Cataracts are one of the leading causes of vision loss in people over 45. A condition that commonly develops as the eye ages, by the time we reach 80, more than half of us will have developed a cataract.

A cataract is a clouding of the lens in your eye which is normally transparent. The lens, located inside the eye, behind the iris and the pupil, focuses light onto the retina at the back of your eye, where it is converted to nerve signals that are passed to the brain, allowing you to see. When your lens becomes cloudy, the images projected onto your retina become blurry and unfocused and therefore the signal to the brain is also unclear. You can compare this to looking through a dirty or cloudy window. If the window is not clear, you can’t see well.

Usually cataracts develop slowly over time so your vision gradually worsens. While the majority of cataracts are a result of the aging process, there are also congenital cataracts that are present at birth, secondary cataracts that result from eye surgery or diseases such as glaucoma or diabetes and traumatic cataracts that result at any age from an injury to the eye.

While you may be able to live with mild or moderate cataracts, severe cataracts are treated with surgery. The procedure involves removing the clouded lens and replacing it with an intraocular lens (IOL) implant. Cataract surgery is a common procedure that has a very high success rate of restoring vision to patients. Modern cataract surgery is frequently done as an outpatient procedure. Patients will have greatly improved vision the next day, and will continue to improve over the next few weeks. Surgery is often done in one eye first, and surgery on the second eye, if needed, may be done 2 weeks later.

Learn more about the specifics of Cataracts on the links below:

• Signs & Symptoms of Cataracts Understand the warning signs and symptoms of cataracts to prevent them from affecting your daily life.

• Risk Factors of Cataracts Learn more about the risk factors associated with cataracts and what measures you can take to prevent or delay them.
• Treatment for Cataracts and Cataract Surgery Treatment options for living with cataracts. Learn more about cataract surgery and how to know if it is right for you.
• Intraocular Lenses (IOLs) If you are getting cataract surgery, there are a variety of IOLs to choose from including presbyopia-correcting IOLs, which can also correct for near vision loss associated with aging.
• Preventing Cataracts Additional information including lifestyle factors that could impact cataracts.

Are you in the market or mood for a new pair of eyeglasses? The selection is vast, with many fashionable, attractive pairs of glasses to browse through. How can you narrow down your options and choose the style of frames that are best for you?

Questions to Ask Yourself When Choosing Eyewear

1. What’s my taste? Do I prefer a bold or subtle expression? Do I favor modern lines, a retro look or more conservative, classic styles?
2. Where do I plan to wear these eyeglass frames- at work, in the backyard, or for social outings?
3. What colors work best with my skin and hair tones?
4. What are the primary colors in my wardrobe?
5. What’s the shape of my face?
6. Do I like my current eyeglasses? If not, then what’s the problem?

Bring this information to your local St. Albert practice when you pay a visit to the eyeglass store, and most of the work will already be done! The staff will be able to hone in quickly on the eyeglasses that are most suitable.

How to Judge Fit and Comfort

Research conducted by the eyewear industry indicates that women pay more attention to how eyeglasses appear on their face, while men are more interested in how they feel and fit. Yet even if looks are your primary concern, if your eyeglasses aren’t comfortable – you won’t be pleased for long.

To judge the fit of frames when trying them on:

• Frames should be wide enough for your face and not too snug on sides of your head. The edges of your eyeglasses should extend beyond the sides of your face. This ensures that the temples won’t press in on your head as they rest on your ears.
• The curves at the end of each temple should go past your ear without pushing down on it. If they don’t, then the temples aren’t long enough.
• The built-in nose piece or silicone nose pads should fit comfortably and firmly, without pinching the bridge of your nose. Silicone nose pads can generally be adjusted.
• Your glasses should be able to stay in place when you move your head to and fro. Nod a few times, turn your head right and left, and bend over to touch the floor. Make sure that your glasses don’t slip off.

Is One Pair of Eyeglasses Enough?

Take a look at your closet. You likely own more than one pair of shoes, right? Unless you’re on a very tight budget, more than one pair of eyeglasses isn’t a luxury. Eyewear is a hip accessory, and the same pair may not be appropriate for all parts of your modern lifestyle. Just like your clothing, your eyeglass needs differ for home, work and social occasions.

