Vision Care of Maine - Eye Examinations

The Eye Exam the Key to Protecting Your gift of Sight

Comprehensive Eye Examination
A complete eye exam involves a series of tests designed to evaluate your vision and check for eye diseases. Our doctors use state of the art diagnostic instruments, aim bright lights directly at your eyes and request that you look through a seemingly endless array of lenses. Each test while at your eye exam evaluates different aspects of your vision and overall ocular health.

At your eye exam:
Your doctor will most likely dilate your pupils to examine your retina and ocular nerve. You will need to bring sunglasses or will be given protective shades before you leave but, it is always a good idea to have transportation from the clinic.
Your exam may include:

Complete History
It is important to know systemic and previous ocular disease or trauma as indication of either current or future eye disease. We will also ask about the eye health of your family members
Optometrists and ophthalmologists use a wide variety of tests and procedures to examine your eyes. These tests range from simple ones, like having you read an eye chart, to complex tests, such as using a high-powered lens to visualize the tiny structures inside of your eyes.
Your comprehensive eye exam Will take an hour or more, depending on the number and complexity of tests that fully evaluate your vision and the health of your eyes.
Your Visual Acuity
Among the tests performed in a comprehensive eye exam are visual acuity test that measures the sharpness of your vision. These usually are performed using a projected eye chart to measure your distance visual acuity and a small, hand-held acuity chart to measure your near vision.

Cover Test

The cover test checks how well your eyes work together and focus on an object.
While doing this, your eye doctor will assess whether the uncovered eye must move to pick up the fixation target, which could indicate strabismus or a more subtle binocular vision problem that could cause eye strain or amblyopia ("lazy eye"). The test is then repeated up close.

Retinoscopy

In retinoscopy, the room lights will be dimmed and you will be given a large target (usually the big "E" on the chart) to fixate on. As you stare at the "E," your eye doctor will shine a light at your eye and flip lenses in a machine in front of your eyes.
This test is especially useful for children and patients who are unable to accurately answer the doctor's questions.

Refraction

This is the test that your eye doctor uses to determine your exact eyeglass prescription.
Your eye doctor will use a phoropter and or trial lenses to precisely determine your prescription for glasses or contacts.

The refraction determines your level of hyperopia (farsightedness), myopia (nearsightedness), astigmatism and presbyopia.
The technician doctor will use an autorefractor to automatically determine your prescription. In addition the technician will check your glasses on a lensometer to compare the prescription in your glasses as a comparative to the autorefractor.
An autorefractor, like a manual refraction, determines the lens power required to accurately focus light on your retina. Autorefractors are especially useful in certain cases such as evaluating young children who may not sit still, pay attention or interact with the eye doctor adequately for an accurate manual refraction.

Our Nidek OPD II and our Zeiss Visante / Atlas use advanced wavefront technology to detect even obscure vision errors based on the way light travels through your eye. This technology is used primarily for custom and eye glass lens determination.

Slit-Lamp Examination

The slit lamp is an instrument that the eye doctor uses to examine the health of your eyes.
The slit lamp lets your eye doctor see the structures of your eyes up close.
Slit lamp exam of the front of the eye.

The slit lamp, also called a biomicroscope, allows your eye doctor to get a highly magnified view of the structures of your eye to thoroughly evaluate your eye health and detect any signs of infection or disease.

During this test, your doctor will have you place your chin on the chin rest of the slit lamp and will then shine the lamp's light at your eye. The doctor looks through a set of oculars (much like a microscope in a science lab) and examines each part of your eye in turn.

He or she will first examine the structures of the front of your eye (lids, cornea, conjunctiva, iris, etc.). Then, with the help of a special high-powered lens, your doctor will view the inside of your eye (retina, optic nerve, macula and more).

A wide range of eye conditions and diseases can be detected with slit-lamp examination, including cataracts, macular degeneration, corneal ulcers, diabetic retinopathy, etc.

The Glaucoma Test

Glaucoma tests have several variations, all designed to measure the pressure inside your eyes.
A tonometer measures the pressure in your eyes to help determine whether you have glaucoma.
For this test, your eye doctor will put eye drops in your eye to numb it. Your eyes will feel slightly heavy when the drops start working. This is not a dilating drop — it is a numbing agent. Then the doctor will have you stare straight ahead into the slit lamp while he or she gently touches the surface of your eye with the tonometer to measure your IOP.
Applanation tonometry is painless. At most, you may feel the tonometer probe tickle your eyelashes. The whole test takes just a few seconds.
You typically have no warning signs of glaucoma until you already have significant vision loss. For this reason, routine eye exams that include tonometry are essential to rule out early signs of glaucoma and protect your eyesight.
Pupil Dilation

To obtain a better view of the eye's internal structures, your eye doctor instills dilating drops to enlarge your pupils. Dilating drops usually take about 20 to 30 minutes to start working. When your pupils are dilated, you will be sensitive to light (because more light is getting into your eye) and you may notice difficulty focusing on objects up close. These effects can last for up to several hours, depending on the strength of the drop used.
Using dilating eyedrops lets the doctor see inside your eyes better.
Once the drops have taken effect, your eye doctor will use various instruments to look inside your eyes. You should bring sunglasses with you to your eye exam, to minimize glare and light sensitivity on the way home For patients that are very sensitive they may want to bring a driver to the eye exam.

Pupil dilation is very important for people with risk factors for eye disease, because it allows for the most thorough evaluation of the health of the inside of your eyes.
The FDT Visual Field Test
Your doctor will check for the possible presence of blind spots in your peripheral vision by performing a frequency doubling technology (FDT) visual field test. These types of blind spots can originate from eye diseases such as glaucoma. The FDT gives your doctor the ability to rule out the presence of these blind spots. If the test is positive your doctor will then order a full visual field test.