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All About Vision

Eye Exams for Children

According to experts, 80% of learning is visual, which means that if your child is having difficulty seeing clearly, his or her learning can be affected. This also goes for infants who develop and learn about the world around them through their sense of sight. To ensure that your children have the visual resources they need to grow and develop normally, their eyes and vision should be checked by an eye doctor at certain stages of their development.

According to the American Optometric Association (AOA) children should have their eyes examined by an eye doctor at 6 months, 3 years, at the start of school, and then at least every 2 years following. Elemental Eyecare provides eye exams for children five years of age and older. If there are any signs that there may be a vision problem or if the child has certain risk factors (such as developmental delays, premature birth, crossed or lazy eyes, family history or previous injuries) more frequent exams are recommended. A child that wears eyeglasses or contact lenses should have his or her eyes examined yearly. Children’s eyes can change rapidly as they grow.

Eye Exams in School-Aged Children: Ages 6-18

Undetected or uncorrected vision problems can cause children and teens to suffer academically, socially, athletically and personally. If your child is having trouble in school or afterschool activities there could be an underlying vision problem. Proper learning, motor development, reading, and many other skills are dependent upon not only good vision, but also the ability of your eyes to work together. Children that have problems with focusing, reading, teaming their eyes or hand-eye coordination will often experience frustration, and may exhibit behavioral problems as well. Often they don’t know that the vision they are experiencing is abnormal, so they aren’t able to express that they need help.

In addition to the symptoms written above, signs of vision problems in older children include:

  • Short attention span
  • Headaches
  • Frequent blinking
  • Avoiding reading
  • Tilting the head to one side
  • Losing their place often while reading
  • Double vision
  • Poor reading comprehension

The Eye Exam

In addition to basic visual acuity (distance and near vision) an eye exam may assess the following visual skills that are required for learning and mobility:

  • Binocular vision: how the eyes work together as a team
  • Focusing
  • Peripheral Vision
  • Color Vision
  • Hand-eye Coordination
  • Tracking

The doctor will also examine the area around the eye and inside the eye to check for any eye diseases or health conditions. You should tell the doctor any relevant personal history of your child such as a premature birth, developmental delays, family history of eye problems, eye injuries or medications the child is taking. This would also be the time to address any concerns or issues your child has that might indicate a vision problem.

If the eye doctor does determine that your child has a vision problem, they may discuss a number of therapeutic options such as eyeglasses or contact lenses, an eye patch, vision therapy or Ortho-k, depending on the condition and the doctor’s specialty. Since some conditions are much easier to treat when they are caught early while the eyes are still developing, it is important to diagnose any eye and vision issues as early as possible.

Following the guidelines for children’s eye exams and staying alert to any signs of vision problems can help your child to reach his or her potential.

Contact Lens Basics

If you need vision correction for nearsightedness, farsightedness or astigmatism, contact lenses are a popular and effective option. In the United States, approximately 20% of the population who requires vision correction wears contact lenses. Currently dating back more than 125 years, contacts are presently available in a wide variety of materials and types. As opposed to the situation years ago, nowadays almost everyone can wear contact lenses.

Eyeglasses may be an attractive way to accessorize your outfit and make a fashion statement, yet you may sometimes prefer your appearance without glasses. Contact lenses allow you to have sharp vision without eyeglasses or costly vision surgery. Another benefit of contacts is that they grant a wider field of vision than glasses. This is a major advantage when it comes to playing sports or engaging in hobbies and professions such as photography.

If you are considering wearing contact lenses, you’ll need to schedule an initial eye exam and contact lens evaluation with your eye doctor. In the United States, contacts are regarded as medical devices that require a prescription by an eye care professional (ECP). In order to determine the best lenses for you, your ECP will assess your visual condition, structure of your eye and natural tear production.

Contact lenses are categorized depending upon the following factors:

  1. Material composition
  2. How long they can be worn before you have to take them out
  3. Life span- how long they can be used before you have to toss them and grab a new pair
  4. Design of the lenses

Material Composition of Contact Lenses

There are four different types of contact lens materials:

Soft Lenses

Over 90% of contact lenses on the market today are classified as soft lenses. These ultra-comfortable, thin contacts are constructed from gel-like plastics that contain a high percentage of water. They cover the entire cornea of your eye (clear front surface) and it is typically easy to adapt to wearing them.

