Comprehensive Eye Exam

What is a comprehensive eye exam?

When you see your optometrist you are taking a very important step towards ensuring a lifetime of clear and comfortable vision. Your optometrist is a primary health care practitioner regulated by government under the Health Practitioners Competence Assurance Act 2003.

Only a registered optometrist may use the title optometrist and prescribe glasses or contact lenses. Your optometrist is also able to prescribe or sell a range of medicines for treating eye infections and allergies. Your optometrist will need to examine your eyes before deciding the next step because it is necessary to make a diagnosis before commencing treatment of your eye condition. For some eye diseases treatment with a medicine is necessary and sometimes a person with eye disease will be referred for surgical treatment. It is important to understand that without a proper diagnosis, a number of sight-threatening conditions might develop unchecked.

Without treatment these disorders can progressively destroy your sight and blindness can result. According to the World Health Organisation 75% of blindness in the world is preventable. 

When you first consult an optometrist you should expect to have a comprehensive eye examination. This will take time as there is a lot to cover. 

Key Elements of the Process

  • Questions about your medical history
  • An assessment of your internal eye health, including retina, optic disc, and blood vessels
  • A Slit-lamp assessment of your external eye including lids and lashes
  • An assessment of your colour perception as some general diseases affect colour vision
  • Examination to assess glaucoma including a measure of the pressure in each eye
  • An assessment of visual functions including any refractive error
  • Tests of your eye muscles to check they move and coordinate properly
  • Visual fields test to check for blind spots caused by eye disease or brain damage (e.g. glaucoma or stroke)
  • An assessment of pupils function and response
  • Discussion of the diagnosis
  • Discussion of the management options and plan for treatment
  • Recording all of above in your clinical record 

As your optometrist is a health professional you should expect to be asked about your age, about the state of your general health, and also about your family history of diseases such as glaucoma, diabetes and heart disease.

Often, in order to see all of the inside of your eye your optometrist will need to dilate your pupils. Dilation involves using eye drops to make the pupil bigger and it takes some time for the drops to work.

After dilation your close-up vision may remain blurred for several hours as the pupil slowly goes back to its normal size. You will be more sensitive to light while the pupil is dilated but the process is painless and does no damage to your eyes. It is advisable not to drive for at least 2 hours after the drops have been instilled into your eyes – sometimes longer, depending on which typ0e of drops have been used.

For some conditions optometrists will recommend treatment with medicines that you can buy from the practice or the pharmacy. Many optometrists will also be able to prescribe eye medicines just as your GP does and they might also order lab tests if an infection is present. This means you should expect to be asked about any medicines you are taking, even if they are not for your eyes.

If you need spectacles or contact lenses then you can expect that your optometrist will prescribe the most appropriate correction. Prescribing decisions after examination will be derived using direct measurements made by your optometrist during the examination, allied to consideration of your responses to the various tests that you will experience. This is because vision is a very complex human sense that involves both the eyes and the brain working together to interpret what we see.

The complexity of vision is most apparent when the findings at examination specify an accurate correction and yet you may not feel comfortable when using the new lenses. This phenomenon is caused by failure to adapt and can be overcome by making small adjustments to the correction. Your optometrist will record information about your final preferred correction to update your prescription findings.

This becomes your dispensed prescription.

Optometrists provide comprehensive eye examinations as part of your primary eye health care. Optometrists also provide consultations for specific purposes including:

  • checking for diabetic eye disease
  • glaucoma monitoring and management
  • advice on optics and visual performance
  • binocular vision problems
  • low vision care
  • industrial eye health and safety issues
  • sports vision
  • contact lenses
  • red eyes, eye infections, dry eyes and eye allergies
  • children's eye examinations