Eye Exam and Vision Testing Basics

Getting an eye exam is an important part of staying healthy. But do you know when you and your family members should get eye exams? Do you know what a complete eye exam should cover? 

Get the right exam at the right time and ensure your vision lasts a lifetime.

When Should You Have an Eye Exam?

Childhood vision screening

From birth through the teenage years, children’s eyes are growing and changing quickly. The American Academy of Ophthalmology and the American Association for Pediatric Ophthalmology and Strabismus have developed specific childhood eye screening guidelines. Follow these guidelines to get your child screened at the right times. These screenings help identify when your child might need a complete eye exam.

Baseline eye exams for adults

If your eyes are healthy and vision is good, you should have a complete exam by your ophthalmologist once in your 20s and twice in your 30s.

There are some exceptions:

• If you have an infection, injury, or eye pain, or you notice sudden floaters and flashes or patterns of light, call your ophthalmologist.
• If you wear contact lenses, see your eye specialist every year.
• If you have diabetes or have a family history of eye disease, talk with your ophthalmologist about how often your eyes should be examined.

The American Academy of Ophthalmology recommends that adults get a complete eye examination at age 40. This is when early signs of disease or changes in vision may appear. It is important to find eye diseases early. Early treatment can help preserve your vision.

Not everyone should wait until age 40 for an eye exam

Some adults shouldn’t wait until they are 40 to have a complete eye exam. See an ophthalmologist now if you have an eye disease or risk factors such as:

• diabetes
• high blood pressure
• family history of eye disease.

After an exam, your ophthalmologist can tell you how often you should have your eyes checked in the future. It’s important to follow the schedule your ophthalmologist gives you, especially as you age. Your risk for eye disease increases as you get older.

Seniors and eye exams

If you are 65 or older, make sure you have your eyes checked every year or two. Your ophthalmologist will check for signs of age-related eye diseases such as:

• cataracts
• diabetic retinopathy
• age-related macular degeneration
• glaucoma

Remember, always follow the schedule your ophthalmologist recommends for future eye exams.

What Do Ophthalmologists Check During Eye Exams?

A comprehensive eye exam is simple and comfortable. It shouldn’t take more than 45 to 90 minutes. Your doctor may have a staff member do portions of this exam. Here is what the exam should include:

Your medical history

Your doctor will ask you about your vision and your general health. They will ask about:

• your family’s medical history,
• what medications you take, and
• whether you wear corrective lenses.

Your visual acuity

This is the part of an eye exam people are most familiar with. You will read an eye chart to determine how well you see at various distances. You cover one eye while the other is being tested. This exam will determine whether you have 20/20 vision or not.

Your prescription for corrective lenses

Your doctor will ask you to look at an eye chart through a device called a phoroptor. The phoroptor contains different lenses. It will help determine the best eyeglass or contact lens prescription for you.

Your pupils

Your doctor may check how your pupils respond to light by shining a bright beam of light into your eye. Pupils usually respond by getting smaller. If your pupils widen or don’t respond, this may reveal an underlying problem.

Your side vision

Loss of side vision (peripheral vision) may be a symptom of glaucoma. This test can find eye problems you aren’t aware of because you can lose side vision without noticing.

Your eye movement

A test called ocular motility evaluates the movement of your eyes. Your ophthalmologist looks to see if your eyes are aligned. They also check that your eye muscles are working properly.

Your eye pressure

Eye pressure testing, called tonometry, measures the pressure within your eye (intraocular eye pressure, or IOP). Elevated IOP is one sign of glaucoma. The test may involve a quick puff of air onto the eye or gently applying a pressure-sensitive tip near or against your eye. Your ophthalmologist may use numbing eye drops for this test for your comfort.

The front part of your eye

Your ophthalmologist uses a slit-lamp microscope to light up the front part of the eye. This includes the eyelids, cornea, iris and lens. This test checks for cataracts or any scars or scratches on your cornea.

Your retina and optic nerve

Your ophthalmologist will put dilating eye drops in your eye to dilate, or widen, your pupil. This will allow them to examine your retina and optic nerve for signs of damage from disease. Your eyes might be sensitive to light for a few hours after dilation.

Other Tests During an Eye Examination

Your ophthalmologist may suggest other tests to further examine your eye. This can include specialized imaging techniques such as:

• optical coherence tomography (OCT)
• fundus photos
• fluorescein angiography (FA)
• topography, which is a scan of the surface of your cornea
• automated visual field

These tests help your ophthalmologist detect problems in the back of the eye, on the eye’s surface or inside the eye to diagnose diseases early.

Each part of the comprehensive eye exam provides important information about the health of your eyes. Make sure that you get a complete eye exam as part of your care for your overall health.

Shadows or Dull Areas in the Vision Huntington Beach

What are Shadows or Dull Areas in the Vision?