First introduced in 1971, soft lenses used to be made from hydrogel materials. At present, silicone hydrogel is the most widespread, popular version. They permit a higher quantity of oxygen to reach the eye, which is healthy and comfortable.

Hard, Gas Permeable Lenses

Also called GP or RGP (rigid gas permeable) lenses, these contacts are smaller and made from plastics that have no water. They often provide the advantage of more acute vision, yet it generally takes longer to adapt to wearing them.

Hybrid Lenses

The center zone of these lenses is made from rigid gas permeable lenses, and a soft lens material encircles the border. Hybrid lenses thereby provide the best of both worlds – sharp vision from the center and a soft, comfortable border.

Wearing Time for Contact Lenses

The two primary kinds of contact lenses are daily wear and extended wear. Daily wear lenses must be removed on a nightly basis, and extended wear lenses may be worn up to seven days; a few brands of extended wear lenses are approved by the FDA for monthly wear (also known as “continuous wear” lenses). Extended wear lenses are very convenient even if you always remove them before going to sleep, as they are safe and comfortable for napping. Don’t sleep in your lenses unless you’ve discussed this with your doctor, since improper wear times can lead to corneal damage.

Life Span for Contact Lenses

All contact lenses must be discarded after a specified amount of time, even if you care for them well and properly. Soft contact lenses in particular accumulate lens deposits and contamination, which raises your risk of eye infections.

  • Daily disposable lenses: the most convenient and healthiest option, these lenses are replaced after one day of wear
  • Overnight disposable lenses (kept in your eyes overnight): must be replaced after one week
  • Monthly wear lenses: these are discarded after wearing for 30 days.
  • Gas permeable contact lenses: these are more resistant to lens deposits and can last up to a year or in many cases even longer with excellent care.

Designs for Contact Lenses

Contact lenses vary depending upon the type of vision correction that is required. The most common design is spherical, which works for nearsightedness, farsightedness and astigmatism. Toric lenses, which come in both soft and GP versions, possess multiple lens powers to correct astigmatism. Bifocal and multifocal lenses utilize a number of zones for different viewing needs, such as near, intermediate and far vision. They are often a good option for presbyopia. Orthokeratology (ortho-k) lenses are designed to reshape the cornea overnight, which corrects daytime vision without a need for eyeglasses or lenses.

Additional Features of Contact Lenses

Colored contacts: Lenses can be worn in color tints that enhance the natural color of your eyes or change your eye color totally. Blue eyes can be made more vibrant, or brown eyes can be altered to green.

Special-effect contacts: These lenses offer an extreme change to the color of your eyes and are generally used for costumes or theatrical effects. You can look like a zombie, an animal, or whatever you envision!

Prosthetic contacts: Disfigurations caused by disease or accidents can be masked by these colored contact lenses. With a medical orientation, prosthetic lenses are generally used to match the appearance of both eyes.

Contact Lenses that are Right for You

To identify the lenses that are ideal for your needs, you must first have a complete eye examination and contact lens evaluation performed by your eye doctor. Your ocular health will be inspected and detailed measurements of your eyes will be taken. Trial lenses will be inserted to check for the best possible and most comfortable fit and vision

After your initial fitting, follow-up visits for contact lenses are important. Your eye doctor will check that the fit is right and that no complications are developing. Your tolerance to contact lenses will be assessed. Sometimes a change in the fit or type of lens is necessary.

Your contact lens prescription will be issued after the fitting process is complete.

Proper Care and Handling of Contact Lenses

It is relatively simple to care for contact lenses. A single, multi-purpose lens solution is generally all that’s required for cleaning, disinfecting and storing your lenses. With daily disposables, routine care is totally eliminated and you can enjoy the feeling of a brand new fresh clean lens every day.

Your eye doctor or contact lens technician will instruct you how to take care of your contact lenses before you leave the office.

