Comprehensive Eye Exam

"Comprehensive Eye Examination in jaipur by eye destination. "

Introduction
The best way to ensure a lifetime of good vision is through regular, comprehensive eye examinations. In addition to ensuring proper eyesight, regular exams allow the early detection and treatment of diseases, improving the likelihood for successful treatment. Several eye diseases, such as glaucoma, show no symptoms in their beginning stages and can only be detected by a qualified examiner.
Not all eye examinations need be comprehensive. Some may be specifically formatted for the evaluation, diagnosis and treatment of a specific complaint. Generally, a comprehensive examination takes about hour, depending upon the number and type of tests required.

Someone to drive you home

A comprehensive eye exam requires that your pupils be dilated with eye drops. This enables us to thoroughly examine and accurately measure the eye. The drops that are used are longer lasting than what you may be accustomed to from past visits to the eye doctor.

These will leave your vision somewhat blurry and brighter than normal for about four hours. We recommend that you bring a pair of dark sunglasses and a friend or family member to drive you home afterwards. We also offer a type of eye drop that reverses dilation (reducing the time to about one hour), although many patients prefer not to use it because it usually causes side effects of irritation and redness.

Symptoms and complaints

You will need to supply some basic information about why you are having an exam at this time. Here are some common questions you might need to answer:
  • Why are you here?
  • Did you bring your glasses or contacts?
  • Do you have a specific problem?
  • What are your symptoms?
  • When does it happen?
  • How often does it occur?


Case history

Since the eyes are a part of the body, they can be affected by seemingly unrelated health conditions. You will need to supply information about your vision and health history, medications, symptoms of vision problems and other background information.

These are divided into 3 categories:

Ocular: The physical condition of your eye, including past injuries, infections, surgeries, changes in vision correction.

General: Lifestyle, including the past and current condition of your health, what medications you have taken, plus cigarette smoking, caffeine and alcohol consumption.

Family: Family members with health issues such as high blood pressure, diabetes, thyroid dysfunction, coronary artery disease, or elevated cholesterol. These can be inherited and may show early signs in the eye.


Examinations

Generally, the examination is divided into these areas:

Visual Acuity (VA)  : An assessment of the quality of your vision is called the Visual Acuitytest, or VA. This test determines how well your eye makes images and is measured for distance and near vision with standardized eye charts, at standardized testing distances, under specific lighting.
The Visual Acuity is noted as: a fraction of the testing distance vs. the size of the letter Basically, the first number is the testing distance and the second is the relative size of the image. For more information on how this works, see: Normal Vision.

External Examination: This is an examination of the external parts of each eye and the surrounding associated tissues. Structures examined include: the eyelids, lashes, conjunctiva, iris, cornea, crystalline lens and anterior chamber structures. A slit-lamp biomicroscope is used for much of this exam. Gonioscopy, a detailed examination of the drainage system in the anterior chamber, may be included for people who may haveglaucoma. This specialized test is generally not part of a routine examination.

Peripheral visual fields : This test may be performed by the use of a hand-held or by automated instrumentation, called the auto-perimeter test. It is included for people at risk for glaucoma or for routine "baseline" screening.
Defects in the peripheral visual field may be an indication of internal eye conditions, including retinal detachment and glaucoma, or may be the result of problems with the brain or vascular system.

Pupil reflex tests : In this test, a light is shone into your eye and the iris is observed for its ability to constrict (reduce in size) and dilate (increase in size). Abnormal pupil reflexes may indicate faulty neurological (brain) development or could be a sign of an internal eye infection.

Ocular motor tests : These tests measure how well your eye muscles work and whether they are working in harmony with each other. In children, faulty ocular motor skills often leads to learning disabilities, as well as poor coordination with other motor skills such as walking or athletic abilities. In adults, if one is previously tested as normal and then suddenly not normal, this may indicate neurological disease, including multiple sclerosis, brain tumor, or result from stroke or other systemic diseases.

Binocular vision tests : This is testing to determine if both eyes are working together for accurate depth perception. "3-D" red/green or polarized lenses are often used for these tests.
In children, poor or lacking binocular vision may indicate overall faulty vision system development and lead to learning disabilities and "clumsiness".
In adults, if one is previously tested as normal and then suddenly not normal, this may indicate neurological disease, including multiple sclerosis, brain tumor, or the result of a stroke or other systemic disease.

Color vision tests : The analysis of color perception is often tested on children but not necessarily on adults, unless there is reported change in color perception or a particular job requirement is involved (piloting for example). Changes in color perception for adults can be related to internal eye disease, neurological problems or drug toxicity.

Ophthalmoscopy : This is a test used for observing of the internal structures of the eye. It is the only technique aside from surgery that allows direct observation of the complete network of blood vessels. It can help diagnose hardening of the arteries, high blood pressure, diabetes mellitis, as well as other whole-body and eye-specific disorders.
It employs an instrument called an ophthalmoscope: A direct ophthalmoscope is a handheld instrument brought very close to the eye. Using a light source to illuminate the inside of the eye, this instrument provides magnified but somewhat limited view of the inside of the eye. An indirect ophthalmoscope is a spectacle-mounted or headband mounted apparatus worn by the examiner, and is considered to be the standard of care. It is used to provide a significantly wider field of view in stereo (3-D). Drops are required to dilate (open up) the pupil. A more recent variation of indirect ophthalmoscopy is performed with small hand-held lens at the slit-lamp. Often both types of ophthalmoscopes are used during an examination. Direct ophthalmoscopy may be done prior to the visual analysis, while indirect ophthalmoscopy is often performed following vision testing, as the dilating drops may effect optical measurements.

Tonometry: This is the test for measuring the internal pressure of the eyeball. Elevated pressure is one of the signs of glaucoma. There are a number of instruments used to test eye pressure. Some require that an object be placed for a moment against the cornea in the front of the eye (usually requiring a drop of anesthetic and sometimes a liquid to color the tears) and some use a burst of air to press against the eyeball. ED utilizes instruments that do not use the air burst because they offer greater accuracy and comfort for his patients. Tonometry is often performed at the end of an examination.

Keratometry:  This procedure measures the curvature of the cornea in two perpendicular meridians. The front of the eye may be round like a basketball, or irregular like a football (see Astigmatism).

Retinoscopy and Auto-refractometry: These are objective tests for test your capability to see images clearly, which don't require your input and allow your examiner a good starting point for the determination of your lens prescription. Your subjective input is necessary in a separate test for refinement. A retinascope is a handheld instrument that allows the doctor to focus a spot of light onto the back of the eye through varying lenses. Anauto-refractor does much the same thing automatically.

 
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