It’s always helpful to know what to expect at a medical appointment so that you can properly prepare and feel at ease. A comprehensive eye exam includes a variety of tests, some performed by an optometrist and some by a trained optical assistant. Here’s what you can expect at your next eye exam, from the pretests to the exam room:
Questions about your medical history
When you schedule your eye exam, the receptionist will ask you to arrive 10-15 minutes early in order to fill out your medical history. This is a very important step to ensure the optometrist knows if you’re genetically predisposed to any eye conditions or if you’ve had any health issues in the past that may affect your vision.
A look at your current prescription eyewear
Don’t forget to bring your current prescription glasses along to the exam. The doctor will want to know what type of correction you’re currently using and how well it’s working for you. If you wear contacts, make sure to wear them into your appointment so that the lenses have time to settle on your eyes prior to the exam.
A trained assistant typically performs the pretests prior to meeting with your optometrist. These tests provide valuable information about your vision and the health of your eyes. These tests include:
- Visual Field Test – This test detects blind spots in your vision–a potential sign of some eye or neurological diseases. The assistant will ask you to look through a viewfinder at a lighted screen and press a button each time you see a dot flicker within your field of vision.
- Autorefractor – This test gives the doctor an approximation of your prescription to use as a baseline for determining an accurate lens power. The assistant will ask you to look through a viewfinder and focus on a small image as the instrument takes several readings.
- Blood Pressure Test – Blood pressure is an important indicator for overall health and can have direct effects on the ocular system. Primary eye care doctors are often one of the only medical providers a patient regularly visits, making this test even more important. High blood pressure is a serious health risk that not only affects the heart, but the eye as well. It can cause bleeding or strokes inside the eye and is a risk factor for eye diseases such as glaucoma.
- Puffless Glaucoma Test – Some optometry offices now check the pressure of the inside of your eyes without the dreaded puff of air or eye drops. As the assistant checks your eye pressure using a handheld instrument, you’ll feel the slightest tickling sensation on your lashes. Glaucoma can cause significant vision loss before there are any noticeable symptoms, making this test essential to protecting your vision.
- Retinal Scan – A retinal scan, or Ultra-Wide Digital Retinal Imaging, is a picture of the surface of the retina that allows the doctor to screen for abnormalities. In many cases this can be done in lieu of dilation.
- Ocular Coherence Tomography (OCT) – This test complements the retinal scan providing a deeper look into the retina. Rather than just providing an image of the surface, the OCT reveals the different layers of the retina. This gives a crosswise view that can reveal abnormalities, such as the early stages of macular degeneration, that might be invisible on a retinal scan. The OCT gives your optometrist the tools to have a deeper understanding (pun intended) of the condition of your eye. It also gives him or her the ability to catch abnormalities in their earliest stage, preventing vision problems for you in the future.
- Neutralization – The assistant will check the prescription of your current glasses using a process called neutralization. In the exam room, the optometrist will determine which lens power gives you the sharpest vision, and he or she will compare this new prescription to that of your current eyewear. This helps your doctor decide if there’s enough of a change to require an update in your lenses and also helps them to better understand any vision problems you’ve been experiencing.
In the exam room:
After the pretesting, you’ll meet with your optometrist who will ask you a few questions to understand your specific needs. For example, he or she may ask why you scheduled the exam and to describe your work habits. This conversation will help ensure the doctor can accurately diagnose any vision issues you’re experiencing. Here are the standard tests that you can expect during this part of your eye exam:
- Visual acuity tests – This is the standard eye test we’re all familiar with: Your doctor will project a combination of letters and numbers on the wall and have you read them aloud to determine the smallest size letters you can read.
- Cover test – By covering and uncovering your eyes as you look at distant and near targets, your doctor can determine how your eyes work together.
- Ocular Motility – While keeping your head still, you’ll be asked to follow a target with your eyes. This tests the six muscles attached to the outside of each eye that allow eye movements up, down, right and left.
- Pupil responses – The doctor will shine a light into each eye to test your pupil responses. Abnormalities can indicate a host of ocular and neurological conditions.
- Subjective Refraction – Using an instrument called a phoropter, your doctor will test different lens powers on your eyes. You’ll be asked several times to decide which of two lens choices is clearer. Don’t worry if it’s difficult to tell the two apart. Saying you’re not sure is a valid answer and will help the doctor determine the strength of your prescription.
- Slit Lamp Exam – During this test, you’ll be asked to place your forehead and chin on the rests of an instrument called a binocular microscope. The doctor will shine a light into one eye at a time and examine its front surface (eyelids, conjunctiva, cornea, iris and lens) and the back (the retina and optic nerve).
- Dilation – The retinal scan (performed during pretesting) will usually take the place of dilation, but in some cases, the doctor will need to perform both procedures. Dilation enlarges the pupil through the administering of eye drops. The drops take 20-30 minutes to take effect and cause light sensitivity and blurry vision up close for up to several hours.
- Review and consultation – Your doctor will review and discuss with you all of the exam data collected and present options for treatment. Together you will formulate a plan for new glasses, contact lenses, or follow-up testing if necessary.
Your eye exam should be a pleasant and educational experience. You should feel comfortable asking your doctor any questions you might have about your vision. You should leave your eye exam with a full understanding of why each test was performed and what the results indicate about your vision and eye health.
How often should you have an eye exam?
Whether you wear corrective lenses or have 20/20 vision, we recommend a yearly comprehensive eye exam. As you get older, it’s especially important to track your eye health on a consistent basis so that you know what’s normal and what’s cause for concern. A yearly eye exam keeps you on top of your eye health and ensures that health issues are caught before they cause long-term damage to your vision. If you spend long hours in front of a computer screen or have visually demanding requirements, it’s especially important to keep your prescription up to date to prevent eye strain and fatigue.
Schedule your eye exam today to make sure you’re always seeing your best.