Worker Productivity and Computer Vision Syndrome

Since 43% of adults work at jobs that require prolonged use of a computer, tablet or other digital devices, computer vision syndrome (CVS) and blue light exposure are becoming increasingly serious threats to our vision, health and productivity.

Computer Vision Syndrome in the Workplace
Computer Vision Syndrome (CVS), also known as digital eye strain, is an increasingly common condition felt by those that spend two or more hours daily in front of a screen. Symptoms can include blurred vision, eye strain and fatigue, headaches, dry, red, irritated eyes, neck and back pain and headaches. Typically the symptoms of CVS are not permanent, however they can have an impact on comfort, productivity and one’s ability to focus. In rare cases, CVS can even be debilitating.

Studies show that symptoms of computer vision syndrome have become the most common workplace complaint or injury among workers with 50-90% of computer users reporting symptoms to some degree. These symptoms have been shown to have an impact on worker productivity.

The Effects of CVS on Productivity
In a study which looked at the correlation between computer vision and workplace productivity performed at the School of Optometry at the University of Alabama at Birmingham correlations were found between proper vision correction and overall productivity as well as the time it takes for a worker to complete a task. Even minor and unnoticeable vision problems were shown to affect productivity by up to 20% and to cause an increase in mistakes.

Blue Light Exposure
Blue light or high-energy visible (HEV) radiation exposure is another effect of extended digital device use. Excessive blue light exposure has been linked to sleep cycle disturbance – which can have an overall negative impact on alertness and one’s ability to focus. Blue light may also cause long term damage to the retina. While studies are currently being done to determine the effects of blue light, it is clear that protecting your eyes from blue light is recommended for eye health.

Workspace Ergonomics and Computer Eyewear
From both the worker’s and the employer’s perspectives, an investment in a combination of workspace ergonomics and computer eyewear can benefit the workplace and overall productivity. Workers will be more productive and experience fewer visual and musculoskeletal symptoms that can cause discomfort and distraction. Employers will benefit from productivity gains and reduced worker’s compensation claims.

Computer Glasses

Digital devices have impacted our world in so many positive ways, allowing us to connect, work, play, and get information at the speed of light. In fact, many people have a hard time when they “disconnect.” But all of this good brings with it a measure of concern: Digital Eye Strain or Computer Vision Syndrome.

Nearly 70 percent of U.S. adults experience digital eye strain as a result of the growing use of computers and digital devices. Adults aged 18 to 34 report feeling eye strain at a higher rate (45%) than their older counterparts. New research also suggests that overexposure to blue light, also referred to as high-energy visible or HEV light, may contribute to vision problems such as cataracts and age-related macular degeneration (AMD). Implications are just now being studied, but the short-term impact of digital eye strain affects individuals on a daily basis. Eye care providers are noting a steady rise in the incidence of myopia as well, which research suggests could be correlated to the increase of screen time and near focusing.

Symptoms of Digital Eye Strain include:

  • Headaches
  • Blurred or double vision
  • Sore eyes
  • Dry or watery eyes
  • Sensitivity to light
  • Neck, shoulder or back pain

In addition to these symptoms, emerging research shows that blue light from digital devices causes sleep disturbances by interfering with the REM cycle of sleep.

As people move from their computer to their tablet to their phone, more and more of these symptoms are being seen, and in younger and younger people. Computer glasses offer a solution to reduce the strain on your eyes and your exposure to blue light radiation.

How Computer Glasses Work

Computer glasses reduce eye strain by adjusting the focus slightly so that your eyes feel like they are focusing on something further away. They also have a tint to remove the glare and block blue light from entering into your eyes.

Finding the Right Pair

There are a number of companies that make computer glasses, some that are designed for device users without a prescription or that would wear the glasses with contact lenses. Other manufacturers provide options to incorporate vision prescriptions into the lens.

