Eye Exam Checklist: What Your Doctor Will Check

During an eye exam, your doctor evaluates more than just how well you see. It’s a detailed process aimed at identifying vision problems and detecting early signs of health issues. Here’s a quick breakdown of what to expect:

• Medical History: Your doctor will ask about past eye problems, family history, medications, and any current symptoms.
• Vision Tests: Includes distance and near vision tests, eye movement checks, and determining your prescription for glasses or contact lenses.
• Eye Health Check: Examines the outer eye, eyelids, and internal structures like the retina and optic nerve. This may involve pupil dilation.
• Pressure Testing: Measures intraocular pressure to screen for glaucoma.
• Specialized Tests (if needed): Checks for peripheral vision, color vision, depth perception, or specific conditions like dry eye or diabetic eye disease.

Regular exams are essential for maintaining vision and catching silent conditions like glaucoma or diabetic retinopathy early. Always bring your current eyewear, a list of medications, and be prepared for dilation if necessary.

Routine Eye Examination

Medical History and Initial Discussion

Before any testing begins, your doctor will gather crucial background information to personalize your exam. The details you provide allow your doctor to better understand your specific risk factors and tailor the examination to fit your needs. This conversation is the foundation for reviewing your overall medical and eye health history.

Past Medical and Eye Health Records

Your doctor will carefully review your health history to identify potential risks. Conditions like diabetes can harm retinal blood vessels, increasing the likelihood of issues such as diabetic retinopathy, glaucoma, and cataracts. Similarly, high blood pressure can damage the retina, cause fluid buildup, and even lead to optic nerve damage. These problems often develop silently, without noticeable symptoms, making your health history a key tool for early detection.

Family history is just as important. If relatives have experienced conditions like glaucoma, macular degeneration, or inherited issues such as retinoblastoma, myopia, amblyopia, or strabismus, these details can help your doctor identify early warning signs. This information shapes the focus of critical tests, such as those assessing your retina and optic nerve.

Don’t forget to mention any previous eye problems, surgeries, or injuries. If you use glasses or contact lenses, bring your current prescription – or the eyewear itself – as this can help establish a baseline for comparison.

Your medications also play a significant role. Provide a complete list, including prescriptions, over-the-counter drugs, supplements, and herbal remedies. Some medications can have side effects that impact your eyes. For example, certain blood pressure medications may reduce tear production, while some antibiotics might increase sensitivity to light.

Current Symptoms and Daily Habits

Be prepared to discuss any vision problems you’re currently experiencing. Describe the symptoms in detail, including when they began, how long they last, and what makes them better or worse. For example, instead of saying "my vision is blurry", try to clarify whether it worsens at certain times of the day, affects one or both eyes, or happens during specific activities like reading or driving.

If you’ve been dealing with headaches or eye discomfort, share when they occur, how intense they are, and any patterns you’ve noticed. For instance, eye strain from extended computer use might lead to headaches that grow worse as the day progresses.

Your daily routines and work environment also matter. Share how much time you spend looking at screens, whether you work outdoors or under specific lighting conditions, and your level of sun exposure. If you wear contact lenses, include details like the brand, type, and how long you typically wear them.

For pediatric exams, mention any pregnancy-related factors that could have influenced a child’s eye development.

Lastly, don’t overlook environmental factors at home or work. Exposure to chemicals, dust, or bright lights, as well as whether you use protective eyewear, can affect eye health. Even small details, like frequent eye rubbing due to allergies or direct air conditioning, can provide valuable context.

This information helps guide the next steps in your exam, ensuring the tests address your unique risks and needs.

Vision Clarity and Function Tests

After reviewing your medical history, your doctor will shift focus to assessing how well your eyes see and function together. These evaluations are the foundation of your eye exam, helping determine whether you need corrective lenses or other treatments. They measure how your eyes perceive details and work as a team.

Distance and Near Vision Testing

Visual acuity tests gauge the sharpness of your vision by having you read letters on a chart. Starting with large letters at the top and progressing to smaller ones, this test measures how clearly you can see at different distances.

For distance vision, the chart is placed about 20 feet away. Your results are expressed as a fraction, such as 20/20, which indicates normal vision. If your result is 20/40, it means that at 20 feet, you see what someone with normal vision sees from 40 feet away.

