Eye Exams
All children without obvious signs or symptoms of eye problems, should still have an eye exam around age 4 or 5. Conditions such as amblyopia, often referred to as “Lazy Eye” (poor vision in one eye) need to be diagnosed before age 8 in order to be effectively treated. Often times, a teenager will present for their first eye exam with one blind eye due to amblyopia, and has never complained of symptoms of blur. By that time, it is too late to improve the condition, which will limit vision and depth perception for the remainder of life. Future routine eye exams will be recommended every year or two, depending on the patient’s eye conditions.
For adults without any known eye problems, The American Optometric Association recommends that you have a baseline eye examination by age 40. A baseline screening can help identify signs of eye disease at an early stage when many treatments may have the greatest impact on preserving vision.
Many eye diseases are inherited so if you have a family history of eye disease, or if you have a medical condition that puts you at a greater risk for developing eye diseases such as diabetes or high blood pressure, you should not wait to have a comprehensive eye exam. Once you’ve had an exam, Dr. Massengale will recommend how often you should return for eye examinations. It is recommended for patients 50 or older to have yearly eye exams. This is especially important for the early detection of certain age-related eye diseases such as cataracts, glaucoma, and macular degeneration.
What can I expect in a comprehensive eye exam?
A comprehensive eye exam is relatively simple and comfortable. You can expect Dr. Massengale and his team to check the following:
Your medical history. Our team will ask you questions related to your vision and overall health. It is important to note any family medical history as well, which can play a role in early detection for certain diseases that are inherited.
Your visual acuity. This is a measure of the eye’s ability to see an image at a certain distance. To determine visual acuity, a standard eye chart is used. The test is performed on one eye at a time. A measurement of 20/20 vision is a term used to express normal visual acuity. In 20/20 vision, individuals can clearly see at 20 feet what the “normal” eye should see at 20 feet. If for example, your vision is 20/40, that means you must be at a 20 foot distance to see what the normal eye can see at 20 feet.
Your pupils. Dr. Massengale and his team will check your pupils by shining a bright light into each eye.. Pupils should become constrict smaller. If either eye does not react properly, it must be determined whether or not this represents a simple muscle problem of the iris (colored part of the eye), or a more serious condition of the optic nerve, which can be a serious neurological issue.
Visual fields. This test looks at your peripheral vision (side vision). Most people don’t recognize on their own when they’ve lost peripheral vision, which makes this test very important because loss of side vision may be a symptom of glaucoma, stroke or other vascular issue, or problem in the brain.
Ocular motility (eye movement). This is a test of eye muscle function. Dr. Massengale and his team will want to see how easily your eyes move in all directions, how well they can track objects, and how your eyes align with each other. Certain eye muscle or cranial nerve problems present with restrictions to eye movements.
Intraocular eye pressure (IOP). This test, called tonometry, measures the pressure within your eye. An elevated IOP may be a sign of glaucoma, and is most certainly a high risk factor for it.
The external eye. A slit lamp microscope is used to illuminate the front part of the eye, including the eyelids, cornea, iris, and lens. As you keep your head steady on a chin rest, a beam of light is projected onto and into your eye. The slit lamp uses a narrow light beam and magnification to see a cross-sectional picture of the eye. This will reveal any pathology of the external portion of the eye, including corneal, scleral or conjunctival disease, eyelid issues, narrow angle glaucoma, intraocular inflammation or cataracts.
The internal eye. Dr. Massengale and his team will put drops in your eye to dilate your pupil. This will allow him to thoroughly examine your retina and optic nerve, located at the back of your eye, for signs of damage. Your eyes might be temporarily sensitive to light for a few hours after they are dilated, making it difficult to drive. This is why it is important to arrange for a family member or friend to drive you home from your eye exam.
Dr. Massengale may suggest additional testing to further examine your eye using specialized imaging techniques such as OCT (optical coherence tomography), topography or fundus photos. These tests can be crucial in diagnosing eye disease in its early stages.