Keith Brown Independent Optician - Tunbridge Wells and West Malling

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10 reasons for having an eye examination

What happens in an eye examination?

An eye examination is carried out by an optometrist and usually takes about 30 - 45 minutes (but may take longer if extra tests are required). As well as testing your sight, the optometrist will check the health of your eyes and look for signs of general health problems. The examination will normally include the following elements:

History and symptoms

At the start of the eye examination, your optometrist will ask why you are having your eyes examined, whether it is a routine check-up or if you have you come for a specific reason. If you are experiencing problems with your eyes or vision your practitioner will need to know what symptoms you have, how long you have had them and whether any changes have happened suddenly or slowly over a period of time.

Your optometrist will also need to know about your general health including any medication you are taking, whether you suffer from headaches, or have any close relatives with a history of eye problems. You will be asked about your previous spectacles or contact lenses. Additional information, which will help your practitioner to make an accurate assessment, includes your occupation, whether you play sports or have any hobbies.

Examining the eye

Your eyes will be examined both externally and internally. This will enable an assessment to be made of the health of your eyes and may identify any other underlying medical problems. The interior of your eye will be examined using an ophthalmoscope, a special torch which shines a light through the pupil allowing a detailed study of the internal structures. Your pupil reflexes will also be tested.

Other tests which may be carried out, if necessary, include for example those for glaucoma or colour vision deficiency. If you are over 40, the College of Optometrists recommends you should be checked to make sure you are not developing glaucoma. If you have glaucoma you will not normally notice until some sight has already been lost. Checking for glaucoma involves a combination of two or three of the following three tests: looking inside your eye; measuring the pressure inside your eye (which may be done with a puff of air or after using drops to gently numb your eyes); and checking your visual fields to make sure you don't have have any abnormal blind spots. Many optometrists now offer extra tests, such as photography of the interior and exterior of the eye, for which an additional charge may be made. Extra tests are also needed for contact lens fitting and check-ups.

Vision

Remember to take your spectacles or contact lenses with you when you attend for an eye examination. Your vision will be measured both with and without spectacles or lenses to check for any problems with your eyesight. The optometrist would normally assess your distance vision (for TV and driving), your near vision (for reading and close work) and your intermediate vision (for computer use).

Your optometrist will then carry out a series of tests to measure the type and extent of any problem with your vision. You will then be asked to choose between different lenses to see which ones help the quality and clarity of your vision.

Eye movements and co-ordination

Eye movements and co-ordination are checked to make sure that both eyes are working together, and that undue stress is not being placed on the eye muscles. Good muscle balance is particularly important for those who use computers or read for prolonged periods.

After the eye examination

Your practitioner will now have a detailed knowledge of the health of your eyes, the standard of your vision and any special requirements that you may have. This information will be explained to you but if you do not understand anything or require more information, ask your optometrist who will be only too pleased to help. You will also have the opportunity to discuss the best form of vision correction to suit your individual lifestyle and visual needs.

At the end of the examination you will be advised on the appropriate interval until your next examination and be handed a prescription for spectacles or contact lenses, or a statement which confirms that your eyes don't need correction. If you need medical treatment for an eye condition you may be referred to your doctor or hospital.

When you have your prescription made up, you will be given help in choosing spectacles or contact lenses. If you choose contact lenses you will be given advice on the various types of lenses available, the procedures for fitting lenses and further information about caring for and cleaning your lenses.

If you are not satisfied with your spectacles or contact lenses make sure that you contact your practice so that the matter can be dealt with promptly. As part of continuing care and service your optometrist will be happy to adjust or make minor repairs to your spectacles where possible.

Most optometrists will send you a reminder when your next appointment is due. Remember that if you have a problem with your vision or your eyes before your next eye examination is due there is no need to wait - contact the practice and make an appointment for a check-up.

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What does my optical prescription mean?