If owning a solitary pair is enough for you, then choose frames that you love and feel good about no matter what you’re wearing or where you go. These eyeglasses will be on your face constantly, so take your time and pick a style that fits your unique personality and vision requirements.

If you thought the trickiest part of choosing a new pair of glasses was the frame selection, think again. You should be putting just as much thought and consideration into the lenses that you select for your new specs.

Here’s why: The quality and type of lenses in your eyeglasses will not only correct your visual acuity, but they will allow you to continue to see your best through various conditions. Whether it is keeping the lenses free from scratches, fog, glare or UV rays, or making them stronger or more attractive, your eyeglass lenses can help to keep your eyes safe and comfortable wherever the day (or night) takes you.

Lens Coatings

Here are a variety of coatings that you can apply to your lenses to maintain optimal vision and comfort and to protect your lenses and your eyes.

Anti-reflective/Anti-glare Coatings

Anti-reflective (AR) also known as anti-glare coatings help reduce the reflections and glare on your lenses, improving your vision and comfort in high-glare environments, and the look of your glasses as well (you can see your eyes clearly without a reflection on the front of the lens). Reflections from the sun, television and computer screens and bright lights (especially when driving at night) can cause eye strain, headaches and difficulty seeing. AR coatings and lenses can reduce this effect, improving your vision quality and comfort in these circumstances.

Scratch Resistant Coatings

Scratches not only affect the smooth look of the surface of your glasses but they can disrupt your vision. A scratch-resistant coating adds an extra layer of protection on the surface of the lens to significantly reduce scratching. This coating is particularly great for kids who may tend to be a little more rough with their eyewear.

Ultraviolet Coatings

Ultraviolet (UV) coatings protect your eyes from harmful UV rays from the sun. This coating can turn standard lenses into UV blocking lenses that can block 100% of the UV light from entering your eyes. UV is linked to the development of a number of eye diseases such as cataracts, macular degeneration and retinal damage.

Anti-fog Coatings

Particularly if you live in a cold climate, you may have experienced walking indoors from the cold and having your glasses lenses fog up completely. This can take a few minutes to resolve and can be dangerous if you are driving or need to see clearly. Anti-fog coatings will eliminate this effect, creating a smooth transition from cold to hot environments.

Lens Options

You may want to go with an upgraded lens to improve the look, strength or functionality of your glasses.

High Index Lenses

High index lenses have a higher refractive index which means they reflect more light than standard prescription lenses. What this means for you, the consumer, is that they can be made thinner and lighter than traditional lenses. High index lenses are particularly popular with those that need a high prescription as they are able to avoid thick lenses, adding comfort and a smoother look, but a higher price tag.

Trivex or Polycarbonate Lenses

Trivex or polycarbonate lenses are impact resistant lenses – a fantastic choice for sports and safety eyewear as well as standard sunglasses and eyeglasses for active types or kids. These lenses also offer full UV protection and are lightweight for optimal comfort.

Polychromatic Lenses

Polychromatic lenses are made with special technology that turns them into sunglasses when exposed to sunlight. The lenses darken automatically when you go outside and return to normal when you go back indoors. Polychromatic lenses can come in a number of tint colors and are great when you need prescription sunglasses but don’t want to carry around or pay for another pair.

Aspheric Lenses

Aspheric lenses use advanced technology to create a slimmer, flatter and lighter lens than standard prescription lenses. While aspheric lenses can improve the appearance of any prescription lens, they are especially beneficial for those who are farsighted since those lenses tend to bulge out in the middle.

So the next time you are in the market for new eyeglasses, speak to your St. Albert optometrist about the best lens choices for your eyes, your vision and your lifestyle.

Since 43% of adults work at jobs that require prolonged use of a computer, tablet or other digital devices, computer vision syndrome (CVS) and blue light exposure are becoming increasingly serious threats to our vision, health and productivity.

Computer Vision Syndrome in the Workplace
Computer Vision Syndrome (CVS), also known as digital eye strain, is an increasingly common condition felt by those that spend two or more hours daily in front of a screen. Symptoms can include blurred vision, eye strain and fatigue, headaches, dry, red, irritated eyes, neck and back pain and headaches. Typically the symptoms of CVS are not permanent, however they can have an impact on comfort, productivity and one’s ability to focus. In rare cases, CVS can even be debilitating.

