Comprehensive Eye Exam
Regular eye exams are important in maintaining eye health. During a comprehensive eye exam, eye diseases or other abnormalities that are not yet causing symptoms can be detected. Early intervention is crucial in preventing vision loss from a disease such as glaucoma or diabetic eye disease, which may not cause symptoms until significant and irreversible damage has taken place. Early detection of eye problems gives a patient a choice of treatment options and reduces the risk of permanent damage. Dr. Aizuss provides patients in Encino, West Hills, and the surrounding area with comprehensive eye exams.
Benefits of an Eye Exam
A comprehensive eye exam should be performed once every year, particularly after age 65. Children should have periodic eye exam tests to ensure that their vision is normal so that their schoolwork does not suffer. Older adults are at higher risk for eye conditions such as glaucoma, macular degeneration, and cataracts. During a comprehensive eye exam, simple refractive errors are detected, and serious eye problems or diseases, including the following, are diagnosed:
- Amblyopia (lazy eye)
- Strabismus (crossed eyes or eyes that turn in or out or up or down)
- Eye-tracking difficulty
- Diabetic retinopathy
Even in younger, healthy adults who are asymptomatic, a regular eye exam is essential. Serious medical conditions, such as high cholesterol, diabetes, and high blood pressure, can be detected, allowing patients to seek treatment early.
How often should I have an eye exam?
Considering how important good vision is to each of us, it’s somewhat disconcerting how rarely many people choose to have their eyes examined. People often go a decade or more without having their eyes checked, particularly if they have good vision. This is taking a big gamble that could dramatically change your life if you lose. Particularly after the age of 40, sight-robbing conditions such as glaucoma can sneak up without you knowing it.
Here is the timeline from the American Academy of Ophthalmology for when everyone should get an eye exam:
- Children 5 years and younger — Children under three should see a pediatrician to check for the most common eye problems, such as lazy eye. Otherwise, children between 3 and 5 should see a pediatric ophthalmologist for an eye exam. Dr. Aizuss sees children ages 10 and older, unless by special referral or arrangement.
- School-age children and teens — Your child needs his or her vision checked before they enter first grade. From there, vision should be checked every one or two years to be sure their refraction/vision correction prescription hasn’t changed.
- Adults — If you don’t have vision problems and don’t have a family history of eye disease, this is the schedule for adults:
- Every five to 10 years in your 20s and 30s
- Every two to four years from 40 to 54
- Every one to three years from 55 to 64
- Every year after age 65
These adult numbers should increase in frequency if you wear glasses or contact lenses, if you have a family history of eye disease, or if you have a chronic disease that can affect your eyes, such as diabetes.
Eye Exam Procedure
A comprehensive eye exam involves a series of tests to evaluate your vision and check for eye diseases. Dr. Aizuss will use a variety of instruments, have you look through a variety of changing lenses, shine bright lights at your eyes, and touch your eyeball after anesthetic eye drops have been applied to measure the intraocular pressure. The goal of each of these tests is to evaluate a different aspect of your vision quality or the health of your eyes.
The key is to not only check your eyes for their degree of refractive error, but to also catch any eye problems as early as possible. This is because many eye conditions and diseases don’t exhibit symptoms until they have already caused vision damage.
These are what we will test:
- Visual acuity test — This uses an alphabet eye chart, also called the Snellen chart. You read the letters that get progressively smaller the farther down your read.
- Refraction assessment — As light rays enter the front of your eyes, they are bent as they reach the retina in the back of the eye. If the light rays aren’t focused properly, you have a refractive error. Glasses or contact lenses correct these errors. To fine tune the amount of error and correction we use a phoropter, where alternate lenses are rotated in front of your eyes to find which correction gives you the best vision. We also use computerized vision analzyers to provide an objective measure of your eyeglass prescription or refraction in addition to the subjective component wherein you answer, which is better one or two?
- Eye muscle test — You simply follow an object and Dr. Aizuss watches your eye movements to check for muscle weakness, poor control, or poor coordination between eyes. He also performs an alternate and cross cover test to evaluate binocular muscle balance.
- Vision field test — This determines if you have difficulty seeing in any areas of your overall field of vision. We use an automated perimetry machine where you look at a screen with blinking lights on it. You press a button each time you see a light. This test is ordered when appropriate for a given patient.
- Color vision test — To test for any color vision problems, we show you several multicolored dot-pattern tests. There are numbers and shapes within the dot patterns. If you can’t see certain colors, you won’t see the numbers/shapes in the dots. This test is only used when indicated or when a patient is on certain high risk medications.
