Posted on February 6, 2018
Most of us are under the impression that as long as we can see well, we do not need a routine eye check-up. Sometimes, we believe a visit to the optician to get a pair of glasses is sufficient for our eye health.
The reality is quite different: most of the vision threatening do not have symptoms in the early stages, and cannot be picked up by a test for refractive error (power of glasses) alone. Also, in India, optometrists and opticians do not perform an eye evaluation beyond the power of glasses.
Eye exams are performed by licensed eye doctors and involve not only checking your visual acuity and power of glasses, but also the comprehensive health of your eyes. This include measuring your eye pressures, eye alignment, as well as evaluation of the front (anterior segment) and back of the eye (including retina and optic nerve).
In addition to this, your eye doctor can detect early signs of serious diseases such as diabetes, high blood pressure, possible brain tumor and risk of stroke, based on the appearance of blood vessels, retina and optic nerve.
Therefore, the most critical reasons for an eye exam include:
- Establishing a healthy eye baseline, so any change can be picked up faster.
- Early detection and management of eye diseases
- Early detection, and monitoring of several systemic diseases like diabetes, high blood pressure etc.
How often do we need an eye examination?
The need for an eye examination depends on your age and general physical health. The table given below only provides broad guidelines with respect to timing of the eye test, your doctor will usually inform you of when your next check needs to be scheduled. This is true only if you do not have any specific eye diseases, and are otherwise healthy. Comprehensive eye exams with your doctor, therefore, should be scheduled at:
- Age 6 months
- Age 3
- Age 5 or 6 – before joining school and every two years thereafter
- Age 18 to 40 – at least every two years
- Age 41 and older – at least every year
Special considerations which merit a more frequent eye evaluation include any symptoms of redness, pain, watering, misalignment, decrease in vision, blurring of vision, frequent headaches etc. In addition to this, more frequent evaluations are required if:
- If you have a refractive error more than -5 Diopters, you will need an annual eye examination regardless of your age. This is true even if your power of glasses is zero post LASIK. If your power of glasses before LASIK was high, you will continue to require a comprehensive eye evaluation, annually.
- If you are diabetic, you will need a comprehensive eye exam at least annually. Depending on the degree to which your retina has been affected, and your blood sugar control, you may need more frequent eye exams.
- In case you are on certain drugs for arthritis, tuberculosis and depression, your doctor may want to schedule more frequent eye tests to monitor the side effects of medication on your eye.
- If you are a contact lens user, you may also need regular exams with the eye doctor to review your prescription, annually.
- In case you are a glaucoma suspect, again, your eye doctor may schedule more frequent exams. This is true for any suspicion or beginning of eye disease: glaucoma, Age related Macular Degeneration, Cataract, Retinal degeneration, or ocular surface disease.
If you have a refractive error more than -5 Diopters, you will need an annual eye examination regardless of your age. This is true even if your power of glasses is zero post LASIK. If your power of glasses before LASIK was high, you will continue to require a comprehensive eye evaluation, annually.
What will happen during the eye exam?
A routine eye check may be divided into two parts. In some hospitals, the first part is actually carried out by an optometrist while the second part is done by the ophthalmologist. In certain clinics, everything is done by the doctor himself or herself. This depends on the doctor’s preference, and how busy he or she is. In either case, the final prescription is always supervised by the doctor.
The doctor will talk to you of any concerns regarding your eye or general health, and also enquire about any past medical or surgical history. He or she will also ask you about any family history of disease and if you are currently on any medication.
Checking visual acuity:
Your vision for near and distance will be checked. In case found deficient, you will be prescribed corrective glasses or contact lenses
Your eye pressure will be checked either with a non-contact tonometer, or with a contact machine. The latter will involve the use of topical anesthetic drops.
Slit lamp evaluation:
You will be asked to sit on a special machine called the slit lamp, which is basically a microscope with a built in illumination system. With this, you doctor is able to see a magnified image of all eye structures. To see your optic nerve and retina, you doctor will use a system of lenses to make the light focus posteriorly.
A dilated may not be scheduled every time you see a doctor. This involves instilling eye drops (which takes about an hour) to dilate your pupils, so that your doctor can evaluate your retina and optic never in greater detail. A dilated evaluation makes your vision will be blurred for three to eight hours (depending on dilating agent used) and you will not be able to drive back form the doctor’s appointment. Also, you will feel an increased intolerance to light. Therefore it is prudent to ask the doctor ahead of time if you will be needing a dilated exam and make arrangements for this. If you are diabetic, have a high refractive error, or have an eye disease like retinal degeneration, AMD or glaucoma, chances are you will require a dilated eye evaluation.
In case your eye doctor suspects any disease process, he or she will schedule or order some specific tests which will help in diagnosis and management of that disease process, separate from the routine eye check-up.
The old adage, a stitch in time saves nine, is especially true for a routine eye examination. If you are regular with your eye exams you can be assured that your eye health is being monitored regularly, and any threats to your eye health and vision can be picked up and managed in time.