What is My Eye Doctor Checking During an Eye Exam?


An optometrist’s office can look like a small research laboratory at first glance, but it doesn’t have to be a mystery. Learning a few of the basics of a comprehensive eye exam will help you better understand why the doctor is performing specific tests. When you’re more informed, then it’s much easier to ask your doctor better questions and stay on top of your eye health.

Breaking Down a Comprehensive Eye Exam

Visual acuity test: The Snellen eye chart, with its rows of smaller and smaller letters, is still the standard to test the sharpness of your vision. It serves as a baseline indicator for your eye doctor to proceed from.

Refraction test: With a better idea of where your vision is, the doctor will then proceed to perform a refraction test either with a manual phoropter or autorefractor to determine your specific prescription. Many doctors still perform the manual test placing multiple lens options in front of your eyes to reach the ideal prescription, but autorefractors are useful for children and patients who cannot provide appropriate responses to the doctor.

Slit-lamp exam: With a new prescription, you’re good to go, right? Not just yet. Vision correction is important, but it’s paramount that your doctor also discover the underlying causes of your vision loss. He or she will use a slit lamp to observe the outsides and insides of your eyes under higher magnification. Beyond general vision loss, conditions like cataracts, ulcers on the surface of the eyes and macular degeneration are discoverable.

Puff test for glaucoma: Damage to your optic nerve occurs over time when pressure builds up in the fluids of your eyes. Unfortunately, you won’t normally be aware of this problem until vision loss begins. Therefore, your doctor will perform a “noncontact tonometry” test that blows a small, painless puff of air on the surface of your eyes to determine their internal pressure.

Pupil dilation: If necessary, your doctor may use eye drops that temporarily expand your pupils to observe the structures at the back of the eye more closely. This, in combination with the slit lamp, makes it much easier to identify chronic health and eye conditions like diabetic retinopathy (damage to the optic nerve as a result of diabetes).

Other Possible Eye Tests During the Eye Exam

Other tests common during a comprehensive eye exam can include:

  • Color vision: Specially designed images with different colored dots determine if you have red-green color blindness
  • Eye alignment: The classic cover test where you cover one eye and focus on distant and close-up objects. It helps the doctor determine how well your eyes work in unison with one another
  • Ocular motility (eye movement): These tests are used to determine how well your eyes are able to switch between and focus on objects at various distances, as well as stay focused on moving objects
  • Depth perception: To determine depth perception problems, you may be asked to look at a series of patterns with 3D glasses and decide which one appears to be the closest
  • Visual field: Depending on your overall exam, your doctor may decide to test your eyes for blind spots and peripheral vision loss

Contact Lens Examination and Fittings

Normally, a contact lens examination will not be a part of a comprehensive eye exam and must be scheduled as a separate appointment with your eye doctor. These examinations take a little more time, as there are different methods to determine the exact prescription of your contact lenses and ensure they are fitted properly to the surface of your eyes. Furthermore, a follow-up exam is required to guarantee the success of the fitting and the health of your eyes.

Overall, the nitty-gritty of a comprehensive eye exam sounds like a lot, but normally you’ll only be with the doctor for a little over an hour. And hopefully you now feel more comfortable with what to expect … and see the preventive benefits of going once per year.

Use your VSP Individual Vision Insurance Plan to schedule an eye exam with your eye doctor. If you don’t have vision insurance, find out how VSP can help you save on your next eye exam or pair of glasses.

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