- Slit-lamp examination — The slit lamp is a microscope that illuminates and magnifies the front of your eye. We examine your eyelids, lashes, cornea, iris, lens, and the fluid chamber in your eye. We also have slit lamp photography and can project your findings on a video screen to share with you important findings of interest.
- Retinal examination — Sometimes called funduscopy or ophthalmoscopy, this is the examination of the back of your eye, where the retina, optic disc, and various blood vessels are found. For this exam, we may dilate your eyes with eyedrops. These keep the pupil from getting smaller when a light is shown on it.
- Glaucoma screening — Glaucoma is a disease where pressure builds inside your eyeball, intraocular pressure. This pressure damages the optic nerve and your vision. For this test, as noted earlier, we instill a topical anesthetic and touch your eye with an applanation tonometer to measure your intraocular pressure.
Based on the diagnostic findings of the eye exam, eyeglasses or contact lenses, medication for infection or inflammation, and vitamins or other supplements may be recommended. In some cases, eye surgery may be necessary or advised.
Eye Exam FAQs
Is there anything I need to do to prepare for my eye exam?
If you’re a new patient for Dr. Aizuss, you’ll need to bring any current eyewear you use, along with insurance information. Otherwise, there isn’t any preparation for an eye exam. If you’ve been having any issues, such as an increase in floaters, be sure to mention that to Dr. Aizuss.
How long does an eye exam take?
Our comprehensive eye exams take about one hour to one and one half hours.
Is there recovery after an eye exam?
There isn’t any recovery. If we dilated your eyes, they will be more sensitive to sunlight, but sunglasses provide adequate protection until they return to normal.
Can I drive after my eye exam?
Yes, you can drive yourself home. As mentioned above, if you did need dilation, you can still drive. You’ll simply need good sunglasses because your eyes will be more sensitive to sunlight for up to 24 hours.
Will I need to get my eyes dilated during my eye exam?
Modern ophthalmoscopes allow better examination of the retina at the back of the eye, so Dr. Aizuss doesn’t usually need to dilate the eyes of the patient. However, sometimes he still needs to do so to allow more detailed view of the retina. Our office also has the Optos digital fundus photography device which permits a wide view of the eye through the undilated pupil but is still not as effective as an indirect ophthalmoscopic examination through a dilated pupil.
Common Refractive Errors
The most common eye conditions diagnosed during a comprehensive eye exam involve refractive errors that cause blurry vision. These conditions affect millions of people in the United States and often get progressively worse as patients age. Refractive errors are easily treated.
Also known as nearsightedness or shortsightedness, myopia is a condition of the eyes in which nearby objects are clear, and distant objects are blurry. Almost a third of people in the United States have some degree of nearsightedness. In myopia, the eye is too long. Myopia is corrected with minus lenses or concave lenses.
Also known as farsightedness, hyperopia is a condition of the eyes in which the focus on distant objects may be better than the focus on objects closer to the eye, making nearby objects appear blurry. However, in adults with hyperopia both distance and near objects are blurred. Children may often compensate for hyperopia by dialing plus power in the eye via accommodation which is our ability to focus at near. The eye is designed to focus images directly on the surface of the retina; with hyperopia, light rays focus behind the surface of the retina, producing a blurry image. Hyperopic eyes are shorter than normal. The hyperopic refractive error is corrected with plus or convex lenses.
Astigmatism occurs when the eye has two different curves so it is shaped like a football on the surface instead of a baseball. There are two types of astigmatism: corneal, in which the shape of the cornea (the clear covering of the eye) is astigmatic and lenticular, in which the lens is imperfectly shaped. Corneal astigmatism is more common. Astigmatism can result in blurred vision at any distance.
Presbyopia, meaning “old eye,” is a condition in which the eyes lose their ability to focus on close objects. It is considered a normal part of the aging process. Symptoms typically begin when patients are between 40 and 45 years old. Presbyopia is the loss of accommodation or the ability to dial plus power into the eye via muscles inside the eye. It occurs because the lens stiffens with age.
All of these vision conditions can be effectively treated with either eyeglasses, contact lenses or laser vision correction. Corrective lenses may need to be used only during certain activities, such as reading, watching television or driving, or may be needed at all times. A comprehensive eye exam is essential in checking for vision problems, eye diseases, refractive errors and overall health. How frequently the eyes should be examined is based on the patient’s age and specific circumstances.
Dr. David Aizuss from Ophthalmology Associates of the Valley proudly serves patients in Encino, West Hills, Calabasas, Agoura Hills, Tarzana, Woodland Hills, Sherman Oaks, and Reseda, CA and surrounding areas with comprehensive and advanced eye exams. Call (818) 907-1038 to schedule an eye exam appointment today!