What to Expect When Visiting the Ophthalmologist

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.  

If you’re ready to plan a comprehensive eye exam with an ophthalmologist in NYC, read on for an overview of what you may encounter, including various tests and how they work.

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.

As you await your next eye exam with an ophthalmologist in New York City, rest assured your exam will be thorough, free of discomfort and remains the best way to adequately manage the health of your eye.