What happens during a routine eye exam?
When you come in for your eye exam at one of our offices, our eyecare provider or optometrists always ask about your general health history and any specific eye concerns that you have. Following that, our specialists will perform a thorough eye exam, which is painless and swift. They check your vision through a visual acuity test in the exam room, where you will have to read letters out loud from the visual chart at a distance. You will also have your vision tested for near vision through a series of printed cards.
After that, you will receive eye drops from the doctor to numb your eyes. By doing so, the doctors will be able to test your eye pressure without discomfort. Other eye drops will dilate your pupils, allowing the doctors to see the inner portion of your eye. Depending on the information obtained about the condition of your eyes during the exam, you may receive additional testing or care recommendations to pursue.
What happens during a comprehensive eye exam?
In addition to the visual acuity test, additional tests like the evaluations of side vision, movement of the eyes, and the ability to track a moving object will be performed in a comprehensive eye exam. A device known as the Phoropter helps determine the proper prescription if you need glasses or contact lenses. Another common eye test known as Tonometry, is used to measure the pressure in your eyes. Eye drops will be administered to numb your eyes, which will make this part of the exam more comfortable.
The magnification and illumination provided by the slit lamp will allow your doctor to see the front portion of your eyes and check for irregularities in your cornea, lens, iris or the eyelid. Your doctor will use dilating drops to widen your pupil and enabling access to see your retina and the nerve You might be sensitive to light right after this portion of the exam, but after a a few hours, your eyes will adjust and are no longer sensitive to light.
What is refraction assessment and why is it important?
Refraction assessment is a test performed to measure the strength of your eyeglass lens prescription and it is performed using a device called a Phoropter. The phoropter is a large device that looks like a mask and is positioned in front of your face. The doctor will adjust the device to sit at your eye level during the testing process. During this procedure, our eyecare providers and optometrists typically use the phoropter to check the refraction in your vision by testing under several different lens. You respond to each option to pick the best lens that gives you the sharpest and the most precise visuals.
How is retinal examination accomplished?
A retinal examination is an extremely powerful diagnostic tool that can help with early intervention and treatment of several severe eye disorders and detect abnormalities in blood vessels and the optic disk. Our eyecare providers at Johnson Eyecare can examine the rear portion of your eye by administering special eye drops to dilate your pupils a bit wider, allowing more light to enter your eyes. Other devices like the ophthalmoscope may be used to direct a light beam into your eye to illuminate the rear portion. Another option is to combine a condensing lens and bright light to examine the inner structures of your eyes, like the retina and the optic nerve. This process can be completed in both the sitting up or reclining position.
What are common eye diseases or conditions?
If your eye doctor at Johnson Eyecare observes any signs of degenerative conditions or eye disease, additional testing may be required to investigate further. The doctor also charts the results of your exam, which allows them to easily track any changes over time.
Common eye problems and diseases include the following:
What is a Cataract?
A cataract is the clouding of the internal lens in the eyes, which interferes with the ability to see clearly. In a healthy eye, this lens would be clear, allowing light to enter seamlessly, and that enables you to see clearly. When you have a cataract, the clouding of the lens makes it like seeing through a foggy window. Some common symptoms of cataracts are:
What is a Glaucoma?
Glaucoma can be described as a group of diseases that affect the eyes. It is characterized by the damage of the optic nerve and loss of visual fields. Unfortunately, any damage to the optic nerve can lead to progressive and even irreversible vision loss, which is what makes this disease so serious. Glaucoma is most likely to be caused by a failure within the eye to properly maintain a healthy intraocular pressure or IOP, resulting in an elevated pressure within your eyes. while elevated eye pressure is a common contributor to glaucoma cases, even people with a normal IOP can develop glaucoma.
Experts currently believe that patients with glaucoma who do not have elevated eye pressure levels may suffer from poor blood flow to the optic nerve. A viscous fluid within the eye called the aqueous humor circulates through your eyes and it brings nourishment and lubrication before draining through a tiny mesh-like tissue. When that drain gets clogged, the fluid gets backed up and creates a greater-that-normal pressure on your eyes, leading to severe damage to your optic nerve. The optic nerve is responsible for transmitting data from your eyes to your brain, and over time, the damage caused by the increase in pressure can lead to permanent blindness.
What are some common symptoms of Glaucoma?
It is important to note that while the damage from glaucoma can cause vision distortions or even blindness, some people have very few to no symptoms initially. This is why it is absolutely critical to get your eyes checked through routine eye exams to proactively identify subtle signs of glaucoma.
Some common symptoms of Glaucoma include:
What is Macular Degeneration?
The macula is the portion of your eye that collects images and sends them to your brain to be interpreted as sight. As AMD develops, the condition begins damaging the macula - a term used to refer to a small spot that sits near the center of the retina. It is the part of your eyes that collects light and sends to your brain to be transformed into sight. The macula is the most sensitive part of the retina and it is responsible for creating a sharp, clear central field of vision.