When shopping for computer glasses you want to make sure you find the right pair. The eyewear should sit nicely on your face and provide a comfortable tint. Here are some of the options available:

  • Single Vision Computer Glasses: Provide the optimum lens power and field of view for viewing your computer screen without straining or leaning in to reduce symptoms of CVS. These are ideal for when the computer is at a fixed working distance, and work well if the user needs to view multiple screens at the same working distance.
  • Office Lenses or Progressive Lenses: No-line multifocal eyewear that can be made to correct near, intermediate and some distance vision with a larger intermediate zone for computer vision if indicated. Perfect for those with presbyopia which is the gradual loss of focusing ability that occurs naturally with age. Office lenses work like progressive lenses but provide a wider field of view for intermediate (1-3 m) viewing distance and near working distance (about 40 cm).
  • Blue-Blocking Lenses: Definitely recommended for this electronic age, blue-blocking lenses block blue light emitted from computer screens that is associated with glare, eye strain and possible sleep disturbances.
  • Anti-glare and filtering coatings (treatments): Eliminate reflections from the surfaces of your lens to reduce eye strain and discomfort from glare. Some coatings can also block blue light emitted from computer screens.

While all of these are good options for protecting your eyes, the 20/20/20 rule still applies – after every 20 minutes of near tasks, look at something beyond 20 feet away for at least 20 seconds…it’s a good time to stretch the rest of the body too.

Eye exams are important to test your focusing ability, and to ensure that both eyes are working and focusing at the same place. Many people do not have the same prescription in each eye.

Children and Computer Glasses

Children are using digital devices more than ever and this trend will only continue as smartphones take over and tablet and computer-based learning increases. Their use extends well beyond the school day , as they use computers for homework and gaming and smartphones to text with their friends.

Computer glasses should be used for children proactively before eye strain begins to keep their eyes healthy longer and prevent nearsightedness.

Computer Eyestrain

Digital eye strain is an increasingly common condition as digital devices become more ingrained into our daily lives. Digital eye strain, eye fatigue and computer vision syndrome (CVS) are conditions that result from extended exposure to digital screens such as computers, smartphones, tablets and televisions from a combination of factors including the blue light radiation emitted from the devices and the pixelated content that is difficult for our eyes to focus on.

Symptoms of computer or digital eyestrain tend to be noticed after someone has used a digital device for as little as 2 hours a day. Studies show that 60% of people spend more than 6 hours a day in front of a digital device and 70% of adults report some symptoms of computer vision syndrome (CVS) which include:

  • Eyestrain
  • Headaches
  • Blurred or double vision
  • Physical and mental fatigue
  • Dry or watery eyes
  • Red or irritated eyes
  • Difficulty focusing
  • Sensitivity to light or
  • Neck, shoulder or back pain (caused by compromised posture to adjust to vision difficulty).

Digital eye strain also impacts your ability to focus and lessens productivity. Most people do nothing to ease their discomfort from these symptoms because they are not aware of the cause.

Protecting Your Eyes from Digital Eye Strain and Blue Light

There are a number of options for reducing digital eye strain and your exposure to blue light which include workspace ergonomics, computer glasses, specialized lenses and protective coatings. The first step is to get a comprehensive eye exam, making sure you speak to your eye doctor about how often you use a computer and digital device. This will help your doctor to get the full picture of your eye and vision needs in order to determine which option is best for you. It was also help the doctor to identify any underlying issues that could be worsening your symptoms.

Alleviating Digital EyeStrain

Workspace Alterations

Proper Lighting and Screen Brightness: You want the screen to be as bright as the surrounding environment or the brightest object in the room (depending on what is most comfortable for you). Therefore interior lighting or sunlight from the outdoors should be dimmed or blocked. Use fewer light fixtures or lower voltage light bulbs and close curtains or blinds when possible. Adjust the brightness and contrast of your monitor to the levels that are most comfortable.

Reduce Glare: Glare is a significant cause of computer eyestrain so it is important to minimize it as much as possible. Set up your computer where glare from windows won’t affect your screen or cover windows when this is not possible. Glare can also reflect from walls and shiny finishes on desks and other surfaces. An anti-glare screen on your monitor or an anti-reflective (AR) or anti-glare coating applied to your eyewear can also help to minimize glare and the strain it causes to your vision.