At the end of your private eye examination you will be given a prescription which will probably look something like the example below:

Keith Brown Opticians
West Malling or Southborough address

Tel: 01732 848384 or 01892 535683

Name of Patient:

Address:

Sph
Cyl
Axis
Prism
VA
Rdg Add
Near VA

Right Eye

Left Eye

I have today examined the patient in accordance with the regulations with the following results:

* The prescription above was issued

* No clinical change in prescription was necessary

* No prescription was required

* The patient was referred to a medical practitioner

The next eye examination is recommended in ______ months

Signature of Optometrist______________( MCOptom)
Date:________

You can see that the findings for the right eye are presented on the top line and for the left eye on the bottom line. Another way is to show the right eye on one side the form (normally the left) and the left eye on the other side of the form.

A prescription is usually valid for two years, but your optometrist may be recommended that you have your eyes examined more frequently than this, depending on your particular circumstances.

Remember, an eye examination does not only check that your prescription is right for you; it is also a check on the health of your eyes and visual system. Many eye diseases can go unnoticed until it is too late to treat them effectively so it is important to have regular eye examinations even if you feel you can still see well.

The "sph" box for "sphere" represents the amount of long or short light that is present. The larger the number the stronger, and therefore the thicker the spectacle lens will be. Plus lenses are used to correct long sight and minus lenses are used to correct short sight.

The "cyl" box for "cylinder" represents the amount of astigmatism that is present. Astigmatism is caused when the eye is not completely spherical (like a football) its shaped more like a rugby ball. This causes the vision to be distorted for both distance and near objects. The cylinder may be plus or minus regardless of whether the sphere is positive or negative.

The "axis" box represents the orientation of the cylinder (from 0-180 degrees) and is the angle at which the lens is set into the frame.

The "prism" is the correction needed (if any) to align the eyes, so that they are looking straight and working well together. A prism is a lens that bends the path of light without altering its focus.

"VA" stands for visual acuity. This indicates the standard of vision (for each eye) when corrected. It may or may not be included in the prescription and is usually presented as a fraction. In the UK, VA is conventionally measured at 6m, so the numerator is 6 (eg 6/6). In the US, VA is measured at 20 ft (eg 20/20). The larger the denominator, the worse the eye sees, so a VA of 6/12 is half as good as 6/6.

"Rdg add" (reading addition) shows the additional positive power that is needed to enable the eyes to focus for close work. This is usually only needed for patients over 40-45, since focusing ability declines as we get older (presbyopia). If a reading addition is stated, this means you need different spectacle prescriptions for reading and for distance.

"Near VA" represents the smallest sized print that can be read with the prescription. This is usually written as Nx where x is a number representing the print size. N5 is the smallest sized type that you will normally find and N8 is approximately the size of normal newsprint.

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What if my optometrist refers me to my doctor?

Following your eye examination, your optometrist may suggest that it would be wise to seek advice from either your general practitioner (GP) or a specialist. You may be referred for medical advice on general health problems. For example, your optometrist may ask your GP to check for something specific, such as diabetes or high blood pressure. Alternatively, you may be referred to a specialist at the hospital, usually an ophthalmologist, who is a doctor specialising in eyes. Feel free to ask your optometrist if you have any questions about this.

If you need to be referred, your optometrist will inform you of the reasons for referral and write to your GP (you will either be given the letter to take to the GP or it will be posted) and will tell you whether or not you need to make an appointment to see your GP or whether your GP will contact you.

If your optometrist has asked your GP to arrange a hospital appointment for you, your GP will normally send your optometrist’s letter, along with a covering letter with any relevant medical details, to the hospital. These letters will be read by the specialist at the hospital who will decide how urgently you need to be seen. The hospital will then write to you with an appointment time. You may request to see any letters that are written about you.

Under new regulations introduced in 2004, optometrists may also refer patients directly to a hospital eye department rather than via the GP although they must inform your GP of their findings and the reason for the referral. You should also be given a copy of the referral letter.

If you have not heard anything from your GP or the hospital within a few weeks of your optometrist referring you, you should contact your GP. Your optometrist may not automatically be told whether you have been seen by your GP or the hospital. As the urgency of appointments depends on the urgency of your condition, you should not worry if there appears to be a long time to wait between receiving the appointment notice and the date of the appointment.

In exceptional circumstances, where your eye condition requires urgent attention, it may be necessary for your optometrist to refer you directly to a hospital accident and emergency department. In this case, your optometrist will normally give you a letter to take with you and inform your GP of the reason for referral.

How do I make a complaint?

What does an eye examination cost?

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