Eye Exams

Vision-Care

Comprehensive eye exams provide important information to your eye doctor about the overall health of your eyes. Having regular eye exams is important to ensure your vision lasts a lifetime.

What can you expect during your eye exam?

During your eye exam, your eye doctor will ask you about your medical history, including questions about your general health, your vision and if you wear eyeglasses or contact lenses, and medications you may be taking.

Your eye doctor will then conduct various vision tests, such as the following, to see if you are nearsighted, farsighted, have astigmatism (a curved cornea that blurs vision), presbyopia (age-related vision changes), or some other eye problem:

Visual Acuity

You will be asked to read an eye chart (known as the Snellen chart) to determine how well you see at various distances. You cover one eye while the other is being tested. The eye chart tests your visual acuity (sharpness of vision) to determine whether you have 20/20 vision or not.

Pupils  

Your doctor will check how your pupils respond to light by shining a bright beam of light into your eye. Your pupils should respond by getting smaller. If they don’t, this may be due to an eye problem and may require further testing.

Side Vision. Your doctor will test for any loss of side vision (peripheral vision). If you have any loss of side vision, this may be a sign of glaucoma.

Eye Movement. Your doctor will test your eyes for ocular motility–the movement of your eyes, and will also check that your eye muscles are working right and that your eyes are aligned. If eyes are not aligned, this visual problem is called strabismus.

Eye Pressure. Your doctor will measure the pressure within your eyes with a tonometer. If you have elevated intraocular eye pressure, this is a sign of glaucoma.

Front Part of Your Eye. Your doctor will use a slit lamp microscope to light up the front part of the eye, which includes the eyelids, cornea, iris, and lens, to check for cataracts or any scars or scratches on your cornea.

Retina and Optic Nerve. Your eye doctor will put eye drops into your eye to dilate your pupil, which will allow him or her to examine your retina and optic nerve for signs of damage from disease.

Note: When you are scheduled for a comprehensive eye appointment, expect to have your eyes dilated and arrange to have someone drive you to your appointment, as your eyes might be sensitive to light for a few hours after dilation.

What does 20/20 vision mean?

The phrase 20/20 vision refers to normal vision. A person with 20/20 vision can see what an average individual can see on an eye chart when they are standing 20 feet away. The top number refers to your distance in feet from the chart. The bottom number indicates the distance at which a person with normal eyesight can read the same line.

What is the goal of correcting vision with eyeglasses or contacts?

The goal of correcting vision with eyeglasses or contacts is to bring a person’s vision to 20/20.

In prescribing eyeglasses or contacts for vision correction, your doctor will ask you to review an eye chart through a device called a phoroptor. The refraction test, also termed a vision test, is an examination that tests an individual’s ability to see an object at a specific distance. The test involves looking through the phoropter to read letters or recognize symbols on a wall chart through lenses of differing strength which are contained within the device. During this process, the eye doctor will ask you “Which is better…one or two?” This test is performed as part of a normal eye examination to determine whether an individual has normal vision. This device will help determine the best eyeglass or contact lens prescription for you. 

Why doesn’t Medicare cover the cost of a refraction test?

Unfortunately, Medicare considers a refraction test a routine test and therefore does not approve it making it a non-covered service. Since Medicare doesn’t cover it, many commercial insurance companies follow suit and also consider it a non-covered service.  At FSN Eye Center, we can help cover the cost of a refraction test. Contact us at (815) 932-2020 or email us using our contact form for a $45 coupon (valid only at this office). We will attach this coupon to your account when you make an appointment.

How does your vision change as you age?

As a child, you can lose your 20/20 vision around age 8 or 9. As you get older, your visual acuity may stay the same until you reach your 60s or 70s when it may decrease slightly. 

Even though your visual acuity may not change, you may lose your near vision when you reach middle age. As you get older, your eyes’ lenses become less flexible making it hard to change focus from objects that are far away to close objects. This is called presbyopia. You may need reading glasses or bifocals to correct the problem.

How often should you get your eyes examined?

You should have a comprehensive eye exam every 1 to 2 years, depending on your age, risk factors, and whether you currently wear eyeglasses or contact lenses.

If you have an eye disease or risk factors such as diabetes, high blood pressure or a family history of eye disease, you should schedule an appointment for a comprehensive eye exam before the age of 40. According to the Centers for Disease Control and Prevention (CDC), diabetics should have an eye exam every year to check for early signs of eye problems such as diabetic retinopathy.

Since your risk for eye diseases increase as you get older, you should have your eyes checked every year or two after the age of 40. Your doctor will check for signs of age-related eye diseases such as:

This is the age when early signs of disease or changes in vision may appear. It is important to find eye diseases early, as early treatment can help preserve your vision. 

If you wear eyeglasses or contact lenses, as a general principle, eyeglass prescriptions are good for 2 years, and contact lens prescriptions are good for 1 year. That should be a guide for when you should have your next eye exam to see if there have been any changes to your vision requiring a new prescription.

What are the early signs and symptoms of vision changes?

Early signs and symptoms of possible vision changes may include increased sensitivity to glare, increased lighting requirements, more time required to adjust to bright light and/or darkness, reduced contrast sensitivity, decreased ability to judge depth perception, decreased ability to focus close up, or decreased color sensitivity.

What is the difference between a vision screening and an eye exam?

A vision screening assesses your vision, whereas a comprehensive eye exam includes a battery of tests to evaluate the health of your eyes and your vision.

Why is regular vision screening important for children?

Regular vision screening is important for newborns, infants, preschoolers, and school-age children because a child’s vision system is not fully formed and equal input from both eyes is necessary for the brain’s vision centers to develop normally. If a young child’s eyes cannot send clear images to the brain, his or her vision may become limited in ways that cannot be corrected later in life. If problems are detected early, however, it is usually possible to treat them effectively.

How often should children have vision screening done?

According to the American Academy of Ophthalmology and the American Association for Pediatric Ophthalmology and Strabismus vision screening should be done following these specific childhood eye screening guidelines.

Newborns

An eye doctor should examine a newborn baby’s eyes and perform a red reflex test (a basic indicator that the eyes are normal). If a baby is premature or at high risk for medical problems, an eye doctor should perform a comprehensive eye exam.

Infants

It is recommended that an infant have a second screening during a well-child exam between the ages of 6 months and the first year. 

Preschoolers

Additional eye screenings should be done for preschoolers between the ages of 3 and 3½ to check visual acuity and eye alignment. If the child is not old enough to cooperate with an eye exam using an eye chart, photoscreening is another way to check visual acuity. Either test is important to check whether the child can focus normally at far, middle, and near distances. 

School-aged children

School-age children should have eye screening done for visual acuity and alignment upon entering school, as nearsightedness is the most common refractive error in this age group and can be corrected with eyeglasses. If an alignment problem or other eye health issues is suspected, the child should have a comprehensive exam by an ophthalmologist.

If your child fails a vision screening or the screening is inconclusive or cannot be performed, then you should schedule your child for a comprehensive eye exam.  A comprehensive eye exam can facilitate the diagnosis of visual problems. The eye doctor will use eye drops to dilate the pupil so the eye and the visual system can be more thoroughly examined.

After an exam, your ophthalmologist can tell you how often you should have your eyes checked in the future. It’s important to follow the schedule your ophthalmologist gives you, especially as you age. Your risk for eye disease increases as you get older.

Eye Exams at Fisher-Swale-Nicholson Eye Center

Periodic eye exams are an important part of preventive healthcare. Contact Fisher-Swale-Nicholson Eye Center at (815) 932-2020 to schedule your comprehensive eye exams.