As we examine your eyes, we’re looking for a variety of conditions. Sometimes, your symptoms will lead us to look for specific problems, like conjunctivitis, cataract, or retinal detachment. Other times, we’ll find evidence of conditions like glaucoma that have no symptoms at all. For returning patients, we’ll compare your exam finding from prior visits to determine what’s changing and how quickly.
For new patients, our exam will establish baseline findings that will be useful for comparison later on. The examination usually begins by one of our doctors asking detailed questions about the reason for your visit. If there’s something worrying you about your eyes or vision, this is the time to say so. From there, we’ll ask you about your medical and surgical history, to better understand your health and how it might impact your vision. We’ll ask for a list of medications you take and whether you have any allergies to medications you have taken in the past. Some medications have important side effects that can affect the eyes. We’ll probe your family history to discover if any relatives have had eye problems, because some eye conditions are heritable.
We’ll ask about how you use your eyes in daily life, to better understand your visual needs at work and at play. All of this information helps us to take care of you better. As required by our ethics and by law, we treat it all confidentially.The examination usually begins by checking visual acuity at a standard 20 foot testing distance, with and without glasses or contact lenses. After that, we’ll check your near vision to make sure you can see comfortably at a variety of distances, especially in the distance for driving, up close for reading and at arm’s length for computer work. Depending on how well you do, we’ll check to see if your glasses or contact lens prescription has changed.
We’ll listen carefully to your vision needs and make recommendations about what kind of vision correction can best meet those needs. As the technology of lenses continues to advance, there are new options in lens design, specialty lens coatings and materials we can discuss with you. Our opticians are highly trained and will work with you to get exactly the kind of glasses you want. We’ll check the complex neurology of eye movements, pupil function and visual fields. At our slit lamp microscope, we will assess the structures in the front of the eye, including the lids, lashes, conjunctiva, cornea and colored iris. Through this instrument, we have a highly magnified view of your eye’s natural lens, and can see if cloudiness or opacities are developing, which are the hallmarks of cataract. Using an applanation tonometer or an electronic version, we will check your intraocular pressure, which if elevated, is an important risk factor for glaucoma. This simple test requires an anesthetic eyedrop to numb the eye, and it wears off in about ten minutes. Sometimes, we’ll dilate your eyes, in order to have a complete view of the peripheral retina, where retinal tears and detachments are most likely to occur.
We’ll look carefully at the color, size and contour of the optic nerve in each eye, which are important indicators of its healthy functioning. The dilating eyedrops we commonly use, tropicamide and phenylephrine, cause the pupils to remain enlarged for up to 6 hours. During that time, reading and other close work may be very difficult. For most people, driving is not affected, but we’ll offer to give you dark glasses to shade your eyes from bright light when you leave. In children especially, we’ll often check color vision sense and ocular alignment in order to confirm that vision development is proceeding normally.
At the end of the exam, we’ll talk with you about our findings and what they mean. If some additional testing is needed to confirm a diagnosis like glaucoma, we’ll recommend it.
Educating you about your eye conditions is one of our goals, and we’ll spend enough time with you to answer your questions, discuss your prognosis and go over your treatment options.
If you’d like, we’ll give you some printed materials, or direct you to information on our website or at your local library to learn more.