Many patients may be
unsure of what they can expect during their first visit to an ophthalmologist,
a medical doctor with expertise in eye disease, treatment and surgery. Unlike
an optometrist, an ophthalmologist specializes in more advanced eye diseases
and conditions like glaucoma, macular degeneration and signs of retinal
detachment. If you’ve made an appointment with an ophthalmologist, you’ve likely
either identified risk factors for eye disease (such as distorted vision,
floaters, loss of peripheral vision and more), or you are wisely taking a
precautionary measure to seek out a complete medical exam from a licensed
medical doctor. In fact, a complete medical exam by an ophthalmologist is
highly recommended before the age of 40 and even earlier for those with a
family history of eye disease.
Discussion and Basic Examination
The first thing you
can expect in an ophthalmological eye exam is a thorough discussion of your medical
history, with specific focus on any eye or vision problems you may be
experiencing. The answers to these questions will help determine the focus of
the proceeding exam and may influence possible treatment.
Next, your
ophthalmologist will ensure that basic eye tests are conducted to determine
issues with things like eye muscle strength and coordination, visual acuity,
the presence of astigmatism or presbyopia, refractive errors, or an impaired
field of vision. If you’ve previously been examined by an optometrist most of
these tests, such as following a beam of light with your eye, reading an eye
chart, or identifying when an image passes into your peripheral vision, will be
familiar. No aspect of a basic examination involves discomfort or direct contact
with the eye.
Slit-Lamp Examination
A comprehensive eye
exam will then evaluate more complex aspects of eye health. To provide a
medical diagnosis of the condition of your cornea, iris and pupil your
ophthalmologist will perform a slit-lamp examination, in which a microscope and
high-intensity light will be directed towards the pupil for a magnified and
detailed view of structures. A slit-lamp examination can diagnose serious eye
conditions such as macular degeneration, cataracts, or conjunctivitis.
For a more in-depth
look at the cornea, your slit-lamp examination may also involve the application
of the liquid fluorsecein, which, by dying the film of tears over your eye, can
make damaged cells easily visible. The fluorsecein may cause slight discomfort
depending on your sensitivity to eye drops, but will wash out naturally with
tear production.
Retinal
Examination
An ophthalmologist’s examination of the
retina (also known as ophthalmoscopy or funduscopy) is an imperative part of any comprehensive, medical ophthalmological
exam. Once the eye is dilated, this exam will allow your doctor to evaluate
your optic disk, retina and the blood vessels positioned beneath the retina
(known as the choroid) to check for any signs of detachment, diabetic
retinopathy, hypertension and more. Remember, a detached retina will cause
permanent blindness.
An ophthalmologist may check these areas of
the eye using one of three methods. If conducting a direct examination, a
doctor will use an ophthalmoscope to place a beam of light directly onto your
pupil to illuminate the back of your eye, where the retina, optic disk and
choroid are located. If your doctor chooses to proceed with an indirect
examination, you may be asked to lie down or recline as a condensing lens and a
mounted lamp are used to investigate the inner eye with a detailed, three
dimensional view.
Finally, your doctor may opt to conduct
another type of slit-lamp exam, in which a beam from the slit lamp is projected
through a special lens held in front of you, also affording a more detailed
view of the inner eye. Regardless of which examination is conducted, you can expect
a pain-free experience completed in less than ten minutes.
Glaucoma Screening
In a comprehensive eye
exam from an ophthalmologist, you can also expect a screening for glaucoma, an
eye disease that can cause blindness if not treated early. This screening an
important part of a complete medical eye examination and is typically conducted
in one of two ways.
Using applanation
tonometry, a doctor will measure the pressure of your eyeball (intraocular
pressure) by determining the force needed to temporarily flatten a section of
your cornea. Applanation tonometry
requires the application of flourescein and droplets of an anesthetic to the
eye, so that as the doctor uses a tonometer device to touch the surface of the
cornea and determine pressure, you’ll still be able to see clearly yet not feel
a thing.
If your
ophthalmologist chooses to screen for glaucoma using noncontact tonometry, you
can expect to receive a quick puff of air to the eyeball to estimate
intraocular pressure. While the air may startle you or cause your eye to water,
no direct contact will be made to your eyeball.
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