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Eye examinations

Proper diagnosis is the first and most important step in the patient's cooperation with the doctor. It is important to conduct it in a reputable clinic that has modern equipment and employs doctors who accurately interpret test results.

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In the case of children and adolescents, follow-up eye examinations should be conducted once every two years or, if necessary, as recommended by a specialist. Routine ophthalmic check-up with the pediatrician should be carried out during the so-called “eye check-up. The balance sheet, the dates of which are given in each health booklet. When a child enters elementary school, screening tests such as balance sheets and eye exams are usually reminded by the school nurse. Sometimes such examinations are conducted directly in the school office.

In adults, follow-up (and therefore PROFILACTIVE) eye examinations should be performed at least every 2 years. After age 40, diseases such as cataracts, glaucoma, and macular degeneration (AMD) begin to develop. Initially, they may not give any symptoms, but if not diagnosed in time, they can become the cause of significant deterioration of vision and even blindness. Then there is no longer any question of ad hoc treatment or selection of glasses/contact lenses, one has to resort to surgical solutions.

Proper diagnosis is the first and most important step in the patient’s cooperation with the doctor. It is important to conduct it in a reputable clinic that has modern equipment and employs doctors who accurately interpret test results.

Standard eye examination to select corrective glasses or contact lenses

Computerized eye examination – autorefractometry

A standard eye exam, commonly referred to as a computerized eye exam, is a test performed with an autorefractometer, which is a device used to measure the optical error of the eye (refractive error – commonly referred to as a defect in vision). The principle of the autorefractometer is based on completely painless and non-invasive introduction of a beam of infrared radiation into the eye, followed by analysis of the reflections of this beam reflected from its structures. Reflections are processed by a computer processor, which generates data that tells the refractive defect.

The measurement for each eye takes only a few seconds, and the test subject only has to look through a small aperture, where he or she sees an image representing a distant object. The result of the test determines only the approximate optical correction (powers of glasses or contact lenses) that can be used. Now an ophthalmologist or optometrist steps in and, using tools other than a computer, determines the optimal eyeglass correction (or contact lenses) for a person.

Wide diagnostic possibilities of modern ophthalmology

Of course, patients visit ophthalmologists for more than just eyeglasses or contact lenses. They are also brought here by spontaneous eye diseases and systemic diseases, in the course of which, as one of the ailments (or, for example, a side effect of taking medications), vision disorders and eye diseases appear.

It also happens that during a standard eye exam, the doctor discovers something disturbing and implements further diagnostics. Finally, modern ophthalmology, which includes refractive surgery, has surgical methods to offer that not only greatly improve vision in cases of large/complicated visual defects, but also save that vision when implantation of an artificial lens proves to be the only salvation. Patients therefore visit ophthalmologists’ offices to find out whether laser vision correction or artificial lens implantation is possible in their case.

When there is a need for diagnostics more complicated than a standard eye exam to select corrective glasses or contact lenses, the specialist has the ability to perform a really large number of maximum precise detailed examinations.

Diagnostic tests in modern ophthalmology

Examination of the fundus of the eye

Examination of the fundus (ophthalmoscopy, funduscopy or fundus speculum) – in the diagnosis of systemic disorders, such as diabetes mellitus, atherosclerosis hypertension and intracranial hypertension, autoimmune (autoimmune) diseases such as lupus or rheumatoid arthritis and the diagnosis of abnormalities in the structure and function of the retina, choroid membrane and optic nerve

CT scan of the optic nerve

Computed tomographic examination of the optic nerve (e.g., OCT or GDx or HRT ) – for the diagnosis of glaucoma

OCT examination of the eye

OCT examination of the eye (optical coherence tomography) – in the diagnosis of retinal diseases, AMD, diabetic maculopathy, before planned cataract removal and artificial lens implantation, in monitoring the course of glaucoma, in monitoring the condition of the cornea before and after laser vision correction procedures

Biometry of the eye

Biometry of the eye
In diagnosis before laser vision correction or implantation of artificial lenses

Biomicroscopy

Biomicroscopy (examination of the anterior segment of the eyeball in a slit lamp) – in the diagnosis of glaucoma

Gonioscopy

Gonioscopy (examination of the angle of seepage) – in the diagnosis of glaucoma

Keratometry

Keratometry (ophthalmometry, corneal topography) – in the diagnosis of vision defects and astigmatism (the need to select glasses/contact lenses), before (and after) planned laser vision correction procedures/implantation of artificial lens, in the diagnosis of certain corneal diseases

Pachymetry

Pachymetry
– In the diagnosis of glaucoma and ocular hypertension, before surgical procedures, including laser procedures, on the cornea, as well as in the diagnosis of corneal cone and other corneal disorders

Perimetry

Perimetry (visual field examination) – in the diagnosis of glaucoma

Tonometry

Tonometry (IOP – intraocular pressure test) – in diagnosis before deciding on laser vision correction

Corneal topography

Corneal topography (computer/digital or manual/manual keratometry) – in the diagnosis before laser vision correction and before the selection of artificial implantable lenses, which are used in the treatment of nearsightedness, farsightedness, astigmatism and cataracts, in the diagnosis of corneal conus

SAMPLE “PACKAGE OF TESTS” IN THE DIAGNOSIS OF GLAUCOMA

A set of basic research

– examination of visual defects and visual acuity ,
– examination of the anterior segment of the eyeball in the lamp
Slit-scan (biomicroscopy),
– intraocular pressure testing (tonometry),
– fundus examination after pupil dilation.

A set of additional tests

– visual field examination (perimetry),
– examination of the angle of seepage (gonioscopy),
– corneal thickness test (pachymetry),
– CT scans of the optic nerve (e.g. OCT or
GDx or HRT),
– Imaging studies of the anterior segment of the eye (e.g. OCT or
UBM).

A set of basic research

A set of additional tests

SAMPLE “PACKAGE OF TESTS” IN CATARACT DIAGNOSIS

When diagnosing cataracts, an experienced doctor only needs to see the cloudy lens with dilated pupils. Investigations prior to cataract surgery include:

– autorefractometry,
– biometrics,

– fundus examination,
– macular OCT study.

– autorefractometry,
– biometrics,

– fundus examination,
– macular OCT study.

SAMPLE “PACKAGE OF TESTS” PRECEDING SURGICAL INTERVENTION IN THE EYE (EYE SURGERY)

– Corneal topography/tomography (3D) of the cornea,
– pupil width measurement,
– Intraocular pressure test (IOP measurement) with corneal hysteresis,
– autorefraction,
– subjective refraction,

– a study of binocular vision,
– optical biometrics,
– Optical coherence tomography (OCT) / macula and optic nerve,
– imaging of the posterior segment of the eye,
– Measurement of endothelial cell density,
– biomicroscopic ophthalmic examination.

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