Studies show that symptoms of computer vision syndrome have become the most common workplace complaint or injury among workers with 50-90% of computer users reporting symptoms to some degree. These symptoms have been shown to have an impact on worker productivity.

The Effects of CVS on Productivity
In a study which looked at the correlation between computer vision and workplace productivity performed at the School of Optometry at the University of Alabama at Birmingham correlations were found between proper vision correction and overall productivity as well as the time it takes for a worker to complete a task. Even minor and unnoticeable vision problems were shown to affect productivity by up to 20% and to cause an increase in mistakes.

Blue Light Exposure
Blue light or high-energy visible (HEV) radiation exposure is another effect of extended digital device use. Excessive blue light exposure has been linked to sleep cycle disturbance – which can have an overall negative impact on alertness and one’s ability to focus. Blue light may also cause long term damage to the retina. While studies are currently being done to determine the effects of blue light, it is clear that protecting your eyes from blue light is recommended for eye health.

Workspace Ergonomics and Computer Eyewear
From both the worker’s and the employer’s perspectives, an investment in a combination of workspace ergonomics and computer eyewear can benefit the workplace and overall productivity. Workers will be more productive and experience fewer visual and musculoskeletal symptoms that can cause discomfort and distraction. Employers will benefit from productivity gains and reduced worker’s compensation claims.

Digital devices have impacted our world in so many positive ways, allowing us to connect, work, play, and get information at the speed of light. In fact, many people have a hard time when they “disconnect.” But all of this good brings with it a measure of concern: Digital Eye Strain or Computer Vision Syndrome.

Nearly 70 percent of U.S. adults experience digital eye strain as a result of the growing use of computers and digital devices. Adults aged 18 to 34 report feeling eye strain at a higher rate (45%) than their older counterparts. New research also suggests that overexposure to blue light, also referred to as high-energy visible or HEV light, may contribute to vision problems such as cataracts and age-related macular degeneration (AMD). Implications are just now being studied, but the short-term impact of digital eye strain affects individuals on a daily basis. Eye care providers are noting a steady rise in the incidence of myopia as well, which research suggests could be correlated to the increase of screen time and near focusing.

Symptoms of Digital Eye Strain include:

• Headaches
• Blurred or double vision
• Sore eyes
• Dry or watery eyes
• Sensitivity to light
• Neck, shoulder or back pain

In addition to these symptoms, emerging research shows that blue light from digital devices causes sleep disturbances by interfering with the REM cycle of sleep.

As people move from their computer to their tablet to their phone, more and more of these symptoms are being seen, and in younger and younger people. Computer glasses offer a solution to reduce the strain on your eyes and your exposure to blue light radiation.

How Computer Glasses Work

Computer glasses reduce eye strain by adjusting the focus slightly so that your eyes feel like they are focusing on something further away. They also have a tint to remove the glare and block blue light from entering into your eyes.

Finding the Right Pair

There are a number of companies that make computer glasses, some that are designed for device users without a prescription or that would wear the glasses with contact lenses. Other manufacturers provide options to incorporate vision prescriptions into the lens.

When shopping for computer glasses you want to make sure you find the right pair. The eyewear should sit nicely on your face and provide a comfortable tint. Here are some of the options available:

• Single Vision Computer Glasses: Provide the optimum lens power and field of view for viewing your computer screen without straining or leaning in to reduce symptoms of CVS. These are ideal for when the computer is at a fixed working distance, and work well if the user needs to view multiple screens at the same working distance.
• Office Lenses or Progressive Lenses: No-line multifocal eyewear that can be made to correct near, intermediate and some distance vision with a larger intermediate zone for computer vision if indicated. Perfect for those with presbyopia which is the gradual loss of focusing ability that occurs naturally with age. Office lenses work like progressive lenses but provide a wider field of view for intermediate (1-3 m) viewing distance and near working distance (about 40 cm).
• Blue-Blocking Lenses: Definitely recommended for this electronic age, blue-blocking lenses block blue light emitted from computer screens that is associated with glare, eye strain and possible sleep disturbances.
• Anti-glare and filtering coatings (treatments): Eliminate reflections from the surfaces of your lens to reduce eye strain and discomfort from glare. Some coatings can also block blue light emitted from computer screens.