Near vision testing uses a smaller chart that you hold about 14 to 16 inches from your face. This test is particularly important as aging can reduce the lens’s flexibility, a condition known as presbyopia, making it harder to focus on close objects.

Following these tests, your doctor will evaluate how well your eyes move and coordinate with each other.

Eye Movement and Coordination Check

For clear and single vision, your eyes need to work together seamlessly. Issues with alignment or movement can cause double vision, headaches, eye strain, and trouble focusing.

One common test is the ocular alignment test (Hirschberg test), where your doctor shines a flashlight from about 3 feet away to check the symmetry of light reflection in your pupils. If the reflection is centered in both pupils, your eyes are properly aligned. They may also observe your head posture – such as a tilt – which could signal that your eyes are compensating for alignment issues.

The cover test is another method to detect alignment problems. Your doctor will cover one eye while you focus on a target, then uncover it to see if the uncovered eye shifts to refocus. This is repeated for both eyes to catch any subtle misalignments.

Eye movement testing evaluates how smoothly and accurately your eyes follow a moving object, like a pen or light. It checks the function of the six muscles that control each eye’s movement and ensures your eyes can track objects and shift focus effectively.

Glasses and Contact Lens Prescription Testing

Determining your prescription involves both objective measurements and your input to achieve the most precise and comfortable correction.

The process often starts with an autorefractor, a machine that gives an initial measurement of refractive errors. You’ll look at an image, like a hot air balloon, while the device projects light into your eye and measures how it reflects off your retina. Alternatively, some doctors may use a retinoscope, a handheld tool that shines light into your eye while testing different lenses to find the clearest view.

Next comes the phoropter, a device with multiple lenses that your doctor switches in and out as you look through it. During this step, you’ll compare lens options to identify the one that provides the clearest vision. This subjective refinement ensures your prescription matches your visual needs and comfort.

These tests identify refractive errors like nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. They also provide detailed sphere, cylinder, and axis measurements for each eye.

If you already wear glasses or contact lenses, bring them to your appointment for comparison with your new prescription. This helps ensure the most accurate update to your vision correction.

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Eye Structure and Health Check

Once vision tests are complete, your doctor will examine the different structures of your eye, from the eyelids to the retina. Using specialized tools, they’ll carefully assess each part to detect any underlying issues that may not yet show symptoms.

Outer Eye and Eyelid Inspection

The structural evaluation starts with a close look at the outer eye. Your doctor will inspect your eyelids, eyelashes, and the surrounding skin for any irregularities that could impact your eye health or vision.

During this process, they’ll check for swelling, redness, or unusual growths on your eyelids. Common conditions like styes, chalazion, or blepharitis (inflammation of the eyelid) are often identified during this step. They’ll also ensure your eyelids close properly and verify that your eyelashes are growing in the right direction, as misaligned lashes can scratch your cornea.

Attention is also given to the tear ducts. Your doctor will observe whether your eyes produce enough tears and if the tear drainage system is functioning as it should. Blocked tear ducts can lead to excessive tearing or increase the likelihood of infections.

Additionally, the conjunctiva – the thin membrane covering the white part of your eye and the inner eyelids – is examined. This membrane can reveal signs of dryness, allergies, or infections that may need treatment.

Front Eye Parts Examination with Slit Lamp

A slit lamp examination gives your doctor a magnified, detailed view of the front parts of your eye. This device, a stereoscopic biomicroscope, uses a focused beam of light that can be adjusted to examine the cornea, iris, and lens in three dimensions.

By using different illumination techniques – such as direct focal illumination, optical section, and retroillumination – your doctor can identify issues like corneal scratches, inflammation, or cataracts. These problems can often be detected before they start to noticeably affect your vision.

Eye Pressure Testing

Testing the pressure inside your eyes, known as intraocular pressure, is a key step in identifying glaucoma, one of the leading causes of blindness. Normal eye pressure typically falls between 10 and 21 mmHg, though glaucoma can sometimes develop even with readings in this range.

The most common method, applanation tonometry, involves numbing your eyes with drops before gently touching the surface of your cornea with a small probe to measure the force needed to flatten a tiny area of the cornea.