When the macula is damaged, it affects your ability to receive sensory data perfectly, so the center of your field of view may appear blurry, distorted, or dark - resulting in progressive vision loss. Macular degeneration can be of two types; Wet and dry.
In wet macular degeneration, aberrant blood vessels is the major cause of the problem as they leak blood and fluid. With dry macular degeneration, the macula becomes thin and brittle resulting in the development of tiny clumps of protein. This type of macular degeneration constitutes of about 70 - 80% of cases.
What causes macular degeneration?
The actual causes of macular degeneration are unknown but for many people, this condition occurs as they near seniority, and scientists and medical researchers believe that this could happen in tandem with a combination of environmental factors. This age-related macular degeneration (AMD) occurs in three stages: Early, Intermediate and Late.
In the early stage, macular degeneration is very manageable. It can usually be detected during regular eye exams and most people don’t experience vision loss. In the intermediate stage, there might be some some degree of vision loss, and it usually exhibits some noticeable symptoms. In the late stage, vision loss is pronounced and getting treatment at this stage could potentially reduce the progression of the condition, but the chances of completely restoring vision are low. Patients suffering from AMD typically report developing distorted or blurry vision, particularly in the line of sight that sits straight ahead of them. As the disease progresses, the blurry or distorted area may grow in size, and patients are even likely to develop blank spots in their field of vision. Many patients also report that objects in their line of sight appear darker and lose their brightness as the disease progresses.
AMD by itself does not lead to complete blindness. However, it can definitely prevent patients from being able to carry out simple everyday activities safely and/or efficiently. As AMD progresses patients are likely to lose the ability to see faces, drive, read, write, cook or fix things around the house - just to name a few tasks AMD can interfere with.
Besides age, some other common risk factors of macular degeneration include:
How does diabetic retinopathy cause vision loss?
The retina is the innermost part of your eyes that is made up of a light-sensitive layer, or coat of shell tissue. It detects light and transmits that signal to the brain to facilitate sight. Diabetes affects the body’s ability to use and store sugar, and without proper management, sugar levels in the bloodstream elevate. These higher sugar levels can ultimately cause damage to our blood vessels, as they can weaken the walls of the blood vessels.
Since our eyes and retina rely on a healthy blood supply to function, any damage to the blood vessels within them can affect our vision. Weakened blood vessels often leak blood or a fatty fluid into the retina area, resulting in swelling or vision problems within the eye. Since the retina detects light and converts it into signals that are sent through the optic nerve to the brain - where said light is translated by the brain into an image for us to process - any damage or interference with it is likely to at least result in some distortion of vision, if not full-on blindness.
What are the effects of diabetic retinopathy on my eyes?
If you are dealing with diabetic retinopathy, you are likely to suffer a range of complications.
Some examples of the effects on vision include:
Myopia - Near Sightedness
Blurry or strained distant vision tasks
Corrected with:
glasses
contact lenses
refractive surgery
orthokeratology
Hyperopia - Far Sightedness
More blur and significant strain near vision tasks
Corrected with:
glasses
contact lenses
Presbyopia - Eyes of the Aging
Increasing difficulty with near tasks due to aging after 40 years of age (sometimes earlier)
Corrected by:
progressive addition lenses (PAL)
lined bifocal / trifocal systems
multifocal contact lenses
monovision contact lenses
Astigmatism
Visual irregularity in the way the eye focuses light due to irregular shape changes within the optical structures of the eye such as the cornea and lens.
Corrected by:
glasses
contact lens (Toric)
some refractive surgeries (determined by thorough exam)
Myopia - (near sightedness) Control
In today's near-point-dominated environment with computer screens, tablets and excessive cell phone use, children, as a population, will continue to become more myopic. This excessive near usage will create visual strain and progressive changes. Specific treatments will reduce near-point stress and therefore reduce strain / stress and near sightedness progression.
What are dry eyes?
The name implies the eye is actually dry yet many people who have the problem complain of tearing. In 1995, the National Eye Institute defined it as a disorder of the tear film due to tear deficiency or excessive tear evaporation which causes damage to the eye surface and is associated with symptoms of ocular discomfort. Since then, there has been much interest at improving and treating the root causes of dry eyes.
What are the symptoms of dry eyes?
Your eyes produce adequate tear to function correctly and keep it lubricated, so the surface of your eyes are clear and smooth.
Tears in and of itself, is made up of three layers:
What is Ptosis?
Ptosis is characterized by the drooping of one or both eyelids. In some cases, it might be barely noticeable, but usually it is very pronounced and it interferes with your ability to see clearly.
What Causes Ptosis?
Ptosis could occur for various reasons, but aging is the most common one. Some babies are born with ptosis, while others develop ptosis suddenly after injury. disorders like Myasthenia gravis and Horner syndrome, also feature ptosis as part of their disease symptoms.