While all of these are good options for protecting your eyes, the 20/20/20 rule still applies – after every 20 minutes of near tasks, look at something beyond 20 feet away for at least 20 seconds…it’s a good time to stretch the rest of the body too.

Eye exams are important to test your focusing ability, and to ensure that both eyes are working and focusing at the same place. Many people do not have the same prescription in each eye.

Children and Computer Glasses

Children are using digital devices more than ever and this trend will only continue as smartphones take over and tablet and computer-based learning increases. Their use extends well beyond the school day , as they use computers for homework and gaming and smartphones to text with their friends.

Computer glasses should be used for children proactively before eye strain begins to keep their eyes healthy longer and prevent nearsightedness.

Digital eye strain is an increasingly common condition as digital devices become more ingrained into our daily lives. Digital eye strain, eye fatigue and computer vision syndrome (CVS) are conditions that result from extended exposure to digital screens such as computers, smartphones, tablets and televisions from a combination of factors including the blue light radiation emitted from the devices and the pixelated content that is difficult for our eyes to focus on.

Symptoms of computer or digital eyestrain tend to be noticed after someone has used a digital device for as little as 2 hours a day. Studies show that 60% of people spend more than 6 hours a day in front of a digital device and 70% of adults report some symptoms of computer vision syndrome (CVS) which include:

• Eyestrain
• Headaches
• Blurred or double vision
• Physical and mental fatigue
• Dry or watery eyes
• Red or irritated eyes
• Difficulty focusing
• Sensitivity to light or
• Neck, shoulder or back pain (caused by compromised posture to adjust to vision difficulty).

Digital eye strain also impacts your ability to focus and lessens productivity. Most people do nothing to ease their discomfort from these symptoms because they are not aware of the cause.

Protecting Your Eyes from Digital Eye Strain and Blue Light

There are a number of options for reducing digital eye strain and your exposure to blue light which include workspace ergonomics, computer glasses, specialized lenses and protective coatings. The first step is to get a comprehensive eye exam, making sure you speak to your eye doctor about how often you use a computer and digital device. This will help your doctor to get the full picture of your eye and vision needs in order to determine which option is best for you. It was also help the doctor to identify any underlying issues that could be worsening your symptoms.

Alleviating Digital EyeStrain

Workspace Alterations

Proper Lighting and Screen Brightness: You want the screen to be as bright as the surrounding environment or the brightest object in the room (depending on what is most comfortable for you). Therefore interior lighting or sunlight from the outdoors should be dimmed or blocked. Use fewer light fixtures or lower voltage light bulbs and close curtains or blinds when possible. Adjust the brightness and contrast of your monitor to the levels that are most comfortable.

Reduce Glare: Glare is a significant cause of computer eyestrain so it is important to minimize it as much as possible. Set up your computer where glare from windows won’t affect your screen or cover windows when this is not possible. Glare can also reflect from walls and shiny finishes on desks and other surfaces. An anti-glare screen on your monitor or an anti-reflective (AR) or anti-glare coating applied to your eyewear can also help to minimize glare and the strain it causes to your vision.

Screen size and distance: You want to make sure you are using a high quality (such as a flat LCD) screen that has a relatively large display (look for a diagonal screen size of at least 19 inches) and is located directly in front of your line of vision. Your viewing distance should be about an arm’s length away with the top of the monitor at about eye level or slightly below.

Eye Care

Keep Eyes Moist: When viewing a digital screen or monitor for an extended period of time, we tend to blink less frequently (about ⅓ as often as we should). Blinking however, is critical for keeping the eyes moist, which allows them to remain clear and comfortable and to avoid dry eyes, irritation, blurry vision or eye fatigue.

Focus on blinking by setting a timer for every 20 minutes and slowly closing and opening your eyes 10 times. Keep a bottle of artificial tears handy to use when your eyes are feeling dry.

Give Your Eyes a Break: Schedule and take frequent breaks from your screen. Follow the 20-20-20 rule; every 20 minutes, look at something 20 feet away for 20 seconds. Take this time to stand up and stretch your back, neck and legs as well.

