A comprehensive eye exam requires that your pupils be dilated with eye drops. This enables us to thoroughly examine and accurately measure the eye. The drops that are used are longer lasting than what you may be accustomed to from past visits to the eye doctor.
These will leave your vision somewhat blurry and brighter than normal for about four hours. We recommend that you bring a pair of dark sunglasses and a friend or family member to drive you home afterwards. We used to offer a type of eye drop that reverses dilation (reducing the time to about one hour), although many patients preferred not to use it because it usually caused side effects of irritation and redness; that drop is no longer commercially available.
You will need to supply some basic information at this time. Here are some common questions you might need to answer:
Since the eyes are a part of the body, they can be affected by seemingly unrelated health conditions. You will need to supply information about your vision and health history, past medications, symptoms of vision problems and other background information.
These are divided into 3 categories:
Generally, the examination is divided into these areas:
An assessment of the quality of your vision is called the Visual Acuity test, or VA. This test determines how well your eye makes images and is measured for distance and near vision with standardized eye charts, at standardized testing distances, under specific lighting.
The Visual Acuity is noted as:
Basically, the first number is the testing distance and the second is the relative size of the image. For more information on how this works, see: Normal Vision.
This is an examination of the external parts of each eye and the surrounding associated tissues. Structures examined include: the eyelids, lashes, conjunctiva, iris, cornea, crystalline lens and anterior chamber structures. A slit-lamp biomicroscope is used for much of this exam. Gonioscopy, a detailed examination of the drainage system in the anterior chamber, may be included for people who may have glaucoma. This specialized test is generally not part of a routine examination.
This test may be performed by the use of a hand-held or by automated instrumentation, called the auto-perimeter test. It is included for people at risk for glaucoma or for routine “baseline” screening.
Defects in the peripheral visual field may be an indication of internal eye conditions, including retinal detachment and glaucoma, or may be the result of problems with the brain or vascular system.
In this test, a light is shone into your eye and the iris is observed for its ability to constrict (reduce in size) and dilate (increase in size). Abnormal pupil reflexes may indicate faulty neurological (brain) development or could be a sign of an internal eye infection.
These tests measure how well your eye muscles work and whether they are working in harmony with each other. If one is previously tested as normal and then suddenly not normal, this may indicate neurological disease.
This is testing to determine if both eyes are working together for accurate depth perception. “3-D” red/green or polarized lenses are often used for these tests. If one is previously tested as normal and then suddenly not normal, this may indicate a neurological disease.
The analysis of color perception is often tested on children but not necessarily on adults, unless there is reported change in color perception or a particular job requirement is involved (piloting for example). Changes in color perception for adults can be related to internal eye disease, neurological problems or drug toxicity.
This is a test used for observing of the internal structures of the eye. It is the only technique aside from surgery that allows direct observation of the complete network of blood vessels. It can help diagnose hardening of the arteries, high blood pressure, diabetes mellitus, as well as other whole-body and eye-specific disorders.
It employs an instrument called an ophthalmoscope:
Often both types of ophthalmoscopes are used during an examination. Direct ophthalmoscopy may be done prior to the visual analysis, while indirect ophthalmoscopy is often performed following vision testing, as the dilating drops may effect optical measurements.
This is the test for measuring the internal pressure of the eyeball. Elevated pressure is one of the signs of glaucoma.
There are a number of instruments used to test eye pressure. Some require that an object be placed for a moment against the cornea in the front of the eye (usually requiring a drop of anesthetic and sometimes a liquid to color the tears) and some use a burst of air to press against the eyeball. Dr. Seibel utilizes instruments that do not use the air burst because they offer greater accuracy and comfort for his patients. Tonometry is often performed at the end of an examination.
This procedure measures the curvature of the cornea in two perpendicular meridians. The front of the eye may be round like a basketball, or irregular like a football (see Astigmatism).
These are objective tests for test your capability to see images clearly, which don’t require your input and allow your examiner a good starting point for the determination of your lens prescription. Your subjective input is necessary in a separate test for refinement.
A retinascope is a handheld instrument that allows the doctor to focus a spot of light onto the back of the eye through varying lenses. An auto-refractor does much the same thing automatically.
This test requires your input. The examiner presents a series of lenses and asks for the your opinion as to “which is better, one or two?” There are no absolute answers; only whichever appears more visually clear to you at the time.
The lenses that you choose during the subjective refraction are analyzed for their effects on eye muscle balance and coordination. You are asked to align a presented object or letter horizontally and then vertically. Sometimes, the lens that provides your best vision might cause your eyes to strain inwards or outwards and would not provide comfortable vision. Sometimes a slightly lesser power will be the better choice.
Accommodation is the ability of the crystalline lens in your eye to flex and adjust its focus from distance to near, back and forth effortlessly.
Your near vision is tested by using an eye chart, and a lens power that gives you clear and comfortable near vision is obtained. This may be the same as your distance lens power, or for those experiencing presbyopia it will be used for the bifocal or reading lens power.
The intraocular lenses that are used to replace the cataract come in different prescriptive powers. Your eyes will be measured using the IOL Master to determine the best power of the intraocular lens that will be inserted during surgery. Dr. Seibel may also use additional advanced diagnostic equipment to help select the best lens implant for you.
When the surgery date is set, you will be given a simple list of preoperative instructions.
At Seibel Vision Surgery, your eyes and vision are of paramount importance. To help you make the most informed decisions regarding the welfare of your vision, we are delighted to be of service and are happy to answer any questions you may have.
Please take the time to familiarize yourself with the information contained on this site. We have compiled it especially for you!
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8:30 a.m. to 3:00 p.m.
11620 Wilshire Boulevard, Suite 711
Los Angeles, California 90025
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