Your eyelids are drooping because the muscle is weak or has loosened from its attachment. The drooping eyelids block peripheral vision making driving more difficult. It also affects reading, and walking especially down the stairs or stepping off the curb. Sometimes people bump their heads on objects above them because they cannot see it. For children, it threatens normal visual development. The ptosis would need to be corrected in a timely fashion to restore vision.
How Is Ptosis Treated?
Before proceeding with the treatment, our doctor would first have to evaluate on why the patient is seeking the treatment. Your doctor will review the surgical plan to correct the drooping eyelids and make it look proportional. For patients dealing with vision-related problems due to ptosis, eyelid surgery would be done in the first place to correct the drooping eyelids, followed up by addressing the remaining vision problems through other treatment methods or even a corrective surgery. In most cases, the eyelid surgery will sufficiently remove the vision problem, and further treatment may not be necessary.
What is Dermatochalasis?
Dermatochalasis is characterized by loose, excessive skin around the eyelids. It causes a tired, aged look around your eye because the skin adjacent to your eyes does not have adequate elastin or collagen to hold it in place. The amount of collagen in the skin decreases with age leading to the breakdown of its fibers. As it loses its elasticity, the bulky portion of the eyelid droops over the eyelashes. This would perpetually block the field of vision of the patient and could cause irritation in the eyelid as well as the eye itself.
What is a Blepharoplasty?
A blepharoplasty is a surgical procedure to correct the drooping and sagging of the patient’s eyelids. During a blepharoplasty, our doctor would remove or redrape the excess skin, muscle and the fatty tissues over and around the eyes, to create a more natural and youthful looking eyelid. This procedure to fix the upper eyelid is relatively straightforward and it affects only the surface layers of your skin and the soft tissues around the eye.
On the other hand, Blepharoplasty for the lower lids is complicated and requires more precision. The fat surrounding the eyes can protrude forward, right above the orbital bone, creating bags underneath the eyes. Regular exposure to light usually casts shadows underneath these bags, which creates dark circles under the eye and this makes people look aged and tired. Many surgeons would aggressively remove fat underneath the lower eyelid to eliminate these bags causing a complication. the lower eyelid becomes pulled down causing the eye to be too exposed and dry.
Our doctor has years of experience on various techniques to remove and redrape tissues into the depression between the upper cheek and the lower eyelids. This natural way of filling creates a smooth transition from the lower eyelid to the cheek, which will give you a healthier and more youthful appearance. In addition to that, the skin and muscle tissues are elevated and tightened to reduce the skin wrinkles. Your insurance may cover the cost of surgery depending on the amount and severity of obstruction of vision fields by the drooping eyelids. However, lower eyelid blepharoplasty is very rarely considered a covered benefit.
What are eye floaters?
Eye floaters are spots or tiny shadows or specks in your vision that appears to be floating or moving across your eyes. It would appear to be shifting or darting away if you virtually try to focus on them directly. In the vast majority of cases, eye floaters in all of their forms are benign, and are simply the result of a natural aging process in which flecks of protein and gel shrink and break away from the retina of the eye.
This process creates tiny shapes or flecks that can begin floating within the gel that fills in the back of the human eye, creating shadows on the retina, which leads to the image of floaters in our field in vision. If you suddenly experience an increase in floaters or if you see flashes of light, it is a good idea to schedule an eye exam immediately.
What is causing flashes of light in my vision?
Patients often describe the flashes as sudden instances of bright light on their eyes and it could have a pricking effect. Some patients also describe this condition as swift streaks of light or wavy lines of brightness. When experiencing flashes of light and floaters across the field of vision, most people misinterpret this to be originating from sources outside their body. But in reality, these spots could be originating from either your brain or your eye.
Changes in your vision caused by dark floaters accompanied by sudden flashes of light can be the outcome of retinal detachment, which is a serious emergency medical condition and without immediate medical intervention, a detached retina can lead to permanent blindness. Occasional floating dark spots and bright light flashes on your eyes are normal and they could occur more frequently as you age. However, both the floating dark spots and bright light flashes are also critical symptoms of other pertinent eye conditions, like:
Pink eye (conjunctivitis) is an inflammation or infection of the transparent membrane (conjunctiva) that lines your eyelid and part of your eyeball. Inflammation causes small blood vessels in the conjunctiva to become more prominent, which is what causes the pink or red cast to the whites of your eyes.
The cause of pink eye is commonly a bacterial or viral infection, an allergic reaction or, in newborns, an incompletely opened
tear duct. Though the inflammation of pink eye makes it an irritating condition, it rarely affects your sight. If you suspect pink eye, you can take
steps to ease your discomfort. But because pink eye can be contagious, early diagnosis and treatment is best to help limit its spread.
The most common pink eye symptoms include: