Examinations are provided by a combination of the doctor and the paraoptometric assistants. We use the latest in computer and laser instruments to ensure the best result. The examination will vary from patient to patient depending on the health of the individual and their visual needs. Typically it may include;
- Medical History
- Measurement of visual acuity
- Pupil dilation (to evaluate the back part of the eyes)
- Intraocular pressure (Glaucoma)
- Blood pressure
- Visual field test
- Prescription (lenses or medicine)
Optical coherence tomography (OCT) is a non-invasive imaging test that uses light waves to take cross-section pictures of your retina, the light-sensitive tissue lining the back of the eye. With OCT, each of the retina’s distinctive layers can be seen, allowing your to map and measure their thickness. These measurements help with early detection, diagnosis and treatment guidance for retinal diseases and conditions, including age related macular degeneration and, diabetic eye disease, among others. We are proud to offer this at the Eye Clinic.
Visual Fields Testing
During a routine eye exam, some eye doctors may want to determine through visual field testing the full horizontal and vertical range of what you are able to see peripherally. This range is commonly referred to as "side vision."
Visual field tests assess the potential presence of blind spots (scotomas), which could indicate eye diseases. A blind spot in the field of vision can be linked to a variety of specific eye diseases, depending on the size and shape of the scotoma.
Many eye and brain disorders can cause peripheral vision loss and visual field abnormalities.
For example, optic nerve damage caused by glaucoma creates a very specific visual field defect. Other eye problems associated with blind spots and other visual field defects include optic nerve damage (optic neuropathy) from disease or damage to the light-sensitive inner lining of the eye (retina).
Brain abnormalities such as those caused by strokes or tumors can affect the visual field. In fact, the location of the stroke or tumor in the brain can frequently be determined by the size, shape and site of the visual field defect.
Fundus photography documents the retina, the neurosensory tissue in our eyes which translates the optical images we see into the electrical impulses our brain understands. The retina can be photographed directly as the pupil is used as both an entrance and exit for the fundus camera's illuminating and imaging light rays. The patient sits at the fundus camera with their chin in a chin rest and their forehead against the bar. Then we focus and align the fundus camera. A flash fires as the photographer presses the shutter release, creating a fundus photograph like the picture above. Optometrists use these retinal photographs to follow, diagnose, and treat eye diseases.
Fundus photography can be performed with colored filters, or with specialized dyes including fluorescein and indocyanine green.
Pachymetry is a simple, painless test to measure the thickness of your cornea -- the clear window at the front of the eye. A probe called a pachymeter is gently placed on the front of the eye (the cornea) to measure its thickness. Pachymetry can help your diagnosis, because corneal thickness has the potential to influence eye pressure readings. With this measurement, your doctor can better understand your IOP reading and develop a treatment plan that is right for you. The procedure takes only about a minute to measure both eyes. It also tests for the possibility of glaucoma.
This test helps detect abnormalities in distance stereopsis and thus can give an earlier indication of the need for surgery. This stereopsis test is for patients as young as 4 years of age.
A color vision test checks your ability to distinguish between different colors
Testing Tears Before and After LASIK
Measuring the lactoferrin and Ige levels in your eyes prior to LASIK surgery is a valuable tool for your doctor. Laser surgery is performed on the cornea of your eye. The cornea receives a majority of its nutrition from your tear film. Thus, how well the cornea heals after surgery is dependent on the overall health of your tear film.
It is important to have both lactoferrin and Ige levels measured prior to surgery. This will ensure that your tear film is as healthy as possible prior to performing surgery. If your tests are positive for either dry eye or allergy your doctor can prescribe a course of therapy prior to surgery to alleviate your dry eye symptoms and/or allergy. By improving the dry eye or allergic conditions prior to surgery we improve the healing conditions within the eye and reduce the chance of post surgical complications.
If your exam shows that your tear film is reduced, your doctor may recommend punctual plugs as a method for enhancing your tear film. Punctal plugs are a way of plugging the tear drainage system so that your own natural tears stay on your cornea longer. Punctal plugs can increase the tear film quantity and have been clinically proven to elevate lactoferrin levels in the eye.
Ask your doctor about performing a tear chemistry analysis prior to your LASIK surgery.
Lasik-Why You Need Your Optometrist
Lasik is an exciting vision correction option. It is not a choice that you should make based on advertising or price alone. It is a complex procedure that requires several clinical visits, in-depth discussions, explanations and careful guidance. We are well equipped to manage and deliver your pre and post-operative care throughout this process.