Screen size and distance: You want to make sure you are using a high quality (such as a flat LCD) screen that has a relatively large display (look for a diagonal screen size of at least 19 inches) and is located directly in front of your line of vision. Your viewing distance should be about an arm’s length away with the top of the monitor at about eye level or slightly below.

Eye Care

Keep Eyes Moist: When viewing a digital screen or monitor for an extended period of time, we tend to blink less frequently (about ⅓ as often as we should). Blinking however, is critical for keeping the eyes moist, which allows them to remain clear and comfortable and to avoid dry eyes, irritation, blurry vision or eye fatigue.

Focus on blinking by setting a timer for every 20 minutes and slowly closing and opening your eyes 10 times. Keep a bottle of artificial tears handy to use when your eyes are feeling dry.

Give Your Eyes a Break: Schedule and take frequent breaks from your screen. Follow the 20-20-20 rule; every 20 minutes, look at something 20 feet away for 20 seconds. Take this time to stand up and stretch your back, neck and legs as well.

Computer Eyewear

Computer glasses reduce eye strain by adjusting the focus slightly so your eyes feel like they are focusing on something further away. They also have a tint to remove the glare and block blue light from entering into your eyes. There are a number of options for computer eyewear, both if you need prescription eyewear and not. Speak to your eye doctor about what the best options are for you.
Learn more about computer glasses here.

It is important to know that both adults and children alike are susceptible to computer eye strain from computers and digital devices. With the growing use of such devices in our everyday lives it is important to start educating ourselves and our children on how to combat the negative effects of these habits.

Signs & Symptoms

Cataracts don’t suddenly develop overnight. They generally start off small and only begin to noticeably affect your vision as they grow. The first symptom is usually that your vision becomes blurred, hazy or cloudy. Additionally, you may become sensitive to light, making sunlight, oncoming headlights or indoor lighting appear exceptionally glaring or bright. Colors may seem dim and you may notice halos around lights or double vision.

The symptoms people experience from cataracts may vary. Some individuals even report a temporary improvement in near vision when a cataract first develops, a phenomenon known as “second sight”.

Here is a list of possible signs and symptoms of developing cataracts:

  • Blurry or cloudy vision (that can’t be corrected with a change in eyeglass prescription)
  • Glare from lamps, sunlight, oncoming traffic when driving at night or indoor lighting
  • Colors appear dim and less vibrant
  • Halos around lights
  • Double vision
  • Poor night vision
  • Sudden improvement in near vision

If you experience any change in your vision, visit your eye doctor immediately.

Signs and Symptoms of Diabetic Retinopathy

Diabetes prohibits the body from properly using and storing sugar, leaving excessive amounts of sugar in the bloodstream which can cause damage to blood vessels and various parts of the body- including the eyes and visual system. Diabetic retinopathy is when this condition results in progressive damage to the retina at the back of the eye. The retina is a light-sensitive tissue that is essential for vision, so if left untreated, diabetic retinopathy will eventually cause blindness. Sadly, despite the fact that proper monitoring and treatment can successfully halt the progression of the diabetic eye disease, it is still the leading cause of new cases of blindness in adults in North America.

Symptoms of Diabetic Retinopathy

Diabetic retinopathy progressively damages the blood vessels of the retina to the point that they begin to leak blood and fluids. This leakage causes swelling in the retinal tissue which can impact your ability to focus causing vision loss and if left untreated, eventually will cause blindness. Retinopathy typically affects both eyes and often will have no symptoms in the early stages – making regular eye exams essential for anyone with diabetes. The longer an individual has had diabetes, the more likely it is that they will have some degree of retinopathy.

Symptoms include:

  • Blurred or cloudy vision
  • Seeing floaters or spots
  • Difficulty reading or seeing close objects
  • Double Vision
  • Poor Night Vision

Untreated diabetic retinopathy can also lead to a detached retina. This can happen if the disease has progressed to proliferative retinopathy in which new, fragile blood vessels grow in the retina and the vitreous at the back of the eye. The blood vessels can break, leaking fluid and causing the growth of scar tissue which can cause the retina to detach. If left untreated this can cause blindness as well.

