A comprehensive eye examination takes around 30 minutes and sometimes longer; includes a variety of tests and procedures to determine the health of your eyes and the quality of your eyesight. Once this is completed, your optometrist is in a position to recommend the best eyecare options for you, taking into account your lifestyle needs.
Gathering relevant personal information
Your optometrist will ask a number of questions about your health, your vision and your personal and family medical history. This information helps your optometrist determine if you are at risk of certain eye diseases and vision disorders. It also is the time when you advise your optometrist of any concerns that you currently have with your vision.
Assessing your current eyewear
Your optometrist will conduct an assessment of the prescription, lens type, as well as the condition of the frames and lenses of your existing prescription glasses and or sunglasses to determine their ongoing suitability for correcting your eye sight.
Measuring your vision: visual acuity testing
The clarity of your eyesight or the sharpness of your vision is called your visual acuity. Your optometrist will test how well you see (your visual acuity), typically at distances of approximately 6 metres (distance vision) and 40 cm (near vision). Determining the smallest letters or numbers you can read on a chart typically assesses visual acuity.
Eye alignment and eye muscle balance tests
Your optometrist will assess how well your eyes work together as eye strain often results from eye muscle imbalance. To test for this, your optometrist will cover and uncover each of your eyes several times as you focus on an object across the room. By observing how much your eyes must move when uncovered to refocus on the object, your optometrist can determine if your eyes are properly aligned and how well they work together as a team. Proper eye synchronisation is necessary for clear, comfortable vision. Poor eye synchronisation can lead to eyestrain, blurred vision or double vision. Other tests such as stereoscopic vision testing may be included to aid in the diagnosis of eye alignment or eye muscle imbalance issues.
Pupil response testing
Your optometrist will look closely at your pupils to see if they are the same size and shape. A significant difference in pupil size may indicate a problem with your eyes or even part of the brain. Next, your optometrist will direct a bright beam of light alternately at each of your eyes. By observing the change in size of your pupils in response to the light, your optometrist can determine if your pupils function normally.
Auto refraction/Keratometry
Utilising a Nidek Auto Refractor / Keratometer, your optometrist can obtain an objective, computer assisted assessment of your refraction (please see below) and measure the curvature of your cornea.
Subjective refraction: determining your prescription
The subjective refraction is the part of the eye examination where your optometrist, with your help, determines your exact glasses or contact lens prescription. The computer assisted Nidek motorised refractor (which contains thousands of lens combinations) used by your optometrist to perform your refraction and is ergonomically designed to be smooth and quiet for your comfort.
Examination of the anterior of your eye using slit lamp or bio microscopy
Your optometrist may use an instrument called a slit lamp or bio microscope to take a highly magnified look at the health and condition of the anterior part of your eyes. The slit lamp can also be used to examine the crystalline lens behind the pupil to determine if cataracts are developing.
Glaucoma assessment or eye pressure testing
Depending on your age, eye condition and family history, your optometrist may test you for glaucoma. Glaucoma is a leading cause of blindness. Glaucoma assessment may include tonometry which measures your intraocular pressure, visual field assessment (see later), an optic nerve head assessment and an anterior chamber angle assessment.
Examination of the posterior of your eye
Various structures at the posterior of the eye are examined including the retina (the light sensitive inner lining at the back of the eye), the macula and the optic nerve. These are examined to rule out glaucoma, macular degeneration, diabetic retinopathy and other potentially sight-threatening eye conditions.
Sometime it is necessary for your optometrist to dilate your pupils so they can get a clear view of the entire retina.
When examining your retina, your optometrist may use a hand-held illuminated microscope called a direct ophthalmoscope which gives a highly magnified view, or a binocular indirect ophthalmoscope which provides a three dimensional view, or use the slit lamp and a smaller hand-held lens which provides a more magnified three-dimensional view of the optic nerve and macula.
Digital retinal imaging / photography
If there is a family history of certain eye conditions, or if we find anything out of the ordinary during your eye test, you may need additional tests such as visual field examination or digital retinal imaging.
Digital Retinal Imaging is a simple, painless procedure that can aid in the detection and management of potential sight threatening diseases such as glaucoma, diabetes, hypertension and macular degeneration.
If required, your optometrist will suggest taking a digital image of the back of your eye (retina).
This photograph records the current state of your retina, optic nerve and blood vessels. This image, if compared with previous images, will show any subtle changes in appearance which can allow for the early detection of diseases.
Recommendations
At the conclusion of your eye examination, your optometrist will discuss their findings and recommendations with you. You are now in the best position to determine the best eyecare options for you, taking into account the finding of the eye examination and your own individual life style needs.