions that can relieve discomfort, and improve your vision.

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.

The Aftermath of The Solar Eclipse

What is Solar Retinopathy?
The name given to eye damage which has been caused by looking directly at the sun is solar retinopathy. The recent eclipse has brought attention the harmful effects of viewing the sun without proper viewing devices.

Your eye has an opening at the front (pupil) and a lens which adjusts to focus images you are looking at onto the retina at the back of the eye. The retina is made up of delicate tissue that is sensitive to light. Solar retinopathy occurs when the harmful radiation from the sun reaches the eye and is concentrated by the lens onto the retina. This burns the retina and destroys the cells that enable you to see.

How do I know if I have solar retinopathy?
As there are no pain-sensing nerves in the retina you will not feel any pain while the damage is being caused. Some hours after the event you may experience the following symptoms:

  • eyes may become watery and sore
  • difficulty in seeing shape and detail of objects
  • discomfort with bright light
  • a blind spot in your central vision
  • things may appear to be unusually coloured
  • objects may be distorted in shape

What do I do now?
In the first instance, go to your local optometrist, the eye specialist found in the high street optician’s shop. Unfortunately, there are no treatments currently available, however the optometrist will be able to advise you on the extent of your particular eye damage and assess and monitor your condition. The optometrist can also refer you on to other specialists if necessary. Alternatively, visit your physicians office to get proper referral of care.

Is the damage permanent?
If the damage is mild, your eyesight may return to normal after a time when the swelling at the back of the eye is reduced. The length of time varies with each individual and the extent of the damage. The eye specialist will advise you on how to reduce the discomfort while the swelling goes down.

Unfortunately, if the damage is more severe, your eyesight may be permanently affected. It is only through monitoring of your sight over a period of weeks that the eye specialist will be able to assess the extent of the long-term damage.

What if my sight cannot be fully restored?
If your sight has been permanently affected, much can be done to help you adjust and use your remaining vision as fully as possible. Services on offer vary in different areas and you should ask your eye specialist to discuss the available options with you.

We hope that you enjoyed viewing the recent solar eclipse. If you, or anyone you know has any symptoms of solar retinopathy from improper viewing, please encourage them to see an eye doctor as soon as possible.