Many of the symptoms of diabetic retinopathy, particular in the early stages of vision loss, can be reversed with proper treatment and control of blood sugar levels. Diabetics with or without retinopathy must see an eye doctor at least once a year for a comprehensive eye exam to monitor any changes and ensure that proper treatment is prescribed.

Overview

Macular Degeneration, which is also known as Age-related Macular Degeneration (AMD), because it is usually associated with aging, is a leading cause of vision loss in adults aged 50 and older. The disease is characterized by a gradual loss of central vision and can occur in one eye or both eyes simultaneously.

Understanding AMD

Macular Degeneration is a disease that damages the macula, which is the center of the retina responsible for sharp visual acuity in the central field of vision. The breakdown of the macula eventually results in the loss of central vision and the ability to see fine details. While AMD doesn’t result in complete blindness, the quality of vision is severely compromised leading to what we refer to as “low vision”.

The loss of central vision can interfere with the performance of everyday tasks such as driving, reading, writing, cooking, or even recognizing faces of friends and family. The good news is, there are many low vision aides on the market now that can assist in helping you to perform these tasks.

Wet and Dry AMD

There are two types of AMD, wet and dry.

Dry AMD is the most common form of the disease. It is characterized by blurred central vision or blind spots, as the macula begins to deteriorate. Dry AMD is less severe than the wet form, but can progress to wet AMD rapidly.

Wet AMD is when abnormal blood vessels begin to grow under the retina and leak fluid and blood into the macula, causing distortions in vision. Wet AMD can cause permanent scarring if not treated quickly, so any sudden blur in vision should be assessed immediately, especially if one is aware that they have AMD.

Are You at Risk?

Awareness about the disease, the risk factors and prevention are critical, even for younger generations because taking care of your eyes while you are young will help to reduce the risks later on in life.

The biggest risk factor for AMD is age. Individuals over 60 are most likely to develop the disease however it can occur earlier. Additional risk factors include:

  • Smoking: According to research smoking can double the risk of AMD.
  • Genetics and Family History: If AMD runs in your family you are at a higher risk. Scientists have also identified a number of particular genes that are associated with the disease.
  • Race: Caucasians are more likely to have AMD than those from Hispanic or African-American descent.
  • Lifestyle: Obesity, high cholesterol or blood pressure, poor nutrition and inactivity all contribute to the likelihood of getting AMD.

Prevention of AMD:

If you have risk factors, here is what you can do to prevent or slow the progression of AMD:

  • Regular eye exams; once a year especially if you are 50 or over.
  • Stop smoking.
  • Know your family history and inform your eye doctor.
  • Proper nutrition and regular exercise: Research indicates that a healthy diet rich in “Eyefoods” with key nutrients for the eyes such as orange peppers, kale and spinach as well as regular exercise may reduce your risks or slow the progression of AMD.
  • Maintain healthy cholesterol levels and blood pressure.
  • Dietary supplements: Studies by the National Eye Institute called AREDs and ARED2 indicated that a high dosage of supplements of zinc, vitamin C, vitamin E and lutein may slow the progression of advanced dry AMD (it is not recommended for those without AMD or early AMD). Speak to a doctor before taking these supplements because there may be associated risks involved.
  • Wear 99% -100% UV-blocking sunglasses.

The first step to eye health is awareness. By knowing your risk, taking preventative measures and visiting your eye doctor on a regular basis, you can greatly reduce your chances of facing this debilitating disease.

Why are Eye Exams Important?

For both adults and children alike, eye exams are an important part of one’s general health maintenance and assessment. Your eyes should be checked regularly to ensure that you are able to see as best as possible. Regular eye health exams will also check for signs of eye disease or conditions that can affect not only your vision but your overall health. Vision and eye health is such a critical part in learning and development, therefore, we highly recommend eye exams for infants and children.

