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Comprehensive Eye Exam

A complete eye exam involves a series of tests designed to evaluate your vision and check for eye diseases. Your doctor may use odd-looking instruments, aim bright lights directly at your eyes and request that you look through a seemingly endless array of lenses. Each test during an eye exam evaluates a different aspect of your vision so that the doctor can develop a complete picture of your ocular health and vision quality.

Why eye exams are done

An eye exam is one of the best ways to protect your vision because it can detect eye problems at their earliest stage which is when they're most treatable. Regular eye exams give your eye care professional a chance to help you correct or adapt to vision changes and provide you with tips on caring for your eyes.

When to have an eye exam

Children 5 years and younger: For children under 3, your pediatrician will likely look for the most common eye problems — lazy eye, crossed eyes or turned-out eyes. Depending on your child's willingness to cooperate, his or his first more comprehensive eye exam should be done between the ages of 3 and 5.

School-age children and adolescents: Have your child's vision checked before he or she enters kindergarten. If your child has no symptoms of vision problems and you don't have a family history of vision problems, have your child's vision rechecked every two years. If your child does have vision problems or a family history of vision problems, have your child's vision rechecked as advised by your eye doctor.

Adults: In general, if you're healthy and have no symptoms of vision problems, you should have your vision checked every two years between the ages of 20-40. Between ages 40 and 65, have your vision checked every year. After age 65, get your eyes checked every year or as directed by your medical professional. If you wear glasses, have a family history of eye disease or have a chronic disease — such as diabetes — that puts you at greater risk of eye disease, you need to have your eyes checked more frequently. You might also need more frequent eye exams to check for retinal problems if you were born prematurely or to monitor your eyes for glaucoma if you're of African-American heritage.

What to expect from your doctor

If you're seeing a new eye doctor, or if you're having your first eye exam, expect questions about your vision history. Your answers to these questions help your eye doctor understand your risk of eye disease and vision problems. Be prepared to give specific information, including:

Are you having any eye problems now?
Have you had any eye problems in the past?
Were you born prematurely?
Do you wear glasses or contacts now? If so, are you satisfied with them?
What health problems have you had in recent years?
Are you taking any medications?
Do you have any allergies to medications, food or other substances?
Has anyone in your family had eye problems, such as cataracts or glaucoma?
Has anyone in your family had diabetes, high blood pressure, heart disease or any other health problems that can affect the whole body?

If you wear contact lenses, bring them to your appointment. Your eye doctor will want to make sure your prescription is the best one for you. Also be prepared to remove your contacts for certain exams. Tests that use orange dye (fluorescein) to temporarily color your eye may permanently dye your contact lenses, so take them out before those types of tests.

The Eye Examination process:

An eye exam usually involves these steps:

First, your doctor asks about your medical history and any vision problems you might be experiencing.
Next, your eye doctor checks your eyes using a light to ensure the exterior parts of your eyes are healthy.
Finally, your doctor measures your visual acuity, assesses your need for glasses and examines your eyes for signs of disease.

Part of the examination, such as taking your medical history and the initial eye test, may be performed by a technician who assists your doctor.

Several different tests may be performed during the eye exam. The tests are designed to check your vision and to examine the appearance and function of all parts of your eyes.

Eye muscle test

This test examines the muscles that control eye movement, looking for weakness or poor control. Your eye doctor looks at your eyes as you move them in six specific directions and as you visually track a moving object, such as a pen or a light.

Visual acuity test

This test measures how clearly you can see from a distance. Your doctor will ask you to identify different letters of the alphabet printed on a chart (Snellen chart) positioned usually 20 feet away. The lines of type get smaller as you move down the chart. You cover one eye and read aloud, then cover the other eye and read aloud.

Refraction assessment

Refraction refers to how light-waves are bent as they pass through your cornea and lens. A refraction assessment helps your doctor determine a corrective lens prescription that will give you the sharpest vision. If you don't need corrective lenses, you won't have a refraction assessment.

Your doctor may use a computerized refractor to measure your eyes and estimate the prescription you need to correct a refractive error. Or he or she may use a technique called retinoscopy. In this procedure the doctor shines a light into your eye and measures the refractive error by evaluating the movement of the light reflected by your retina.

Your eye doctor fine-tunes this refraction assessment by having you look through a Phoroptor, a mask-like device that contains wheels of different lenses, and judge which combination gives you the sharpest vision. By repeating this step several times, your doctor finds the lenses that give you the greatest possible acuity.