Eye Exam Beyond the Prescription

What’s Really Involved in a Comprehensive Eye Examination

People might hear it often that they need to get their eyes checked regularly, but many still don’t quite understand why this is important.  This article aims to demystify what goes on in a typical routine comprehensive eye exam and the importance of each test performed.

A lot of people still think they only need an eye exam to get glasses or a contact lens prescription. Others might assume they don’t need an eye exam because they have “20/20 Vision”.  However, these are unfortunate, longstanding misconceptions that could lead to regrettable outcomes when silent non-symptomatic conditions are present.

For many people, the idea of a comprehensive eye exam can feel a little intimidating, especially if it’s their first time visiting an optometrist. Understanding what to expect at your first eye doctor visit can make the process far less overwhelming and even reassuring, since it highlights how these tests go beyond just checking vision—they provide a full picture of your eye and overall health.

Examination of the Front of the Eye

An Eye exam performed by a doctor of optometry consists of a battery of medical-ocular and visual tests. Each test serves a function in assessing a particular aspect of the ocular-visual system.  Certain tests are also sometimes pertinent in giving clues to other systemic conditions in the body, such as Diabetes and Multiple Sclerosis.

Besides the visual acuity and refraction tests, Toronto optometrists perform a comprehensive assessment of the ocular health of the eyes during a routine eye exam. This examination starts by assessing the external extra-ocular muscles, the pupil, and the lid and adnexa. Then the optometrist examines the anterior structure of the eye using tools such as the slit lamp biomicroscopy.

Some of those structures examined include the cornea, conjunctiva, and anterior chamber. Many corneal dystrophies, for example, start without visual symptoms in the early stages. However, when diagnosed early, the prognosis is usually much better.

Other ocular conditions, such as Uveitis (also known as Iritis), can give clues to more serious systemic conditions such as sarcoidosis, inflammatory bowel disease, ankylosing spondylitis, Reiter syndrome, and psoriasis.

Many corneal dystrophies, for example, start without visual symptoms in the early stages. However, when diagnosed early, the prognosis is usually much better. For patients wondering where to start, searching for an optometrist near me can be the first step in ensuring these important conditions are detected before they become more serious.

Examination of the Back of the Eye

After the front structures of the eye are examined, the optometrist proceeds to examine further into the back of the eye. This examination often involves the dilation of the pupil to allow for a better view of the posterior surface of the eye. New technologies such as the Non-Mydriatic Widefield retinal imaging have allowed for a less invasive approach to examining the retina and other posterior structures of the eye.

Further, more advanced diagnostics in modern eye exams, such as the OCT (Optical coherence tomography), are sometimes used by your optometrist. The OCT technology obtains a cross-sectional view of those structures to ensure early disease detection and to further investigate certain conditions. The use of such advanced technology is especially useful for patients with a family history of eye disease or those with other risk factors.

Another standard but important test that’s performed during a routine eye exam is the IOP (intraocular pressure) measurement. Elevated eye pressure is a significant risk factor for developing glaucoma. Most cases of elevated intraocular pressure that require treatment have no symptoms initially or at all.

Symptomatic cases of elevated IOP are usually considered emergencies and have already caused far advanced irreversible optic nerve damage. Such damage to the optic nerve is known as glaucoma, which is a disease that causes peripheral vision loss and progressively leads to complete and irreversible loss of sight if left untreated.

Patients with a family history of the disease and other modifiable and non-modifiable risk factors are at a higher risk of developing the disease and should be monitored by their optometrist more closely. Routine comprehensive eye exams are paramount for early detection of such conditions.

To book an eye exam or a consultation with one of our optometrists, contact one of our offices today, and our staff members will be more than happy to help.