What Happens During An Eye Exam?

A comprehensive dilated eye examination assesses the health and function of your eyes, and is a wise investment toward protecting your eyesight. You should also keep in mind that not all eye examinations need to be comprehensive, and Dr. Milano may be responding to your request for the evaluation, diagnosis and treatment of specific complaints. Generally, a comprehensive examination may take from one half hour to over an hour, depending upon the age of the patient and the number and type of tests required. Dr. Milano performs some of the tests and qualified and highly trained ophthalmic technicians perform others.

Dr. Milano is able to not only check the health of the inside of the eye, but also detect possible signs of systemic diseases such as diabetes, high blood pressure, arteriosclerosis, multiple sclerosis, brain tumors, and more.

When indicated, Dr. Milano may dilate the pupil to get a better view inside the eye. Dilation drops open up the pupil in approximately 20 minutes. The pupil stays dilated for a few hours and some people may experience mild blurring and/or light sensitivity. For the trip home, sunglasses are recommended.

Optometric test procedures can generally be classified in five categories:

General and ocular health

After discussing a patient's health history, previous eye care, as well as occupational and recreational vision needs, the doctor examines:

	The external eye: eye lids, orbit, cornea, conjunctiva, etc.
	The internal structures of the eye: retina, macula, optic nerve head, blood vessels, etc. Using an ophthalmoscope, the doctor checks for signs of cataracts, retinal or macular degeneration, and other eye diseases.
	The anterior portions of the eye: cornea, lens, iris, lids, etc, using a biomicroscope.
	The pressure of the fluid inside the eye.
	Signs of glaucoma using a tonometer.
	Central and peripheral vision fields when necessary.

Refractive status

Tests the clear focus of the eye by checking the curvature of the cornea by projecting light into the eye with a retinoscope to determine the optical correction necessary to neutralize or compensate for a refractive error. This refines the correction during a subjective refraction by asking the patient to look at objects/letters through a phoropter, an instrument containing various combinations of lenses, until a clear focus is obtained.

Mobility tests

Allow the doctor to determine how well the eyes align, coordinate, and track when working together and individually.

Binocular function tests

Determine how well the eyes converge to view near objects, and diverge to see distant objects, how well the eyes maintain a clear image by changing focus quickly (accommodation), and the ability of the eyes to perceive depth and three dimensions of space.

Ancillary testing

Checks for color vision, contrast sensitivity, corneal contours, etc.