Computer Eyewear

Computer glasses reduce eye strain by adjusting the focus slightly so your eyes feel like they are focusing on something further away. They also have a tint to remove the glare and block blue light from entering into your eyes. There are a number of options for computer eyewear, both if you need prescription eyewear and not. Speak to your eye doctor about what the best options are for you.
Learn more about computer glasses here.

It is important to know that both adults and children alike are susceptible to computer eye strain from computers and digital devices. With the growing use of such devices in our everyday lives it is important to start educating ourselves and our children on how to combat the negative effects of these habits.

For both adults and children alike, eye exams are an important part of one’s general health maintenance and assessment. Your eyes should be checked regularly to ensure that you are able to see as best as possible. Regular eye health exams will also check for signs of eye disease or conditions that can affect not only your vision but your overall health. Vision and eye health is such a critical part in learning and development, therefore, we highly recommend eye exams for infants and children.

Vision Screening vs. an Eye Exam

When we recommend regular eye exams, this should not be confused with a vision screening. A vision screening is a basic test that indicates if you have difficulty seeing and require further assessment and corrective measures. It can be performed by anyone, whether it is a school nurse, a pediatrician or even a volunteer at a vision clinic. A vision screening usually only checks vision, it does not check eye health. Also, most vision screenings for kids only check for nearsightedness (when you can not see far), but what happens when the majority of children are farsighted? Most of the time many of these kids get overlooked.

A comprehensive eye exam on the other hand, can only be performed by an eye doctor as it requires special knowledge and equipment to look around and into your eye to check your eye and vision health. Such an exam can assess whether there are underlying causes for vision problems and whether there are any signs of disease which can threaten your site and the health of your eye. A comprehensive eye examination can also diagnose symptoms of diabetes, high blood pressure, high cholesterol, tumors, cancer, autoimmune disorders, and thyroid disorders. A comprehensive eye examination will also provide an accurate prescription for eyeglasses or contact lenses.

Eye Exams for Eye Health

Eye exams are critical because many vision threatening eye diseases such as glaucoma, macular degeneration, cataracts, or diabetic retinopathy have no or minimal symptoms until the disease has progressed. In these cases, early detection and treatment is essential to halting or slowing down the progression of the disease and saving eyesight. During a comprehensive eye examination, your eye doctor will be looking for initial signs of these diseases. If a problem with your eyes arises such as red eyes, eye allergies, dry eyes, eye swelling,eye pain, always seek an eye doctor as your first doctor to call since they are specifically trained to treat eye diseases.

Eye Exams and Children

If your child is having developmental delays or trouble in school there could be an underlying vision problem. Proper learning, motor development, reading, and many other skills are dependent upon not only good vision, but your eyes functioning together. Children that have problems with focusing or hand-eye coordination will often experience frustration and may exhibit behavioral problems as well. Often they don’t know that the vision they are experiencing is abnormal so they aren’t able to express that they need help. Many conditions are much easier to treat when they are caught early while the eyes are still developing, so it is important to diagnose any eye health and vision issues as early as possible.

Eye Exams Over 40

Just like the rest of our bodies, our eyes begin to weaken as we age. There are a number of common age-related eye conditions such as presbyopia, cataracts, and age-related macular degeneration that can begin to affect your vision and your daily life. While some of these conditions are more of an inconvenience, others could lead to vision loss and dependency.

In addition to regular yearly eye exams, it is important to be aware of any changes in your eye health and vision. Also know your potential risk factors as well as your family ocular and medical history. Over half of the vision loss worldwide is preventable with proper treatment and care.

For both adults and children, an eye exam is a critical part in maintaining your overall health and well-being, and therefore, regular eye exams should be incorporated into your health routine. Comprehensive eye exams assess your vision and the health of your eye, looking for early signs of disease that may not have obvious symptoms. You should not wait until you experience a vision problem or symptoms of an eye condition to schedule a routine exam.

Depending on your age, family history, general health and eye health, it is recommended to have an eye exam every one to two years. Of course if you experience any serious symptoms that affect your eyes or your vision, you should contact your eye doctor immediately.

The Difference Between an Optometrist (OD) and an Ophthalmologist (MD or DO)

Confusion about the difference between optometrists and ophthalmologists is common, and many people are not aware of how the two eye care professionals differ.

