Comprehensive Eye Exam
Our physicians perform comprehensive eye examinations which include:
- Refractions (getting checked for glasses)
- Determination of eye pressures (for evaluating of glaucoma)
- Movements of the eye (for evaluating the eyes turning in or out)
- Determination of the front of the eye (for evaluating such conditions as cataracts)
- Retina examination (to rule out such conditions as diabetes and macular degeneration)
- Evaluating the structures around the eye (such as droopy eyelids and growths on the eyelids).
A decision will be made with regards to the need for further testing and follow up interval. The frequency of follow up appointments is determined by the degree and severity of any medical conditions found during the eye exam. The following short presentation will demonstrate the details of an eye exam.
Nearsighted individuals typically have problems seeing well at a distance and are forced to wear glasses or contact lenses. The nearsighted eye is usually longer than a normal eye, and its cornea may also be steeper. Therefore, when light passes through the cornea and lens, it is focused in front of the retina. This will make distant images appear blurred.
There are several refractive surgery solutions available to correct nearly all levels of nearsightedness.
Farsighted individuals typically develop problems reading up close around the age of 40. The farsighted eye is usually slightly shorter than a normal eye and may have a flatter cornea. Thus, the light of distant objects focuses behind the retina unless the natural lens can compensate fully. Near objects require even greater focusing power to be seen clearly and therefore, blur more easily.
Glasses and contact lenses are a few of the options available to correct farsightedness.
Asymmetric steepening of the cornea or natural lens causes light to be focused unevenly, which is the main optical problem in astigmatism. To individuals with uncorrected astigmatism, images may look blurry or shadowed. Astigmatism can accompany any form of refractive error and is very common.
Astigmatism can be corrected with glasses, contact lenses, corneal relaxing incisions, laser vision correction, and special implant lenses.
Presbyopia is a condition that typically becomes noticeable for most people around age 45. In children and young adults, the lens inside the eye can easily focus on distant and near objects. With age, the lens loses its ability to focus adequately.
Although presbyopia is not completely understood, it is thought that the lens and its supporting structures lose the ability to make the lens longer during close vision effort. To compensate, affected individuals usually find that holding reading material further away makes the image clearer. Ultimately, aids such as reading glasses are typically needed by the mid-forties.
Besides glasses, presbyopia can be dealt with in a number of ways. Options include monovision and multifocal contact lenses.
Allergies affecting the eye are relatively common. The most common allergies are those related to pollen, particularly when the weather is warm and dry. Symptoms can include redness, itching, tearing, burning, stinging, and watery discharge, although they are not usually severe enough to require medical attention. Antihistamine-decongestant eyedrops can effectively reduce these symptoms, as does rain and cooler weather, which decreases the amount of pollen in the air.
An increasing number of eye allergy cases are related to medications and contact lens wear. Also, animal hair and certain cosmetics, such as mascara, face creams, and eyebrow pencil, can cause allergies that affect the eye. Touching or rubbing eyes after handling nail polish, soaps, or chemicals may cause an allergic reaction. Some people have a sensitivity to lip gloss and eye makeup. Allergy symptoms are temporary and can be eliminated by not having contact with the offending cosmetic or detergent.
Conjunctivitis (Pink Eye)
This term describes a group of diseases that cause swelling, itching, burning, and redness of the conjunctiva, the protective membrane that lines the eyelids and covers exposed areas of the sclera, or white of the eye. Conjunctivitis can spread from one person to another and affects millions of Americans at any given time. Conjunctivitis can be caused by a bacterial or viral infection, allergy, environmental irritants, a contact lens product, eyedrops, or eye ointments. At its onset, conjunctivitis is usually painless and does not adversely affect vision. The infection will clear in most cases without requiring medical care. However, for some forms of conjunctivitis, treatment will be needed. If treatment is delayed, the infection may worsen and cause corneal inflammation and a loss of vision.
The continuous production and drainage of tears are important to the eye's health. Tears keep the eye moist, help wounds heal, and protect against eye infection. In people with dry eye, the eye produces fewer or lower quality tears and is unable to keep its surface lubricated and comfortable.
The tear film consists of three layers—an outer, oily (lipid) layer that keeps tears from evaporating too quickly and helps tears remain on the eye; a middle (aqueous) layer that nourishes the cornea and conjunctiva; and a bottom (mucin) layer that helps to spread the aqueous layer across the eye to ensure that the eye remains wet. As we age, the eyes usually produce fewer tears. Also, in some cases, the lipid and mucin layers produced by the eye are of such poor quality that tears cannot remain in the eye long enough to keep the eye sufficiently lubricated.
The main symptom of dry eye is usually a scratchy or sandy feeling as if something is in the eye. Other symptoms may include stinging or burning of the eye; episodes of excess tearing that follow periods of very dry sensation; a stringy discharge from the eye; and pain and redness of the eye. Sometimes people with dry eye experience heaviness of the eyelids or blurred, changing, or decreased vision, although the loss of vision is uncommon.
Dry eye is more common in women, especially after menopause. Surprisingly, some people with dry eye may have tears that run down their cheeks. This is because the eye may be producing less of the lipid and mucin layers of the tear film, which help keep tears in the eye. When this happens, tears do not stay in the eye long enough to thoroughly moisten it.
Dry eye can occur in climates with dry air, as well as with the use of some drugs, including antihistamines, nasal decongestants, tranquilizers, and anti-depressant drugs. People with dry eye should let their health care providers know all the medications they are taking, since some of them may intensify dry eye symptoms.
People with connective tissue diseases, such as rheumatoid arthritis, can also develop dry eye. It is important to note that dry eye is sometimes a symptom of Sjogren's syndrome, a disease that attacks the body's lubricating glands, such as the tear and salivary glands. A complete physical examination may diagnose any underlying diseases.
Artificial tears, which lubricate the eye, are the principal treatment for dry eye. They are available over-the-counter as eye drops. Sterile ointments are sometimes used at night to help prevent the eye from drying. Using humidifiers, wearing wrap-around glasses when outside, and avoiding outside windy and dry conditions may bring relief. For people with severe cases of dry eye, temporary or permanent closure of the tear drain (small openings at the inner corner of the eyelids where tears drain from the eye) may be helpful.