Your eye exam will start with the optometric assistant taking you to the testing stations. If you have been in the office before, they have taken the time to review your last exam and any pertinent information that was advised by the doctor at that time. As the ocular health is of utmost importance, it is essential that the optometric assistant reviews your health history.
Autorefraction, autokeratometry, autolensometry, Ishihara colour testing, and Randot stereopsis are performed in this station. For children and seniors that cannot place their head in the autorefractor properly, we do have the Plusoptix autorefractor that permits for measurements at a 1 meter distance. This has been extremely beneficial for our pediatric population as the first examination should be conducted at 6 months of age.
A visual field screening using the FDT matrix checks for function of your peripheral vision. The test uses frequency doubling technology and therefore permits a speedy measure of the peripheral vision, generally under 2 minutes per eye. For more extensive peripheral vision testing, the office has the Humphrey Field analyzer that is used for monitoring of glaucoma, pituitary tumours etc plus also has the required field test that the Ministry of Transport requires for licensing.
From here, you will have a fundus photograph taken. This technology is absolutely incredible in allowing all of your retinal structures to be viewed with one quick flash of light. If the pupil size is good and the picture quality through the lens of the eye is clear, then this helps alleviate the need for having to put dilating drops in the eyes. There are times that the doctor may need to dilate but in most cases it is not necessary and allows you to return to work without blurry vision. Everyone including children over 10 years of age, diabetics and seniors should have this photo taken at every visit.
Now you are ready to see the doctor. All the information from the testing stations and the retinal photography are directly transmitted to the doctor's office for viewing. The doctor will review your case history and again check to see what the main purpose of your visit is. If there was anything you felt uncomfortable relaying to the optometric assistant, this is a good time to let the doctor know.
The doctor will check your vision at distance and at near. There are techniques to measure how well the eyes are working as a team (binocular function) and how well you focus (accommodative testing). Refraction using a retinoscope not only allows the doctor to see what your approximate prescription is but also garners information on how reactive your pupil is and how clear your lens is. After taking all the necessary measurements and involving your subjective input to see which lenses you prefer, a prescription for glasses is now printable. There are many different options in terms of lens design that takes into consideration the distances you work at...generally one pair of glasses will not suffice for all your visual needs.
Health evaluation using the biomicroscope (slit lamp) and reviewing your fundus photograph is next. Included in this health portion is the glaucoma testing where the intra-ocular pressure is measured (here you will see Dr. Fink using the new i-care tonometer). If there are any concerns from the photo, side vision screening and/or the pressure measurement, the doctor will then discuss further testing (such as an OCT scan) and/or referral to an ophthalmologist if there is surgery required. With the expanded scope of practice for optometry, most conditions are now treatable by your optometrist.
The doctor will then review all of your options (glasses, contact lenses, sunglasses, further health testing) and ask if there are any other concerns before continuing to the optical boutique.