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What Happens During an Eye Exam? A Step-by-Step Guide

October 22, 2019

If you’ve never had a comprehensive eye exam before, or if it has been a few years since your last one, you may be unsure about what to expect during your check-up.

Don’t worry — your curiosity is not misplaced! After all, when it comes to a comprehensive eye exam, there are a lot of moving parts.

A number of tests and procedures are used to determine your eye health. They range from simple things, like reading an eye chart to measure your visual acuity, to more complex assessments, like using a biomicroscope to examine the structures of your eye under high magnification.

To give you an idea of what you could expect, here’s a step-by-step guide to what you’re likely to encounter during a comprehensive eye exam.

The Pupil Reactions and External Exam

During this portion of a comprehensive eye exam, your doctor will watch how your pupils adjust to the introduction of objects and light. At the same time, your doctor will examine the whites of your eyes, as well as the position of your eyelids.

The Classic Eye Chart

Visual acuity tests are among the first things that patients usually encounter during an eye exam. These are typically performed using a projected eye chart with letters that get smaller as you read down each line. This measures the acuity of your distance vision. In addition, a small, hand-held acuity chart is also used to measure your near vision.

The Color Blindness Test

This test utilizes Ishihara Plates, which are made up of tiny colored circles that display a number. The number can only be read by people who aren’t color blind.

The Cover Test

The cover test is the simplest and most common way for eye doctors to check how your eyes work together. During a cover test, you’ll focus on a small object located at some distance. Your doctor will then cover each of your eyes alternately, while you stare at the object, to observe how your eyes move.

The Alignment Test

During this test, your doctor will ask you to hold your head still and focus on a small object, like a pen. You’ll keep your focus on this object, and follow the slow movement of it with just your eyes. Your doctor will watch your eyes as they move in different directions to check their alignment.

The Stereopsis Test

One commonly used stereopsis test (which checks the eye-teaming that enables normal depth perception) involves wearing a pair of 3D glasses. You’ll then look at a booklet of patterns — each with four small circles — and point out which circle in each pattern looks nearer than the others. If you can correctly determine the closer circle, then you likely have excellent eye teaming.

The Refraction Test

The refractor test determines the prescription for eyeglasses. This test involves a phoropter machine, which houses many different lenses. Your doctor will switch back and forth between the lenses, asking you to identify if the lens helps you see better or worse. 

The Slit Lamp Test

A slit lamp is a machine made to examine the structures of the eye under high magnification. Your doctor will start by examining the structures at the front of your eyes, like the eyelids, cornea, iris, lens and conjunctiva. In addition, your doctor may also look at the structures farther back in your eye, like the optic nerve and retina. The slit lamp test can detect a wide range of eye conditions, including diabetic retinopathy and cataracts.

The “Puff-of-Air” Test

This test’s formal name is non-contact tonometry (NCT),  though many of us know it as the “puff-of-air” test. During this test, you’ll place your chin on the NCT machine’s chin rest, while looking at a light inside of it. The machine will release a concentrated burst of air into your eye to measure your intraocular pressure, and if the pressure is excessive, this may signal a risk for developing glaucoma.

The Pupil Dilation Test

A dilated eye exam can help identify if you have, or are at risk for, developing common eye diseases that have no symptoms. Dilating eye drops allow your eye doctor to thoroughly examine the health of your eyes. The drops cause your pupils to become larger, allowing more light into the eye. Once your eyes have fully dilated, your eye doctor will look inside your eyes using special lenses. Additionally, more modern retinal imaging devices allow eye doctors to capture a high-resolution, wide-angle photograph of a patient’s retina without needing to use dilating drops.

The Visual Field Test

A visual field test checks for the possible presence of blind spots in your peripheral vision. These types of blind spots can originate from eye diseases, like glaucoma.

As should be apparent from this overview, there’s good reason to have a comprehensive eye exam every year. Beyond helping you maintain clear vision, comprehensive eye exams are essential for maintaining optimal eye, as well as full-body, health. Not only do they help detect conditions that aren’t detectable without an exam, but they can also help provide insights into other health-related conditions, like diabetes.

If you haven’t yet had the benefit of a comprehensive eye exam this year, contact us at OCLI today to schedule your appointment!

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