Another option is the non-contact tonometer, often called the "air puff" test. This method uses a brief puff of air to measure eye pressure without physical contact. While slightly less precise than direct-contact methods, it provides a quick and painless screening.

To ensure accurate results, your doctor will take multiple readings, as eye pressure can vary throughout the day. Higher-than-normal readings don’t necessarily mean you have glaucoma, but they do signal the need for further testing. Once this step is complete, your doctor will move on to examine the back of the eye and optic nerve.

Back of Eye and Optic Nerve Examination

To examine the retina and optic nerve, your doctor needs to look through your pupil to the back of your eye. This step can uncover conditions such as diabetic eye disease, macular degeneration, retinal detachment, and glaucoma-related damage.

Dilating drops are used to widen your pupils, allowing for a detailed view of internal structures. This process takes about 15–30 minutes and may temporarily make your eyes more sensitive to light and blur your near vision.

Using tools like an ophthalmoscope or a specialized lens, your doctor will examine your optic nerve head, where the nerve fibers from your retina connect to your brain. A healthy optic nerve looks pink with a small central cup, while glaucoma damage can enlarge the cup and make the nerve appear pale.

The retinal examination focuses on the blood vessels, macula (responsible for central vision), and peripheral retina. Your doctor will look for signs of diabetic retinopathy, such as microaneurysms, hemorrhages, or abnormal blood vessel growth. Age-related macular degeneration may present as yellow deposits (drusen) or pigment changes in the central retina.

Many clinics now use digital retinal imaging, which captures high-resolution photographs of the back of your eye. These images allow for detailed analysis and provide a visual record for future comparisons, helping detect subtle changes that might not be noticeable during a direct exam.

This thorough structural evaluation plays a vital role in identifying eye diseases early – often before you experience any symptoms – making it possible to address problems sooner and protect your vision over time.

Additional Tests for Specific Conditions

Depending on your age, symptoms, and exam results, your doctor might recommend specific tests to get a clearer picture of your eye health. These tests go beyond the standard exam, targeting particular concerns or conditions that may have been flagged earlier. They help in diagnosing issues more accurately and tailoring treatments effectively.

Side Vision Testing

Peripheral vision testing, also called visual field testing, checks your full range of vision to identify blind spots or areas where your sight might be weaker. This is especially useful for catching glaucoma early, as the disease often affects side vision before central vision.

The process involves sitting in front of a device called a perimeter, focusing on a central point, and pressing a button whenever you see lights flash in your peripheral vision. Each eye takes about 10 to 15 minutes to test. The most common method, automated perimetry, creates a detailed map of your vision, highlighting areas of reduced sight. Small blind spots detected in this test could indicate early glaucoma or other conditions like strokes, brain tumors, or neurological issues affecting vision.

For a quicker check, your doctor might use a confrontation visual field test. Here, you’ll cover one eye and focus on the doctor’s nose while they move their hands around your peripheral field, asking you to signal when you notice the movement.

Color Vision and 3D Vision Tests

Color vision tests, often using Ishihara plates, identify color blindness. This condition affects about 8% of men and 0.5% of women, with red-green color blindness being the most common. While most cases are inherited and present from birth, sudden changes in color perception could signal retinal issues or other eye diseases.

Depth perception, or stereopsis, is tested to see how well your eyes work together to create a three-dimensional view of the world. For this, you’ll wear special polarized glasses and look at images or patterns that appear to have depth. Tests like the Titmus Stereo Test or Random Dot Stereogram are commonly used.

Problems with depth perception can result from conditions such as strabismus (misaligned eyes), amblyopia (lazy eye), or significant prescription differences between the eyes. These issues can impact activities like driving, sports, or judging distances, and often require further evaluation.

Tests for Specific Eye Problems

If specific symptoms or conditions are suspected, your doctor may recommend additional tests to pinpoint the issue and plan the right treatment.

For dry eye, the Schirmer test measures tear production using a small strip of paper placed under your lower eyelid. A result of at least 10 millimeters of wetting is considered normal. Another test, tear break-up time, evaluates how stable your tear film is; results under 10 seconds often indicate dry eye syndrome.

For diabetic patients, optical coherence tomography (OCT) captures detailed cross-sectional images of the retina. This quick, non-invasive test helps detect diabetic macular edema – fluid buildup that could harm central vision – before it’s visible in a standard eye exam.

