What’s really involved in a Comprehensive Eye Examination
People might hear it often that they need to get their eyes checked on regular basis, but many still don’t quite understand why this is important. The aim of this article is 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 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.
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 is 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 Diabetes and Multiple Sclerosis. Besides the visual acuity and refraction tests, 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 usually the prognosis is 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.
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 poster surface of the eye. New technologies such as the Non-Mydriatic Widefield retinal imaging has allowed for a less invasive approach to examining the retina and other posterior structures of the eye. Further, more advanced technology such as the OCT (Optical coherence tomography) is sometimes used by your optometrist. The OCT technology obtains a cross section view of those structures to ensure early disease detection and to further investigate certain conditions. The use of such advanced technology is specially useful for patients with family history of eye disease or those with other risk factors.
Another standard but important test that’s performed during a comprehensive 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 requires 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 lead to complete and irreversible lost of sight if gone untreated. Patients with family history of the disease and other modifiable and none-modifiable risk factors are at a higher disk 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.