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Eye Checkups

Eye Checkups

When You Visit Your Eye Doctor, She's Not Just Checking To See If You Can Read The Third Line On The Eye Chart Clearly. She's Also Making Sure Your Eyes Are Healthy.

To Do This, Many Doctors Use A "Slit Lamp." It's A Special Microscope And Light That Lets Your Doctor See Your Eyes In 3-D, Both Inside And Out. She'll Use It Along With An Ophthalmoscope To Look At The Back Of Your Eye.

What Is The Doctor Looking At?

Before The Exam Starts, You'll Be Asked To Remove Your Glasses Or Contact Lenses. You'll Put Your Chin And Forehead Against Rests To Keep Your Head Steady. Your Doctor May Also Put A Few Drops Of Dye In Your Eyes To Highlight Things She Wants To Look At. She'll Then Turn Out The Room Lights And Turn On The Slit Lamp.
During The Exam, Your Doctor Will Look Through The Microscope, Adjusting The Light From The Slit Lamp To View Certain Parts Of Your Eyes. Things She'll Look At: The Skin Around The Eye. Your Doctor Can Check The Area For Skin Diseases And Abrasions.

Our Eyelids And Eyelashes. Styes (Oil Gland Infections), Folliculitis (Hair Follicle Infections), And Tumors Are Some Of The Conditions Your Doctor Will Look For.

The Surface Of The Eye. This Includes The Tissue Under Your Eyelids And Over The Whites Of Your Eyes. These Areas Can Be Swollen Or Infected. This Can Be Caused By Sexually Transmitted Diseases, Allergies, Or Viruses

The Sclera. This Is The Protective Outer Layer Of The Eyeball. Next To The Sclera Is The Episclera, Which Helps Keep It Healthy. These Areas Can Get Diseases Related To Allergies, Autoimmune Disorders (Where The Body Attacks Itself), And Gout (A Type Of Arthritis).

The Cornea. This Is The Layer Of The Eye That Helps Focus Your Vision. A Slit-Lamp Exam May Show Your Cornea Isn't As Clear As It Used To Be. A Number Of Things Can Cause Your Vision To Blur.

The Iris. This Is The Colored Disc That Surrounds The Pupil And Changes To Allow More Or Less Light Into Your Eye. It Can Be Affected By A Variety Of Diseases And Conditions, Including Freckles Or Melanoma Of The Iris.

Different Types Of Eye Exams

Eye Muscle Test

This Test Evaluates The Muscles That Control Eye Movement. Your Eye Doctor Watches Your Eye Movements As You Follow A Moving Object, Such As A Pen Or Small Light, With Your Eyes. He Or She Looks For Muscle Weakness, Poor Control Or Poor Coordination.

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Visual Acuity Test

This Test Measures How Clearly You See. Your Doctor Asks You To Identify Different Letters Of The Alphabet Printed On A Chart (Snellen Chart) Or A Screen Positioned Some Distance Away. The Lines Of Type Get Smaller As You Move Down The Chart. Each Eye Is Tested Separately. Your Near Vision Also May Be Tested, Using A Card With Letters Similar To The Distant Eye Chart. The Card Is Held At Reading Distance.

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Refraction Assessment

Light Waves Are Bent As They Pass Through Your Cornea And Lens. If Light Rays Don't Focus Perfectly On The Back Of Your Eye, You Have A Refractive Error. Having A Refractive Error May Mean You Need Some Form Of Correction, Such As Glasses, Contact Lenses Or Refractive Surgery, To See As Clearly As Possible.

Assessment Of Your Refractive Error Helps Your Doctor Determine A Lens Prescription That Will Give You The Sharpest, Most Comfortable Vision. The Assessment May Also Determine That You Don't Need Corrective Lenses.

Your Doctor May Use A Computerized Refractor To Estimate Your Prescription For Glasses Or Contact Lenses. 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 Back Through Your Pupil.

Your Eye Doctor Usually Fine-Tunes This Refraction Assessment By Having You Look Through A Masklike Device That Contains Wheels Of Different Lenses. He Or She Asks You To Judge Which Combination Of Lenses Gives You The Sharpest Vision.

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Visual Field Test (Perimetry)

Your Visual Field Is The Full Extent Of What You Can See To The Sides Without Moving Your Eyes. The Visual Field Test Determines Whether You Have Difficulty Seeing In Any Areas Of Your Overall Field Of Vision. The Different Types Of Visual Field Tests Include:

Confrontation Exam. Your Eye Doctor Sits Directly In Front Of You And Asks You To Cover One Eye. You Look Straight Ahead And Tell The Doctor Each Time You See His Or Her Hand Move Into View.