LASIK can treat a broad range of nearsightedness, farsightedness and astigmatism in people who are at least 18 years old, in good general health and have no eye diseases. Only an in-depth examination of your eyes, your individual case, expectations and lifestyle will determine whether LASIK is right for you.
What causes Dry Eye?
Some of the underlying causes of Dry Eye can include the following:
- Environmental Factors
- Smoke, air pollution and/or sunny, windy, cold or dry air conditions
- Contact Lenses-Contact lens wear can promote the detrimental effect of increased tear evaporation resulting in general discomfort, infection, and/or increased protein deposits
- Tear production usually decreases with age and research has shown more than half of individuals over age 65 suffer from mild to moderate dry eye
- Medications and Conditions
- There are several conditions—Rheumatoid Arthritis, Sjogren’s Disease and Menopause— and medications which can lower your ability to produce tears
- Hormone Changes-Changes in hormone levels associated with pregnancy, oral contraceptives and menopause can contribute to dry eye
Dry Eye Syndrome
Dry Eye Syndrome or DES is the decline of the quantity and/or quality of the tears produced. DES is one of the most common eye disorders affection approximately 20% of our population. Who is at risk for this condition? Dry eye can affect men and women of any age.
At particular risk are those who:
- Wear contact lenses
- Are on specific types of medications
- Have suffered external eye diseases
- Are pregnant
- Are postmenopausal
- Have Sjogren's syndrome
- Have had PRK or LASIK
- Use computers and travel frequently
Dry Eye Checklist:
- Red Eyes
- Foreign Body Sensation
- Sandy or gritty feeling
- Light sensitivity
- Watery eyes
- Occasional tearing
- Constant tearing
- Pain or soreness in or around eyes
- Tired Eyes
- Contact lens discomfort
- Decreased contact lens tolerance
- Seasonal allergies
- Dry throat or mouth
- Arthritis/joint pain
What treatments are available?
Depending on the intensity of the condition, treatment may be as simple as suing artificial tears a few times a day. In more persistent cases, however, as simple non-surgical procedure is available that provides long-term relief of DES through the use of tiny plugs call "punctual occluders".
Low Vision Services
People who have lost eyesight due to injuries or eye disease need special types of products to help them function as independently as possible. We offer a full range of these products through our office. Our paraoptometric staff is trained to demonstrate the use of some of these devices. They range all the way from a simple hand magnifier to a closed circuit TV system.
In addition, we can direct those who have low vision problems to products that will help them carry on the day-to-day tasks that they need to perform.
In an effort to encourage infant eye and vision assessments and ensure they are accessible to everyone, the American Optometric Association (AOA) and the Vision Care Institute of Johnson & Johnson Vision Care, Inc., have partnered to create Infant SEE. A no cost public health program, developed to provide professional eye care for infants nationwide. Through Infant SEE, we at the Eye Clinic, will provide a one-time, comprehensive eye assessment to infants in their first year of life, offering early detection of potential eye and vision problems at no cost, regardless of income.
A baby's first visit to an optometrist for an eye assessment should happen between 6 and 12 months of age.
Now there is a comfortable and rapid exam that detects glaucoma before other technologies - the GDxVCC. The GDxVCC evaluates the actual site of damage caused by glaucoma before you experience any vision loss. The GDxVCC is rapid and non-intrusive. There is no pupil dilation or discomfort. You simply lean into the instrument and a safe laser scans the back of the eye and acquires an image.
Digital Retinal Screening
Digital retinal screening is a technology in which your doctor can take high resolution digital photographs of the interior portion of your eye called the retina. The color photo shows detailed images of the various structures of the retina including the optic nerve, blood vessels, nerve fiber layer and the macula. This technology greatly aids the diagnoses and monitoring of many diseases.
Who should have Retinal Screening?
- Diabetic Patients -People with diabetes are at high risk for developing glaucoma, cataracts and diabetic retinopathy.
- Glaucoma Patients - Because most people have no symptoms or warning signs until the disease has advanced beyond repair, it is crucial for glaucoma patients to have retinal screenings to detect even slight changes in the condition of their optic nerve
- Patients with Macular Degeneration - This is caused by the breakdown of the macula (the part of the retina that provides sharp central vision). 90% of the people with AMD have the dry form, which does not usually cause severe vision loss. However, if not detected early, can progress to wet form which is characterized by the abnormal growth of blood vessels that can leak fluid and blood.
Even patients with healthy eyes should be screened to provide a baseline image to help determine if there are changes.