WHAT TO EXPECT
Once you arrive, check-in, and complete any paperwork, we will call you back to begin pretesting. Usually one of our technicians performs pretesting but in some locations and depending on the exam flow, the doctor might perform these screening tests. Pretesting includes running the autorefractor and non-contact tonometer. These instruments will get an estimate of your glasses prescription and the pressure inside your eye. If available and you opt-in, we will then take your retinal images with the Optos and perform a visual field screening.
After pretesting, we will review any issues you may be having with your eyes or vision, along with your medical history. We will evaluate your vision with and/or without glasses, check the alignment of your eyes, how your eyes move together, your pupil function, and possibly a few other tests including color vision. We will then perform your refraction, which determines your glasses prescription. If you choose to have contact lenses, we may fit your lenses either at this stage or at the end of the examination. After we find your new prescription, we will evaluate the front of your eyes and then, in most cases, dilate your pupils if safe to do so. If you refuse dilation for whatever reason, we strongly recommend that you have the Optomap retinal imaging performed as this device enables us to see over 80% of the retina, in most cases.
Once your examination is complete, the doctor will thoroughly review all abnormal findings so that you have a good understanding of your ocular health. The doctor will also be able to make recommendations for you with respect to the proper type of correction to best suit your visual requirements. If you have any additional questions, the doctor will be more than happy to answer them for you.
We are proud to offer the following services
Comprehensive Eye Exams
A comprehensive, or routine eye exam might be more important than you think. Aside from checking your vision and writing your new glasses prescription, the doctor will perform tests to evaluate the health and function of your eyes as well. During your appointment we will perform additional tests including but not limited to your pupil function and eye muscle function. We will also evaluate the front of your eyes and eyelids for any growths or diseases, as well as your retinas and optic nerves for various conditions.
The retinal evaluation is vital in detecting not only ocular conditions like glaucoma and macular degeneration, but also systemic conditions like diabetes, high blood pressure, brain tumors, and more. To evaluate your retina, we use medicated eye drops to dilate your pupils to ensure that we can view your full retina. Please be aware that dilation may cause blurry vision and light sensitivity for a few hours. We encourage all patients to have Optomap retinal imaging performed annually with their comprehensive eye exam, whether being dilated or not.
For more information about the Optomap, click here.
Most contact lens users wear them to improve their distance vision. Some patients require correction for astigmatism, a condition that can cause blur at all distances. People over age 40 might want lenses to help them see both near and far without the use of reading glasses. Others prefer to quickly and safely change the appearance of their eye color with contact lenses. We are proud to use some of the latest soft contact lens technologies available to for a variety of needs.
Specialty Contact Lenses
Specialty contact lenses can greatly assist patients who are visually impaired due to a variety of corneal conditions. Rigid lenses can vault over imperfections in the eye’s surface to create a new, smooth surface for light to pass through and focus clearly. Additionally, we can fit custom cosmetic contact lenses to vastly improve a patient’s appearance after surgical complications or trauma.
Optomap Retinal Imaging
The Optomap retinal camera is not just a retinal camera. It is a wide-field retinal imaging device that can take a picture of over 80% of the retina in a single capture, and over 95% when combining images of different views into the eye. The Optomap uses a red and green laser to capture images, which can be separated during evaluation. Each wavelength, or color, can penetrate different levels of the eye to enable better visualization of the depth of a particular defect within the eye. Our Optos devices can also take pictures known as fundus autofluorescence, which can detect a certain element that manifests in various retinal conditions. While it cannot be described as a replacement for dilation, retinal imaging is far superior to dilation when it comes to accurately monitoring small changes in the retina over time.
For additional information about the Optomap retinal imaging, click here.
Visual Field Testing
There is much more to vision than how well you see straight ahead. Many people have varying degrees of peripheral vision loss. Glaucoma is one of the most common causes of visual field loss, but neurological conditions like strokes, damage to the optic nerve, or more localized damage to the retina can limit the visual field. As part of a routine eye exam, we recommend to have a visual field screening test performed. Even though the screening test is a limited test lasting only from 45 to 90 seconds per eye, it is much more sensitive at picking up visual field defects than a simple finger-counting test in the exam room.
COMMON OCULAR CONDITIONS
Farsightedness, known as hyperopia, makes it more difficult to see objects nearby than in the distance. This is not to be confused with presbyopia, which is the natural reduction in the ability of the eyes to focus up close over time. Mild to moderate hyperopia in young patients typically is of no concern, as the focal (accommodative) system of the eye can compensate. Some younger patients may experience excessive eyestrain or headaches without noticing any significant blur, especially while reading or using the computer. High hyperopia can cause blur and crossed eyes even in young patients. All types of hyperopia will eventually cause blur that is greater for near than for distance as time passes.
If you have blurry vision for both near and distance or tend to see a secondary image even if one eye is closed, you may have astigmatism. Astigmatism refers to light entering the eye and focusing in more than one place. In regular astigmatism, the light focuses in two places. Glasses or contact lenses with two curvatures, or a cylinder component as you will see as part of the prescription, help bring both areas of focused light together to a single point. Irregular astigmatism is typically caused by an irregular corneal surface and is primarily treated with specialty contact lenses. Regular astigmatism is very common in glasses and contact lens wearers. A stable astigmatic correction is no cause for concern, but the prescription and eye wear fitment must be precise to provide the best possible vision.
