COMPREHENSIVE EYE EXAMS - WHAT TO EXPECT
During a complete medical eye exam, many tests are done by very skilled
people. Each test helps rule out a dozen diseases. A checklist is used
to prevent omitting any items. It takes approximately 2 hours maximum
to complete this examination.
The Exam Begins
You will usually be brought to an examination room within 15 minutes of
your scheduled appointment time. Either our medical assistant or our optometrist
will take a history regarding your eye problems, medications, etc. The
medical assistant will then proceed with initial testing and will use
drops in accordance with the doctor's instructions.
Dilation of the pupils is necessary on all complete
exams in order to detect many problems and diseases in the eye. In addition,
the eye drops make the measurements for eyeglasses more accurate in certain
cases. The dilating drops take 30 - 40 minutes to work and involve sitting
in a darkened room to take effect. These drops wear off in a few hours
and require plastic sunglasses to protect the eyes from glare. The receptionist
will give you the plastic dark glasses when you check out. Occasionally
we see a patient whose eyes remain dilated for a few days. There is no
harm in this. If there is discomfort, such as burning, stinging or light
sensitivity, apply warm compresses and call the office for instructions.
If your vision is made blurry with dilating drops, please do not drive
A complete medical eye exam consists of:
Obtaining a proper history of eye symptoms as well
as general medical and family background information.
Measurements of visual acuity.
Checking of your previous glasses.
Measurement of the optical condition of the eye (Refraction) to determine
if glasses will improve the vision.
Examination of pupillary reactions and visual pathway to the brain.
Testing of the eye muscle movements in various directions of gaze.
Check of parallelism of the eyes to discover crossing or other imbalance.
Screening of peripheral visual fields.
Examination of the lids, lashes, and tear flow system.
Microscopic examination of the cornea, iris and anterior chamber.
Dilation of the pupil for examination of the retina, blood vessels
and optic nerve, and peripheral retina.
Other tests as necessary.
ARE MEDICAL EYE EXAMS NECESSARY?
serious eye diseases are silent. For example, glaucoma,
hypertensive retinopathy, vascular occlusions and retinal tears produce
few symptoms in the early phases of disease. Early diagnosis and treatment
is the most successful means to prevent irreversible damage from such
We often see people who have lost vision simply because they did not
know that they should, or simply forgot to have, a medical eye exam.
EXAMS FOR CHILDREN
Children should be seen immediately if there is any abnormality
noted. Look for crossing of eyes, poor tracking (after 4 months of age
it should be perfect), unusually small or unusually large eyes, color
difference and/or white-colored pupil.
All children should be checked before starting kindergarten and annually
thereafter until the 6th grade (if they are not being screened at school).
TO SCHEDULE A BASIC VISION EXAM FOR ADULTS AND CHILDREN?
If your MEDICAL eye examination is normal on your initial visit
you should follow this guideline:
||Preschool Baseline Exam
||Annually (if not screened in school)
||At Least Every 5 Years
||Every 4 Years
||Every 2 Years
| 50 & Over
|| Every 1-2 Years - ask the doctor
Patients with diabetes,
arthritis, or a family history of eye
problems, should be seen as often as instructed by the eye physician.
Pamphlets with an in-depth description of glaucoma are available
in the reception area or upon your request. Those patients who are diagnosed
as having glaucoma, or who are suspected of developing it, will be seen
at least 3 times per year (sometimes more often if not controlled). »
read more about
Patients who have glaucoma are recommended to have a
yearly annual dilated eye exam. Intraocular pressure checks are scheduled
every four months. More frequent monitoring may be necessary if the pressure
is not controlled.
Some baseline measurements are needed for people who have or
are suspected to have glaucoma:
- Central corneal thickness - because this impacts the pressure measurement.
- Gonioscopy (looking at where the eye drains fluid) - because this
can have a direct effect on treatment decisions.
The purpose of treating glaucoma is to preserve the optic nerve and consequently
the vision. In order to know if a person is being adequately treated.
Two tests are routinely recommended on an annual basis:
- A visual field - this is a test that measures how you respond to light
as compared to other people your age. This is somewhat of a subjective
- A Nerve Fiber Layer Analysis - this looks at the anatomy of the nerve
fiber layer that makes up the optic nerve. This is more of an objective
While all of this testing may sound intimidating, the exams are simple
and at present represent the standard of care for glaucoma. Proper
attention and treatment allows for the preservation of vision.
Cataracts represent clouding of the crystalline lens in the eyes.
The frequency of examinations for cataract patients varies depending on
the doctor's findings during each visit. We have pamphlets about cataracts
and cataract surgery. You may take them from our reception area. »
Small self-sealing incision for cataract surgery and intra-ocular
The latest advance in cataract surgery is the small self-sealing
incision in the eye at the time of surgery. Microsurgery and small incision
phacoemulsification techniques are used by the doctors and each operation
is tailored to the patient's needs.
Strabismus, tropia, cast, and squint are terms used interchangeably
to denote a condition in which both eyes do not look at the same object.
Each eye works individually, rather than together as a team. Strabismus
evaluation is performed in our office. Treatment may entail glasses, prisms,
exercises, and at times surgery.
A variety of services are available to our patients, from cataract
extractions and corneal transplants to cosmetic lid surgery with minimal
swelling and quick recovery. » read
more about Surgery Center Procedures
Just imagine the possibility of life without glasses. Eliminating
or reducing your need for glasses is what refractive surgery is all about.
Myopia, or nearsightedness, is a condition in which
light rays focus in front of, rather than on, the retina at the back
of the eye. This results in blurry vision, especially when looking at
objects that are far away.
Hyperopia, or farsightedness, is a condition in which
light rays focus in back of, rather than on, the retina at the back
of the eye. This results in blurry vision when looking at objects up
Astigmatism is caused by an irregular curvature in
the cornea, which is the front window of the eye. With astigmatism,
the cornea is shaped more like a football. The irregular shaped cornea
causes light rays to focus on two different points within the eye. Advances
in technology, resulting in the advent of LASIK (Laser Assisted in-Situ
Keratomileusis) and other refractive procedures, allows for successful
treatment of those with nearsightedness, farsightedness, and astigmatism.
We currently do not perform most refractive procedures in
our practice but are excellent at determining
who would be the best candidates for refractive surgery and will refer
you to the best refractive surgeons if indicated.
VISITS OR CALLS
In case of an emergency at night, on weekends or holidays, one of
our doctors is always on call so patients are seen by one of our own physicians.
In the rare instance that one of our doctors should not be available,
the Ophthalmologist on County Call in Santa Rosa would see the patient.
SCHEDULING A REGULAR EXAM
Regular appointments can be made during working hours Monday through Friday,
9am - 4pm.