Vision Screening vs. an Eye Exam

When we recommend regular eye exams, this should not be confused with a vision screening. A vision screening is a basic test that indicates if you have difficulty seeing and require further assessment and corrective measures. It can be performed by anyone, whether it is a school nurse, a pediatrician or even a volunteer at a vision clinic. A vision screening usually only checks vision, it does not check eye health. Also, most vision screenings for kids only check for nearsightedness (when you can not see far), but what happens when the majority of children are farsighted? Most of the time many of these kids get overlooked.

A comprehensive eye exam on the other hand, can only be performed by an eye doctor as it requires special knowledge and equipment to look around and into your eye to check your eye and vision health. Such an exam can assess whether there are underlying causes for vision problems and whether there are any signs of disease which can threaten your site and the health of your eye. A comprehensive eye examination can also diagnose symptoms of diabetes, high blood pressure, high cholesterol, tumors, cancer, autoimmune disorders, and thyroid disorders. A comprehensive eye examination will also provide an accurate prescription for eyeglasses or contact lenses.

Eye Exams for Eye Health

Eye exams are critical because many vision threatening eye diseases such as glaucoma, macular degeneration, cataracts, or diabetic retinopathy have no or minimal symptoms until the disease has progressed. In these cases, early detection and treatment is essential to halting or slowing down the progression of the disease and saving eyesight. During a comprehensive eye examination, your eye doctor will be looking for initial signs of these diseases. If a problem with your eyes arises such as red eyes, eye allergies, dry eyes, eye swelling,eye pain, always seek an eye doctor as your first doctor to call since they are specifically trained to treat eye diseases.

Eye Exams and Children

If your child is having developmental delays or trouble in school there could be an underlying vision problem. Proper learning, motor development, reading, and many other skills are dependent upon not only good vision, but your eyes functioning together. Children that have problems with focusing or hand-eye coordination will often experience frustration and may exhibit behavioral problems as well. Often they don’t know that the vision they are experiencing is abnormal so they aren’t able to express that they need help. Many conditions are much easier to treat when they are caught early while the eyes are still developing, so it is important to diagnose any eye health and vision issues as early as possible.

Eye Exams Over 40

Just like the rest of our bodies, our eyes begin to weaken as we age. There are a number of common age-related eye conditions such as presbyopia, cataracts, and age-related macular degeneration that can begin to affect your vision and your daily life. While some of these conditions are more of an inconvenience, others could lead to vision loss and dependency.

In addition to regular yearly eye exams, it is important to be aware of any changes in your eye health and vision. Also know your potential risk factors as well as your family ocular and medical history. Over half of the vision loss worldwide is preventable with proper treatment and care.

Your Comprehensive Eye Exam

Your eyes are one of the most complex organs in your body. A comprehensive eye exam to assess your visual system and eye health involves a number of different of tests. Unlike a simple vision screening, which only assesses your vision, a comprehensive eye exam includes a battery of tests in order to do a complete evaluation of the health of your eyes and your vision.

The tests that you will undergo in a comprehensive eye examination may vary from eye doctor to eye doctor but here are are some common exams that you may encounter:

Patient Background and History

One of the most important parts in a comprehensive eye exam is your patient health history. This information will alert your doctor to any conditions that should be monitored closely, such as an allergy to any medications, current or family history of systemic or eye pathology or environmental conditions that could be affecting your vision or eye health. This will also help your doctor to determine any preventative eye care measures that are relevant to keep your eyes healthy for years to come.

Visual Acuity

Visual acuity is a measurement of your vision using an eye chart, the Snellen Eye Chart. In this test the patient is seated at a standard distance and is asked to read letters or symbols of various sizes, which get smaller as you move down the chart. The results are the familiar ratio of 20/20, 20/40 etc. which is a comparison of your vision compared to the average person with good vision, which is typically 20/20. For example, a patient that has 20/40 vision, can only see at 20 feet what the normal person can see from a distance of 40 feet. This test is a preliminary test of how clearly you are seeing in each eye but it does not give you a prescription for corrective lenses.

Refraction

Those who don’t have 20/20 vision have what is referred to in most cases as a “Refractive Error.” The patient may have nearsightedness, farsightedness, astigmatism or other eye conditions that prevent the patient from seeing 20/20. A refraction will tell the doctor which prescription lenses will correct your eyesight to achieve 20/20 vision or whichever amount your vision is correctable to.

