The best way to ensure a lifetime of good vision is through regular, comprehensive eye examinations. In addition to ensuring proper eyesight, regular exams allow the early detection and treatment of diseases, improving the likelihood for successful treatment. Several eye diseases, such as glaucoma, show no symptoms in their beginning stages and can only be detected by a qualified examiner.
Not all eye examinations need be comprehensive. Some may be specifically formatted for the evaluation, diagnosis and treatment of a specific complaint. Generally, a comprehensive examination takes about hour, depending upon the number and type of tests required.
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 also offer a type of eye drop that reverses dilation (reducing the time to about one hour), although many patients prefer not to use it because it usually causes side effects of irritation and redness.
You will need to supply some basic information about why you are having an exam 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, 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.
Rotations and Versions: Your eye’s ability to follow a moving object is evaluated, usually horizontally, vertically and at various angles. The eyes are tested individually and together.
Divergence/Convergence Cover Test: The eyes are observed for their ability to align properly. One eye (then the other) is covered and uncovered, to test the resting position of the eyes and their ability to focus and target a presented object. Alignment is usually tested at distance and near. Misalignment may indicate strabismus (cross- or wall-eyed), uncorrected optical error, or neurological (brain) disease.
Fixation and Saccades: More often performed on children, these tests evaluate the ability of the eyes to maintain attention on one point in space and then to move from point to point accurately without over- or under- shooting the fixation point, thereby requiring an adjustment movement.
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.
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 melitis, as well as other whole-body and eye-specific disorders.
It employs an instrument called an ophthalmoscope:
A more recent variation of indirect ophthalmoscopy is performed with small hand-held lens at the slit-lamp. This method was pioneered by Dr. Seibel in the greater Los Angeles area and achieves superior magnified views to those of a direct 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).
Retinoscopy and Auto-refractometry
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. Scheduling an exam
Aside from your routine exams there are several reasons to schedule a non-emergency visit. These include: gradual loss of ability to focus on near objects, blurred distance vision after concentrated near vision activities or the reverse, change in quality of vision with existing eyeglasses or contact lenses, headaches or eyestrain, especially after near vision tasks.
For routine exams:
In general, Dr. Seibel only sees patients that are 14 years of age and older. For patients younger than that, we will be happy to make some appropriate recommendations. For Emergencies
Any sudden onset of blurred, double, or distorted vision, loss of peripheral vision, increase in number or size of floaters, flashing lights, light sensitivity, pain upon movement of the eyes, halos around lights, any bleeding, pain upon closure or opening of eyelids – these require immediate attention!
If you are already a patient of Dr. Seibel and you have an emergency, you may call (310) 444-1134 at any time .
If you are not yet a patient of ours, please either make an appointment (during regular business hours) or call the nearest hospital emergency room or 911.
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!
Monday, Tuesday, and Thursday
8:00 a.m. to 4:00 p.m.
8:00am to 6:00pm
8:00am to 3:00pm
11620 Wilshire Boulevard, Suite 711
Los Angeles, California 90025