Comprehensive Eye Exams

Our comprehensive eye exams consist of a multi-step process that covers eye health as well as vision correction.

Please note: a comprehensive eye exam does not include contact lens work or prescription. If you currently wear, or would like to consider wearing contact lenses, please let us know when making your appointment.

Please read further to understand what to expect during your visit.


Complete Health History

Optometry is a primary eye care health profession; therefore, we are tasked with obtaining a complete medical history at the time of your examination. A complete medical history consists of all of the following parts:

  • Patient demographics

  • Chief Complaint

  • History of Present Illness

  • Family and Social History

  • Allergies

  • Medication History

  • Review of Systems


Extensive Pretesting

Before you see the doctor, our technicians will perform several important tests.


Autorefraction

The first machine you will enounter is our Marco M3 which has 3 functions: autorefraction, keratomatry, and tonometry.

Invented in the 1970s, autorefraction essentially gives the doctor a starting point for your prescription by using 'objective' measurements of your eyes' optical system. We will further refine the final prescription in the exam using a phoropter to find your final 'subjective' refraction.



Keratometry

Keratometry ("measurements of the cornea") is the process of measuring your cornea's shape (clear front part of your eye). While an important measurement for many ocular conditions, it is required to properly fitting a contact lens as cornea's come in many curves and geometries.

Should your cornea need further testing, we will scan your eyes with a corneal topographer which will provide us with an extremely detailed map of your cornea and visual system.



Tonometry (air puff)

When know you hate it, but measuring your eye pressure is a vital component of any eye exam. Uncontrolled intraocular pressures (IOP) can lead to vision loss. If you prefer to not sit for the air puff machine, please tell your technician so that we can arrange for a different method of IOP measurement.



Optomap Retinal Screening

The optomap ultra-widefield retinal image is a unique technology that captures more than 80% of your retina in a single image while traditional imaging methods typically only show 15% of your retina at one time.

This recommended test is optional for the additional cost of $45; however, it greatly enhances your doctor's ability to detect and diagnose eye diseases.



Screening Visual Field

Your visual field is how much you see, now how well you see. Our office uses a Zeiss Frequency Doubling Technology  to quickly measure your central visual field. This is an important part of any comprehensive eye exam. A failed screening VF will usually lead to a further workup to check for other problems that can affect your visual field such as glaucoma, retinal detachments, brain tumors, strokes or other neurological and/or retinal conditions.



Entrance Testing

Once in the exam room, your technician we will go over your chief complaint and medical history. Afterwards, either your technician or doctor will test several aspects of your visual system that may include the following depending on your age and other factors:

  • Visual Acuity (are you 20/20?)

  • Color Vision (7% of men are colorblind)

  • Stereo Vision (3D vision)

  • Pupil Testing

  • Cover Test (eye alignment screening)

  • EOMs (Extra Ocular Muscle testing)

  • Convergence (can your eyes move in?)



Refraction

Although many other parts of your exam are more-important to your eye and overall health, your refraction may be why you are in the office. Subjective Refractions help us determine your final prescription; however, you may have several prescriptions such as one for driving, reading, bifocals, progressives, contact lenses, computer, music, outdoors, indoors, sunglasses, etc.

Little known fact: you have 3 options when we ask which one is better. The options are 1, 2, or "equal" which means you cannot tell a difference between the 2 options. "Equal" or "no difference" is actually what we are looking for! Many times your doctor will go over these options several times to be sure you are given enough opportunities to tell us for sure which one is better for you. Be sure to keep blinking during this test.

No, we do not know the answers ahead of time!



Anterior Segment Exam

The anterior segment exam is performed using our slit lamp. The slit lamp is large bonicoular microscope that has many options for light color and width (hence the "slit" in slit lamp). Using this device, we look for abnormalities of the front part of your eye that includes the eye lids, lashes, conjunctiva (clear covering of white part of the eye), sclera (whites of eyes), cornea (clear window of the eye), anterior chamber, iris, lens, angles, limbus, and anterior vitreous among other things.

During this partof the exam is when we find conditions such as cataracts, dry eyes, blepharitis, demodex, styes, etc. We also use the slit lamp to perform certain procedures such as foreign body removal, punctal plugs, and contact lens examinations.



Posterior Segment Exam

The posterior segment includes parts of the eyes behind the lens such as the vitreous (jelly of the eye), retina, optic nerve, etc. This is arguably the most-important part of any comprehensive exam so we do not take short cuts. New patients - you will be dilated unless you absolutely refuse! We dilate becasue our bright examination devices would cause the windows of your eyes (the pupils) to close and limit our view. Dilation drops open the pupils and allow us to see inside your eyes to evaluate your posterior segment for diseases such as glaucoma, retinal tears and detchments, tumors, bleeding, retinopathy from hypertesnive and diabetes, etc.

If you cannot, or refuse dilation, then we strongly urge you to opt for the Optomap retinal exam. While not a replacemnt for a true dilation, it is the next best thing.

Note: only the doctors get to put on the funny light helmet.


Further, optional testing

At the conclusion of your exam, your doctor may recommend further testing if abnormaltities were found. This may include testing for glaucoma, binocular vision, retina scans, visual fields, dry eye testing, corneal topography, IPL for dry eye, etc.

We also work closely with many ophthalmologists should you need a referral to a specialist or surgeon.

Interested in contact lenses? At this point you will go see the contact lens technician for either an initial contact lens fitting or evaluation and update of current lenses.


Eye Emergency?

If you have a true ocular emergency after hours please call 804-595-2020 and follow the prompts to contact a doctor. If the doctor cannot respond in a timely manner, please find the nearest emergency room.