Optometrists

Optometrists or Doctors of Optometry attend optometry school which is usually at least four years of graduate level training. They are able to perform eye exams, provide prescriptions for eyeglasses and contact lenses, and diagnose and treat eye diseases as as glaucoma, dry eyes, or eye infections that may require medication or drops. They can consult with and co-manage patients in pre- or post-op surgical care, however they do not perform surgery.

Ophthalmologists

Ophthalmologists are medical doctors that attend medical school and later specialize in ophthalmology. They are able to do all of the services mentioned above but also perform eye surgeries such as cataract surgery, refractive surgery such as LASIK and deal with more urgent eye conditions such as retinal detachment.

Infant and Child Eye Exams

According to the American Optometric Association (AOA) children should have their eyes examined by an eye doctor at 6 months, 3 years, at the start of school and then at least every 2 years following. If there are any signs that there may be a vision problem or if the child has certain risk factors (such as developmental delays, premature birth, crossed eyes, family history or previous injuries) more frequent exams are recommended. A child that wears eyeglasses or contact lenses should have his or her eyes examined yearly.

Adult Eye Exams

Healthy adults under 40 with good vision and who do not wear eyeglasses or contact lenses are recommended to have an eye exam at least every two years. Those that do use vision correction or have a health issue such as diabetes, high blood pressure or another health condition that can have an impact on your eye health should schedule a yearly exam, unless the eye doctor recommends more frequent visits.

Once you reach 40, you become susceptible to a number of age-related eye conditions such as presbyopia, cataracts or macular degeneration, therefore annual or bi-annual exams are strongly recommended.

As you continue to age, particularly after age 55, the risks of eye disease increase, and early detection can be critical to preventing significant vision loss or blindness. Scheduling a yearly eye exam can make all the difference in maintaining your independence and quality of life.

How to Prepare for Your Exam

Prior to your exam you should decide whether you will be seeking special services such as a contact lens exam or LASIK consultation. These services may cost extra. Check with the doctor’s office or your insurance provider to see if they cover any of the exam expenses.

You need to know if you have medical insurance, vision plan coverage or both. Medical insurance usually does not cover “wellness/refractive” exams for glasses or contact lenses. Vision plans will cover exams for glasses or contacts, but usually cannot be used for red eyes, floaters, or other medical eye health problems. Please bring your insurance cards with you.

In addition to bringing your current pair of glasses or contacts if applicable, it is important to be aware of your personal and family history and to have a list of medications or supplements you are currently taking. Your pupils will probably be dilated as apart of your exam, so plan accordingly.

Your eyes are one of the most complex organs in your body. A comprehensive eye exam to assess your visual system and eye health involves a number of different of tests. Unlike a simple vision screening, which only assesses your vision, a comprehensive eye exam includes a battery of tests in order to do a complete evaluation of the health of your eyes and your vision.

The tests that you will undergo in a comprehensive eye examination may vary from eye doctor to eye doctor but here are are some common exams that you may encounter:

Patient Background and History

One of the most important parts in a comprehensive eye exam is your patient health history. This information will alert your doctor to any conditions that should be monitored closely, such as an allergy to any medications, current or family history of systemic or eye pathology or environmental conditions that could be affecting your vision or eye health. This will also help your doctor to determine any preventative eye care measures that are relevant to keep your eyes healthy for years to come.

Visual Acuity

Visual acuity is a measurement of your vision using an eye chart, the Snellen Eye Chart. In this test the patient is seated at a standard distance and is asked to read letters or symbols of various sizes, which get smaller as you move down the chart. The results are the familiar ratio of 20/20, 20/40 etc. which is a comparison of your vision compared to the average person with good vision, which is typically 20/20. For example, a patient that has 20/40 vision, can only see at 20 feet what the normal person can see from a distance of 40 feet. This test is a preliminary test of how clearly you are seeing in each eye but it does not give you a prescription for corrective lenses.

Refraction

Those who don’t have 20/20 vision have what is referred to in most cases as a “Refractive Error.” The patient may have nearsightedness, farsightedness, astigmatism or other eye conditions that prevent the patient from seeing 20/20. A refraction will tell the doctor which prescription lenses will correct your eyesight to achieve 20/20 vision or whichever amount your vision is correctable to.

A refraction may include a couple of steps.