Fluorescein angiography is another imaging test used to examine retinal blood flow. A fluorescent dye is injected into your arm, and as it travels through your retina’s blood vessels, special photos are taken to identify leaks or poor circulation.

Pachymetry, which measures corneal thickness, is often used in glaucoma assessments. Corneal thickness can affect eye pressure readings – thinner corneas might show falsely low pressures, while thicker ones could display higher readings. This test helps doctors interpret your results more accurately.

These specialized tests provide valuable insights, helping your doctor diagnose and manage specific eye conditions more effectively. While not everyone will need these evaluations, they are essential for addressing particular concerns and ensuring the best care.

Getting Ready for Your Eye Exam

Now that you know what happens during an eye exam, it’s time to get prepared. A little planning can make your visit smoother and ensure the most accurate results.

Start by gathering all your current eyewear – this includes your everyday glasses, reading glasses, computer glasses, and sunglasses. If you wear contact lenses, bring them along so your doctor can evaluate their fit and performance.

It’s also a good idea to make a list of all the medications you take, whether they’re prescription, over-the-counter, eye drops, or supplements. Some medications can affect your eyes or interact with drops used during the exam. Don’t forget to bring your vision insurance card, regular medical insurance information, and a photo ID, like a driver’s license. With these items in hand, you’ll be ready for any special procedures, such as dilation.

Be prepared for dilation. If your exam includes dilating your pupils, plan ahead. Dilation temporarily blurs your vision and increases light sensitivity, so arrange for someone to drive you home. The effects typically last 4–6 hours, so avoid tasks that require sharp close-up vision during this time. Pack a pair of dark sunglasses to shield your eyes from bright lights, even indoors.

Take a moment to jot down any recent changes in your vision or unusual symptoms you’ve noticed. It’s also helpful to share your family’s medical history, especially if there’s a record of eye conditions like glaucoma, macular degeneration, or diabetic retinopathy. Conditions like diabetes and high blood pressure can also impact your eyes, so be sure to mention these as well.

Arriving 5–10 minutes early allows time for parking and check-in. Many eye care centers now offer online forms that you can fill out in advance through a secure link sent via text or email, saving you time during your visit. Following these steps ensures your exam is efficient and provides the most accurate results.

Routine eye exams are key to keeping your vision sharp and catching problems early, often before symptoms appear. Serious eye conditions can develop silently, so regular checkups are your best line of defense against vision loss.

Ready to schedule your eye exam? Contact Haas Vision Center in Colorado Springs to book your appointment and take a proactive step toward safeguarding your vision and eye health.

FAQs

What are some signs that I should schedule an eye exam, even if my vision seems fine?

Even if your eyesight seems fine, there are some signs that might suggest it’s time to schedule an eye exam. These include frequent headaches, trouble seeing clearly at night, eye discomfort, or changes in your vision like blurriness or distortion. Beyond vision concerns, eye exams can also uncover hidden health conditions like diabetes, high blood pressure, or high cholesterol – sometimes before any symptoms show up.

Routine eye exams play a key role in keeping your eyes healthy and spotting potential issues early, even if you haven’t noticed any obvious vision problems.

How should I prepare for an eye exam to get the best results?

To make sure your eye exam provides the clearest results, come prepared. Bring a detailed list of any symptoms you’ve been experiencing, the medications you’re taking, and all the eyewear or contact lenses you use regularly. It’s also a good idea to skip eye makeup on the day of your appointment, as it can interfere with certain tests. Lastly, give your eyes a chance to rest beforehand to reduce any strain or fatigue. These small preparations can make a big difference in helping your eye doctor assess your vision and overall eye health accurately.

Why should I share my medical history and list of medications before an eye exam?

Sharing details about your medical history and current medications with your eye doctor is a key step in safeguarding your vision. Why? Because your overall health can play a big role in your eye health. For example, conditions like diabetes or high blood pressure can have a direct impact on your eyes, and having this information allows your doctor to catch potential problems early.

Medications you take may also come into play. Some drugs can cause side effects that affect your vision or eye health. By sharing this information, your doctor can adjust the exam to address your specific needs, ensuring more accurate results and care tailored just for you. This proactive step goes a long way in protecting your eyesight and supporting your long-term eye health.

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