A refraction may include a couple of steps.

Retinoscopy

Retinoscopy is a test that allows the doctor to obtain an approximate prescription for eyeglasses. In this test the doctor uses a hand-held instrument called a retinoscope that shines a light into the patient’s eye. The doctor then analyzes the reflex of the light from the patient’s eye to determine the patient’s prescription for glasses.

An instrument called a phoropter is something most patients associate with an eye exam. This space age appearing instrument, positioned in front of the patient’s face during the eye exam, gives the doctor the ability to determine the patient’s focusing ability as well as their eye alignment. The phoropter also determines which, out of the hundreds and hundreds of potential eyeglass prescriptions, will help the patient see as clear as possible. Using the phoropter, the doctor will ask the patient which series of lenses makes their vision the clearest.

While retinoscopy is quite effective for children and nonverbal patients, there are now a number of computerized or automated instruments available today to help doctors accurately determine a patient’s eyeglass prescription.

Autorefractors and Aberrometers

Autorefractors and aberrometers are computerized machines that are able to measure your refractive error to determine your prescription for glasses or contact lenses. These instruments are usually used in addition to testing described earlier:

– An autorefractor is similar to retinoscopy, which electronically analyses the light reflex from the patient’s eye.

– An aberrometer measures distortions or aberrations in the cornea and lens of the eye that disrupt proper focus of light on the retina. Using wavefront technology, the instrument measures the rays of light as they pass through your eye to look for imperfections which may indicate a refractive error.

Eye Focusing and Eye Teaming Tests

During the comprehensive eye exam, your eye doctor will also want to test how your eyes function individually and together from a mechanical perspective. In order to see clearly and comfortably, your eyes need to work together as a team.

Eye Health

The final and most important aspect of a comprehensive eye exam is a check of your overall eye health. These tests (below) are done to identify any eye conditions or diseases, both inside the eye as well as the external parts of the eye, that could affect your vision and general health.

Slit Lamp Test

The slit lamp or biomicroscope is an instrument that allows the doctor to examine the internal and external parts of the eye in detail, such as the conjunctiva, iris, lens, cornea, retina and the optic nerve. The patient rests their forehead and chin on a headrest to stabilize the head, while the doctor looks into the eye with the slit lamp microscope, which is magnified with a high-intensity light. A slit lamp test enables the doctor to evaluate the eyes for signs of normal aging and eye pathology, such as conjunctivitis, cataracts, macular degeneration or retinal detachment. Early diagnosis and treatment of eye diseases are essential for preventing vision loss.

Tonometry

Tonometry is a test to detect glaucoma by measuring the pressure inside your eye or IOP (intraocular pressure). Glaucoma can cause vision loss and even blindness if the IOP in the eye is too high and damages the optic nerve.

The applanation tonometer, typically attached to a slit lamp, is one of the most common instruments used to measure the pressure in the eye. Prior to doing this test the doctor will numb the patient’s eyes using an anesthetic, before gently applanating (putting pressure on) the patient’s cornea to measure the pressure in the eye.

Pupil Dilation

During your comprehensive eye exam, your doctor may decide to do a dilated eye exam. In this test, your doctor will instill dilating drops in each eye, which would enlarge your pupils to give the doctor a better view of certain parts of the back of the eye. Dilation is done at the discretion of the doctor, with some patients dilated every year and others at specified intervals; the frequency of dilation will vary for each patient.

Typically the drops take around 20 to 30 minutes to take effect and may last up to several hours following the exam; each patient is different. Since more light enters your eyes when your pupils are dilated, you will be more sensitive to bright light, especially sunlight. Although your doctor may provide disposable sunglasses, you may want to bring a pair of sunglasses to wear after the exam to make it more comfortable until the drops wear off.

A comprehensive eye exam is an important part of your overall general health maintenance and should be scheduled on a regular basis. The findings from your comprehensive eye exam can give your doctor important information about your overall health, particularly diabetes and high blood pressure.