Retinoscopy

Retinoscopy is a test that allows the doctor to obtain an approximate prescription for eyeglasses. In this test the doctor uses a hand-held instrument called a retinoscope that shines a light into the patient’s eye. The doctor then analyzes the reflex of the light from the patient’s eye to determine the patient’s prescription for glasses.

An instrument called a phoropter is something most patients associate with an eye exam. This space age appearing instrument, positioned in front of the patient’s face during the eye exam, gives the doctor the ability to determine the patient’s focusing ability as well as their eye alignment. The phoropter also determines which, out of the hundreds and hundreds of potential eyeglass prescriptions, will help the patient see as clear as possible. Using the phoropter, the doctor will ask the patient which series of lenses makes their vision the clearest.

While retinoscopy is quite effective for children and nonverbal patients, there are now a number of computerized or automated instruments available today to help doctors accurately determine a patient’s eyeglass prescription.

Autorefractors and Aberrometers

Autorefractors and aberrometers are computerized machines that are able to measure your refractive error to determine your prescription for glasses or contact lenses. These instruments are usually used in addition to testing described earlier:

– An autorefractor is similar to retinoscopy, which electronically analyses the light reflex from the patient’s eye.

– An aberrometer measures distortions or aberrations in the cornea and lens of the eye that disrupt proper focus of light on the retina. Using wavefront technology, the instrument measures the rays of light as they pass through your eye to look for imperfections which may indicate a refractive error.

Eye Focusing and Eye Teaming Tests

During the comprehensive eye exam, your eye doctor will also want to test how your eyes function individually and together from a mechanical perspective. In order to see clearly and comfortably, your eyes need to work together as a team.

Eye Health

The final and most important aspect of a comprehensive eye exam is a check of your overall eye health. These tests (below) are done to identify any eye conditions or diseases, both inside the eye as well as the external parts of the eye, that could affect your vision and general health.

Slit Lamp Test

The slit lamp or biomicroscope is an instrument that allows the doctor to examine the internal and external parts of the eye in detail, such as the conjunctiva, iris, lens, cornea, retina and the optic nerve. The patient rests their forehead and chin on a headrest to stabilize the head, while the doctor looks into the eye with the slit lamp microscope, which is magnified with a high-intensity light. A slit lamp test enables the doctor to evaluate the eyes for signs of normal aging and eye pathology, such as conjunctivitis, cataracts, macular degeneration or retinal detachment. Early diagnosis and treatment of eye diseases are essential for preventing vision loss.

Tonometry

Tonometry is a test to detect glaucoma by measuring the pressure inside your eye or IOP (intraocular pressure). Glaucoma can cause vision loss and even blindness if the IOP in the eye is too high and damages the optic nerve.

The applanation tonometer, typically attached to a slit lamp, is one of the most common instruments used to measure the pressure in the eye. Prior to doing this test the doctor will numb the patient’s eyes using an anesthetic, before gently applanating (putting pressure on) the patient’s cornea to measure the pressure in the eye.

Pupil Dilation

During your comprehensive eye exam, your doctor may decide to do a dilated eye exam. In this test, your doctor will instill dilating drops in each eye, which would enlarge your pupils to give the doctor a better view of certain parts of the back of the eye. Dilation is done at the discretion of the doctor, with some patients dilated every year and others at specified intervals; the frequency of dilation will vary for each patient.

Typically the drops take around 20 to 30 minutes to take effect and may last up to several hours following the exam; each patient is different. Since more light enters your eyes when your pupils are dilated, you will be more sensitive to bright light, especially sunlight. Although your doctor may provide disposable sunglasses, you may want to bring a pair of sunglasses to wear after the exam to make it more comfortable until the drops wear off.

A comprehensive eye exam is an important part of your overall general health maintenance and should be scheduled on a regular basis. The findings from your comprehensive eye exam can give your doctor important information about your overall health, particularly diabetes and high blood pressure.

Contact lenses are a great alternative to wearing eyeglasses. An often unknown fact is that not all patients wear contact lenses as their primary source of vision correction. Each patient is different, with some patients wearing contact lenses only on weekends, special occasions or just for sports. That is the beauty of contact lens wear, the flexibility it gives each individual patient and their lifestyle.

