Eye Examinations

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Having a comprehensive eye exam each year is the best way to enjoy good vision throughout your life.

What happens during an eye exam?

During the eye exam, Dr. Hale will perform several different tests and procedures to check your vision as well as the overall health of your eyes. A comprehensive eye examination takes about an hour, and it should consist of most of the following parts:

Visual Acuity

A visual acuity test is a measure of how well you see or the sharpness and clarity of your vision. Dr. Hale will ask you to read letters on a chart which is 20 feet away. The smallest letters you are able to read will be recorded as your acuity.

Confrontation Visual Fields

A confrontation visual field is a quick check of your basic field of vision, including your central and side (peripheral) vision. Dr. Hale will sit in front of you and ask you to cover one eye. You will then be asked to say when you can see her hand as it enters your field of vision from the sides.

Extraocular Movements

This test measures the muscles that control eye movement. It is usually a simple test conducted by moving a pen or small object in different directions of gaze. Restrictions, weaknesses or poor tracking of visual objects are often uncovered.

Pupillary Tests

Pupillary reactions (the way your pupils dilate and constrict in response to light) can reveal a great deal about the health of the eyes and of your body. The nerves that control the pupil travel through a long pathway within the body. Certain pupillary reactions can reveal neurological problems, including some serious conditions. Your pupil reactions are tested with a very bright light directed toward one or both of your eyes. Dr. Hale may focus on one eye or swing the light back and forth to study the ways your pupils change.

Cover Test

The cover test is performed to measure how well your eyes work together. The cover test is a simple test in which Dr. Hale asks you to fixate on a near or distant object. She covers one eye, pauses, and then uncovers it. She is evaluating your eye as it is uncovered, as it refixates on the target.

The cover test helps to detect crossed eyes (strabismus), lazy eye (amblyopia) or a decrease in depth perception.

Retinoscopy

Retinoscopy is a test that gives Dr. Hale a way to measure refraction. Usually performed early in an exam, retinoscopy provides her with a starting point to estimate your prescription for glasses, if needed.

Refraction

Most people remember refraction as the part of an exam in which Dr. Hale asks the patient, "Which lens is better, one or two?" Refraction is a subjective test to measure nearsightedness, farsightedness, astigmatism or presbyopia.

Dr. Hale places an instrument, called a phoropter, in front of your eyes. A series of lens comparisons are shown to you. She will ask you which lens is clearer.

The results of the refraction test are primarily what Dr. Hale uses to develop your final eyeglass or contact lens prescription.

Slit Lamp Examination

Dr. Hale uses an instrument called a slit lamp, also called a biomicroscope, to examine the front (anterior segment) and back (posterior segment) part of your eye. This is to evaluate the overall health of the eye.

The instrument magnifies your eyes many times and uses a bright light to illuminate the eye structures. Each part of your eye, including your eyelids and eyelashes, conjunctiva, cornea, iris, crystalline lens and anterior chamber, is examined in a methodical manner to reveal any defects or diseases. Cataracts can be diagnosed using the slit lamp.

Tonometry

Tonometry is the measurement of the eye's pressure, better known as IOP, or intraocular pressure. Dr. Hale will put a drop of anesthetic into your eye. She will then place a small amount of fluorescein (yellow dye) into your eye. A small device called a tonometer is moved close to your eye so that it gently touches the cornea, measuring the pressure of your eye. If your eye pressure is higher than normal, your risk of developing glaucoma increases.

Dilated Fundus Examination

The dilated fundus examination is usually the last step in a comprehensive eye examination. Dr. Hale will administer special eye drops to dilate your pupils. This increases the size of your pupil, giving her a larger window in which to inspect your internal eye health. She is able to examine the vitreous, optic nerve, blood vessels, macula and retina. In addition, Dr. Hale has a Digital Retinal Camera to photograph the inside of the eye.

An instrument called a binocular indirect ophthalmoscope (BIO) is worn on Dr. Hale's head. This frees her hands in order to use a powerful lens to focus light emitted from the ophthalmoscope into your eye. With this instrument, the image is a bit smaller but the field of view is much larger, allowing Dr. Hale to view your entire retina.

The dilated fundus examination is a crucial part of an eye exam, as many eye diseases can be detected during the test.