If you are approaching age 40, you might notice it becoming more difficult to focus for reading and computer use, even if you see well in the distance. The natural process in which the eye loses its ability to focus begins as early as childhood, but because the eyes have such a powerful ability to focus at a young age, the changes do not become noticeable until around age 40. When you can no longer focus for reading like in the past, you are said to have presbyopia. Presbyopia with perfect distance vision is why over the counter reading glasses are so common. Usually, we encourage progressive lenses for presbyopic patients so that vision can be clear at all distances with the same pair of glasses. Options like multifocal contact lenses or monovision can aid in presbyopic contact lens wearers to eliminate the use of glasses for near and far.
COMPUTER VISION SYNDROME
As computer use has increased, particularly since the coronavirus pandemic, more people have begun to experience eyestrain, headaches, posture issues, occasional blurry vision, watery eyes, and difficulty concentrating at work. If any of these symptoms describe you, you may be suffering from computer vision syndrome.
A well-known method within the optometric community to reduce computer-related eyestrain is the 20-20-20 rule. This involves taking a 20 second break to view something 20 feet away (or more) every 20 minutes. While this can help, it might not completely solve the problem.
Glasses can be a tremendous help for those suffering from computer vision syndrome. Simply using reading glasses may not be the proper solution. Newer lens options are available like computer lenses for both intermediate and near, as well as near-boost lenses for patients under age 40, blue light filters, and more. As with all prescription glasses, these would also incorporate your astigmatism and any difference you might have between your eyes. When you are with the doctor, try to accurately describe the computer set up that you most typically use including the distance from the screen. The doctor will use this information to prescribe a lens power and recommend a lens design that perfectly suits your needs.
Everyone who lives long enough will develop cataracts at some point. A cataract is simply the clouding of the crystalline lens, a natural lens right behind the iris, or the colored part of the eye. Age-related cataracts occur later in life and cause glare and blurry vision that cannot be fully resolved with glasses or contact lenses. Cataracts may also be congenital (since birth), traumatic, medication-related, from health conditions, and from other causes. The treatment for a cataract that causes vision that is too blurry for a patient’s lifestyle is surgery. We will be happy to refer you to a qualified specialist if you have cataracts that impact your life. Cataract surgery has become a common and safe procedure to restore eyesight, and you might even not need glasses after the procedure. If we diagnose you with cataracts, you can feel assured that it is typically no cause for concern.
The number one risk factor for developing glaucoma is elevated pressure within the eye. High intraocular pressure damages the optic nerve causing permanent vision loss. The permanent vision loss created by damage to the optic nerve is known as glaucoma. In glaucoma, patients lose peripheral vision first. Many patients with glaucoma but perfect central vision present to their eye care professional when significant vision loss has already occurred. There are many types of glaucoma, the vast majority of which are painless. Some types of glaucoma occur more rapidly and some are very slowly progressive. Glaucoma may even occur in patients with normal eye pressures. The primary treatment is to prevent progression by lowering the intraocular pressure with medicated eye drops. Glaucoma cannot be reversed, so early detection with a comprehensive eye examination is key. Retinal imaging like the Optomap can greatly assist in detecting small changes over time.
AGE-RELATED MACULAR DEGENERATION
The macula is the portion of the retina used for clear central vision. Age-related macular degeneration (AMD), therefore, causes a reduction in vision primarily affecting the central vision. It may be slow or rapidly progressive and can be dry (non-exudative or atrophic) or wet (exudative). While dry AMD is the most common type, it can convert to wet AMD at any time and cause rapidly deteriorating vision. Some risk factors include age, fair skin, smoking, and UV exposure; females tend to be more at risk as well.
DIABETES AND THE EYE
Diabetes can cause extensive damage to the eye and can even lead to blindness. Rapid changes in blood sugar can cause relatively quick fluctuations in vision. Diabetic retinopathy occurs when blood or fluid leaks out of the blood vessels and into the retina. Diabetes can cause new, weak blood vessels to form in the retina, optic nerve, or the iris. When these blood vessels form in the retina, it can lead to a rapid deterioration of vision. Fortunately, modern medicine has allowed most diabetic patients to maintain control of their blood sugar. Even so, diabetic changes can go unnoticed until affecting the macula. Annual retinal evaluations are imperative for diabetic patients even if blood sugar is maintained under control and there are no visual symptoms. Further treatment may be required even prior to having any reduction in central vision.
HYPERTENSION AND THE EYE
Much like diabetes, high blood pressure can cause sight-threatening bleeding into the retina. With an annual retinal evaluation, we can typically catch small changes in the blood vessels prior to any major damage to the retina. Additionally, significantly elevated blood pressure at the time of the exam may present with different retinal signs than a chronically mild elevation of blood pressure. If you have hypertension, be sure to have a complete retinal evaluation at least annually, even with no visual symptoms.
Since most of our bodies are covered in skin, the eye is the only place where we can visualize and evaluate the blood vessels. It is also the only place in the body where we can see a nerve – the optic nerve. Since your arteries and veins run throughout your entire body, any changes in the ocular blood vessels can indicate a variety of systemic conditions, as well as side-effects from medications or medical treatments. The optic nerve essentially connects your eyes to your brain. Changes within the optic nerve can result from a variety of medical conditions including multiple sclerosis (MS), brain tumors, and other neurological conditions or medical treatments.