OPHTHALMOLOGY

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 yourself.

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.

Glaucoma testing.

Testing for cataracts.

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.

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WHY ARE MEDICAL EYE EXAMS NECESSARY?
Unfortunately, many serious eye diseases are silent. For example, glaucoma, diabetic retinopathy, macular degeneration, cataracts, 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 diseases.

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.

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EYE 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).

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WHEN 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:

AGE FREQUENCY
4 Preschool Baseline Exam
5-10 Annually (if not screened in school)
10-30 At Least Every 5 Years
30-40 Every 4 Years
40-50 Every 2 Years
50 & Over Every 1-2 Years - ask the doctor

Patients with diabetes, hypertension, cataracts, glaucoma, macular degeneration, arthritis, or a family history of eye problems, should be seen as often as instructed by the eye physician.

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GLAUCOMA
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 Glaucoma

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 test.
  • 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 measurement.

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.

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CATARACTS
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. » read more about Cataracts

Small self-sealing incision for cataract surgery and intra-ocular lens implants.
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.

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STRABISMUS
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.

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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

Laser Refractive Surgery
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 close.

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.

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EMERGENCY 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.

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SCHEDULING A REGULAR EXAM
Regular appointments can be made during working hours Monday through Friday, 9am - 4pm.

Sebastopol: (707) 823-7628
Clearlake: (707) 994-8644
Northern California: (800) 848-8911

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MAKE AN APPOINTMENT
(707) 823-7628 or  
(707) 994-8644
(800) 848-3911 toll free
or click here to email.

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