Retinoscopy

This test is an objective way for our eye doctors to get a good approximation of your eyeglasses prescription. The room lights are dimmed and an instrument containing wheels of lenses (called a phoropter) is positioned in front of your eyes. You will be asked to look at letters across the room while your doctor shines a light from a hand-held instrument into your eyes from arms length and flips different lenses in front of your eyes.

Based on the way the light reflects from your eye during this procedure, your doctor can get a very good idea of what your eyeglasses prescription should be. This test is especially useful for children and non-verbal patients who are unable to accurately answer the doctor's questions.

With the widespread use of automated instruments to help determine eyeglass prescriptions today, our doctor might forgo performing retinoscopy during your eye exam. However, this test can provide valuable information about the clarity of the internal lens and other media inside the eye. So he/she may still use it when examining someone who may be at risk ofcataracts or other internal eye problems.

Refraction

This is the test your doctor uses to determine your exact eyeglasses prescription. During a refraction, the doctor puts the phoropter in front of your eyes and shows you a series of lens choices. He or she will then ask you which of the two lenses in each pair (“1 or 2,” “A or B,” for example) make the letters on the wall chart look clearer.

Based on your answers, your doctor will determine the amount of myopia (nearsightedness), hyperopia (farsightedness) and/orastigmatism you have, and the eyeglass lenses required to correct these vision problems (which are called refractive errors).

Additional tests

Fundus photography documents the retina, the neurosensory tissue in our eyes which translates the optical images we see into the electrical impulses our brain understands. The retina can be photographed directly as the pupil is used as both an entrance and exit for the fundus cameras illuminating and imaging light rays. The patient sits at the fundus camera with their chin in a chin rest and their forehead against the bar. An ophthalmic photographer focuses and aligns the fundus camera. A flash fires as the photographer presses the shutter release, creating a fundus photograph like the picture above. Eye doctors use these retinal photographs to follow, diagnose, and treat eye diseases.

A visual field test is a method of measuring an individual's entire scope of vision, that is their central and peripheral (side) vision. Visual field testing actually maps the visual fields of each eye individually. The visual field test is a subjective examination, requiring the patient to understand the testing instructions, fully cooperate, and complete the entire test in order to provide useful information. 

Cover test

The cover test is a simple procedure that helps your eye doctor determine if your eyes are aligned properly and work together as a team.

While you are focusing on a small object either across the room or up close, your eye doctor will cover one of your eyes at a time with a small hand-held tool. Depending on how your eyes move when covered and uncovered, he or she can determine your eye alignment and eye teaming ability.

Cover tests can detect even very subtle misalignments that can interfere with your eyes working together properly (binocular vision) and cause amblyopia or “ lazy eye.”

Slit-lamp exam

The slit lamp (also called a biomicroscope) is an instrument that our eye doctor uses to examine the health of your eyes. A slit lamp gives our doctor a highly magnified view of the structures of your eye, including the lens behind the pupil, so he or she can thoroughly evaluate your eye health and check for cataracts and other problems.

The slit lamp is basically an illuminated binocular microscope that is mounted on a table. It includes a chin rest and headband to help you hold your head and eyes still during the exam. With the help of hand-held lenses, our doctor also can use the slit lamp to examine the retina (the light-sensitive inner lining of the back of the eye.)

Tonometry (glaucoma testing)

Tonometry is the name for a variety of tests used to determine the pressure inside the eye. Elevated internal eye pressure can cause glaucoma, which is vision loss due to damage to the sensitive optic nerve in the back of the eye.

Our doctor chooses to measure eye pressure with an instrument called an applanation tonometer, which is usually attached to a slit lamp. For this test, a yellow eye drop is placed on your eyes. Your eyes will feel slightly heavy when the drops start working. This is not a dilating drop — it is a numbing agent combined with a fluorescent yellow dye.

During applanation tonometry (also called Goldmann applanation tonometry or GAT), our eye doctor will have you stare straight ahead in the slit lamp while he or she gently rests the bright-blue glowing probe of the tonometer on the front of your eye and manually measures the intraocular pressure.

Applanation tonometry is painless and takes just a few seconds.

Since glaucoma has no symptoms prior to permanent vision loss, having routine comprehensive eye exams that include tonometry is essential for ensuring the long-term health of your eyes.

Pupil dilation

Your comprehensive exam will sometimes include the use of dilating drops. These medicated eye drops enlargen your pupil so our doctor can get a better view of the internal structures in the back of the eye.

Dilating drops usually take about 20 minutes to fully affect your pupils. When your pupils are dilated, you will be sensitive to light, because more light is getting into your eye. You also may notice difficulty reading or focusing on close objects. These effects can last for up to several hours, depending on the strength of the drops used.

If you don’t have sunglasses to wear after the exam, be sure to ask for disposable sunglasses to wear outside.

Additional testing

Depending on your particular needs, our eye doctor may perform additional tests or schedule them to be performed at a later date.

In some cases, he or she may refer you to a colleague who specializes in advanced care (for diabetic retinopathy , for example) for additional testing and/or treatment.

 

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