If you decide to opt for contact lens wear, it is very important that the lenses fit properly and comfortably and that you understand contact lens safety and hygiene. A contact lens exam will include both a comprehensive eye exam to check your overall eye health, your general vision prescription and then a contact lens consultation and measurement to determine the proper lens fit.

The Importance of a Comprehensive Eye Exam

Whether or not you have vision problems, it is important to have your eyes checked regularly to ensure they are healthy and that there are no signs of a developing eye condition. A comprehensive eye exam will check the general health of your eyes as well as the quality of your vision. During this exam the eye doctor will determine your prescription for eyeglasses, however this prescription alone is not sufficient for contact lenses. The doctor may also check for any eye health issues that could interfere with the comfort and success of contact lens wear.

The Contact Lens Consultation

The contact lens industry is always developing new innovations to make contacts more comfortable, convenient and accessible. Therefore, one of the initial steps in a contact lens consultation is to discuss with your eye doctor some lifestyle and health considerations that could impact the type of contacts that suit you best.

Some of the options to consider are whether you would prefer daily disposables or monthly disposable lenses, as well as soft versus rigid gas permeable (GP) lenses. If you have any particular eye conditions, such as astigmatism or dry eye syndrome, your eye doctor might have specific recommendations for the right type or brand for your optimal comfort and vision needs.

Now is the time to tell your eye doctor if you would like to consider colored contact lenses as well. If you are over 40 and experience problems seeing small print, for which you need bifocals to see close objects, your eye doctor may recommend multifocal lenses or a combination of multifocal and monovision lenses to correct your unique vision needs.

Contact Lens Fitting

One size does not fit all when it comes to contact lenses. Your eye doctor will need to take some measurements to properly fit your contact lenses. Contact lenses that do not fit properly could cause discomfort, blurry vision or even damage the eye. Here are some of the measurements your eye doctor will take for a contact lens fitting:

Corneal Curvature

In order to assure that the fitting curve of the lens properly fits the curve of your eye, your doctor will measure the curvature of the cornea or front surface of the eye. The curvature is measured with an instrument called a keratometer to determine the appropriate curve for your contact lenses. If you have astigmatism, the curvature of your cornea is not perfectly round and therefore a “toric” lens, which is designed specifically for an eye with astigmatism, would be fit to provide the best vision and lens fit. In certain cases your eye doctor may decide to measure your cornea in greater detail with a mapping of the corneal surface called corneal topography.

Pupil or Iris Size

Your eye doctor may measure the size of your pupil or your iris (the colored area of your eye) with an instrument called a biomicroscope or slit lamp or manually with a ruler or card. This measurement is especially important if you are considering specialized lenses such as Gas Permeable (GP) contacts.

Tear Film Evaluation

One of the most common problems affecting contact lens wear is dry eyes. If the lenses are not kept adequately hydrated and moist, they will become uncomfortable and your eyes will feel dry, irritated and itchy. Particularly if you have dry eye syndrome, your doctor will want to make sure that you have a sufficient tear film to keep the lenses moist and comfortable, otherwise, contact lenses may not be a suitable vision option.

A tear film evaluation is performed by the doctor by putting a drop of liquid dye on your eye and then viewing your tears with a slit lamp or by placing a special strip of paper under the lid to absorb the tears to see how much moisture is produced. If your tear film is weak, your eye doctor may recommend certain types of contact lenses that are more successful in maintaining moisture.

Contact Lens Trial and Prescription

After deciding which pair of lenses could work best with your eyes, the eye doctor may have you try on a pair of lenses to confirm the fit and comfort before finalizing and ordering your lenses. The doctor or assistant would insert the lenses and keep them in for 15-20 minutes before the doctor exams the fit, movement and tearing in your eye. If after the fitting, the lenses appear to be a good fit, your eye doctor will order the lenses for you. Your eye doctor will also provide care and hygiene instructions including how to insert and remove your lenses, how long to wear them and how to store them if relevant.

Follow-up

Your eye doctor may request that you schedule a follow-up appointment to check that your contact lenses are fitting properly and that your eyes are adjusting properly. If you are experiencing discomfort or dryness in your eyes you should visit your eye doctor as soon as possible. Your eye doctor may decide to try a different lens, a different contact lens disinfecting solution or to try an adjustment in your wearing schedule.