Manual Testing, Including Tangent Screen And Goldmann Exams. You Sit A Short Distance From A Screen And Focus On A Target At Its Center. You Tell The Doctor When You Can See An Object Move Into Your Peripheral Vision And When It Disappears.

Automated Perimetry. As You Look At A Screen With Blinking Lights On It, You Press A Button Each Time You See A Blink.

Using Your Responses To One Or More Of These Tests, Your Eye Doctor Determines The Fullness Of Your Field Of Vision. If You Aren't Able To See In Certain Areas, Noting The Pattern Of Your Visual Field Loss May Help Your Eye Doctor Diagnose Your Eye Condition.

Color Vision Testing

You Could Have Poor Color Vision And Not Even Realize It. If You Have Difficulty Distinguishing Certain Colors, Your Eye Doctor May Screen Your Vision For A Color Deficiency. To Do This, Your Doctor Shows You Several Multicolored Dot-Pattern Tests.

If You Have No Color Deficiency, You'll Be Able To Pick Out Numbers And Shapes From Within The Dot Patterns. If You Do Have A Color Deficiency, You'll Find It Difficult To See Certain Patterns Within The Dots. Your Doctor May Use Other Tests, As Well.

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Slit-Lamp Examination

A Slit Lamp Is A Microscope That Magnifies And Illuminates The Front Of Your Eye With An Intense Line Of Light. Your Doctor Uses This Device To Examine The Eyelids, Lashes, Cornea, Iris, Lens And Fluid Chamber Between Your Cornea And Iris.

Your Doctor May Use A Dye, Most Commonly Fluorescein (Flooh-Res-Een), To Color The Film Of Tears Over Your Eye. This Helps Reveal Any Damaged Cells On The Front Of Your Eye. Your Tears Wash The Dye From The Surface Of Your Eye Fairly Quickly.

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Retinal Examination

A Retinal Examination — Sometimes Called Ophthalmoscopy Or Fundus Copy — Allows Your Doctor To Evaluate The Back Of Your Eye, Including The Retina, The Optic Disk And The Underlying Layer Of Blood Vessels That Nourish The Retina (Choroid). Usually Before Your Doctor Can See These Structures, Your Pupils Must Be Dilated With Eye Drops That Keep The Pupil From Getting Smaller When Your Doctor Shines Light Into The Eye.

After Administering Eye Drops And Giving Them Time To Work, Your Eye Doctor May Use One Or More Of These Techniques To View The Back Of Your Eye:

Direct Exam. Your Eye Doctor Uses An Ophthalmoscope To Shine A Beam Of Light Through Your Pupil To See The Back Of The Eye. Sometimes Eye Drops Aren't Necessary To Dilate Your Eyes Before This Exam.

Indirect Exam. During This Exam, You Might Lie Down, Recline In A Chair Or Sit Up. Your Eye Doctor Examines The Inside Of The Eye With The Aid Of A Condensing Lens And A Bright Light Mounted On His Or Her Forehead. This Exam Lets Your Doctor See The Retina And Other Structures Inside Your Eye In Great Detail And In Three Dimensions.

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Screening For Glaucoma

Tonometry Measures The Fluid Pressure Inside Your Eye (Intraocular Pressure). This Is One Test That Helps Your Eye Doctor Detect Glaucoma, A Disease That Damages The Optic Nerve.

Several Methods To Measure Intraocular Pressure Are Available, Including:

Applanation Tonometry. This Test Measures The Amount Of Force Needed To Temporarily Flatten A Part Of Your Cornea. You'll Be Given Eye Drops With Fluorescein, The Same Dye Used In A Regular Slit-Lamp Examination. You'll Also Receive Eye Drops Containing An Anesthetic. Using The Slit Lamp, Your Doctor Moves The Tonometer To Touch Your Cornea And Determine The Eye Pressure. Because Your Eye Is Numbed, The Test Doesn't Hurt.

Noncontact Tonometry. This Method Uses A Puff Of Air To Estimate The Pressure In Your Eye. No Instruments Touch Your Eye, So You Won't Need An Anesthetic. You'll Feel A Momentary Pulse Of Air On Your Eye, Which Can Be Startling.

If Your Eye Pressure Is Higher Than Average Or Your Optic Nerve Looks Unusual, Your Doctor May Use A Pachometer. This Instrument Uses Sound Waves To Measure The Thickness Of Your Cornea. The Most Common Way Of Measuring Corneal Thickness Is To Put An Anesthetic Drop In Your Eye, Then Place A Small Probe In Contact With The Front Surface Of The Eye. The Measurement Takes Seconds

You May Need More-Specialized Tests, Depending On Your Age, Medical History And Risk Of Developing Eye Disease.

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