Shadows or dull areas in your vision are small spots that drift around aimlessly in your field of vision casting slight shadows on your retina. The shadows that you experience are known as eye floaters. They are made up of the vitreous, a clear gel-like material that fills most of the eye. The floaters may appear to you as grey or black specks, strings, or cobwebs that drift about when your eye and the vitreous gel inside the eye moves.

Causes of Shadows or Dull Areas in the Vision

The most common cause of eye floaters is age-related changes and is normally found in individuals aged 50 and above.

As you age, the vitreous or jelly-like substance filling your eyeballs begins to liquefy, crowding the inside of the eyeball with deposits and debris. As the vitreous shrinks and sags, it begins to clump together. This debris obstructs some of the light traveling through the eye casting tiny shadows on your retina, causing eye floaters.

Floaters may also occur as a result of less common causes, such as:

• Eye infection or inflammation
• Eye trauma or injury
• Diabetic retinopathy
• Torn or detached retina
• Bleeding in the eye
• Eye medications and eye surgeries
• Near-sightedness

Symptoms of Shadows or Dull Areas in the Vision

Some of the common symptoms of eye floaters include:

• Shadowy specks or dots
• Cobweb shapes
• Rings
• Small lines
• Other irregular shapes

When Should You See a Doctor for Shadows or Dull Areas in the Vision?

You need to seek immediate medical attention from your doctor if you notice:

• A sudden outbreak of new floaters
• More than usual eye floaters
• Blurred vision or loss of side vision
• Appearance of flashes of light
• Eye pain

Diagnosis of Shadows or Dull Areas in the Vision

In order to diagnose eye floaters, your doctor will carry out a thorough eye examination including dilation of the eyes to better visualize the posterior part of your eyes as well as the vitreous humor to establish the cause of the floaters.

Treatment for Shadows or Dull Areas in the Vision

Most eye floaters do not require any kind of treatment. If you experience temporary obstruction of vision due to floaters, just roll your eyes from side to side and up and down to move the obstructing debris. However, if the floaters are a result of an underlying condition such as inflammation, bleeding, or diabetes, then the condition needs to be treated accordingly.

In rare cases, eye floaters may also cause vision impairment. To treat this, your doctor may consider other treatment options, such as:

• Surgical removal of the vitreous: During the surgery, your ophthalmologist will perform a vitrectomy, surgical removal of all or some of the vitreous humor from the eye, through a small incision and replace the vitreous with a solution to assist your eye to preserve its shape.
• Use of laser to shatter the floaters: During this method, your ophthalmologist will employ a special laser to break up the floaters in the vitreous to make the floaters less noticeable.

Related Topics

• Floaters & Flashes
• Vision Disorders
• Blind Spots
• Blurred Vision
• Distortion of Central Vision
• Shadows or Dull Areas in the Vision
• Burning Eyes
• Itchy Eyes
• Watery Eye
• Eye Pain

Dark spot in the eye – causes, diagnosis and treatment

Changes that occur with age affect the entire system of the human body. For most people, after the age of 40, visual acuity may decrease. A common problem is the appearance of dark spots before the eyes. However, this defect is sometimes not associated with age. With the development of technology, a change in lifestyle, which is mainly associated with long-term work at the computer, which means overwork, young people can also face such a pathology. When a dark spot in the eye covers the image, causes discomfort when trying to examine an object, this signals negative changes in the body that may indicate various diseases.

Even slight overlaps of the visual field cannot be ignored, as they may indicate the gradual development of various diseases. To find out the true causes of the appearance of such spots, you need to contact an ophthalmologist. The use of the latest techniques and modern equipment will allow the doctor to quickly examine the fundus, establish an accurate diagnosis and prescribe appropriate treatment. The grounds for an urgent appeal to a specialist are intense opacities, the appearance of a blind curtain that affects most of the eye, the occurrence of flashes of light in the field of view when considering a background of a uniform color, and others.

Contents:

• Types of spots on the eyeball
• What causes the defect
• Diagnosis and treatment

Types of spots on the eyeball

In medicine, a blind area in the visual field that is not associated with peripheral boundaries, called scotoma. A spot is an area that does not allow light to pass through, although light sensitivity is usually normal around it. Lack of visual perception can manifest itself in different ways:

• focus is difficult when looking forward at near or far objects;
• obscuration is only in one place and does not change its position with eye movement;
• the spots seem to shimmer. They are also called “flies”;
• color perception is impaired. Previously saturated shades look faded and faded. It is also difficult for a person to determine exactly what color is in front of him.

Consider two types of cattle:

PhysiologicalPathological

Presented by:

• blind spot. In fact, this is an area on the retina that every healthy eye has. It is distinguished by an absolute lack of sensitivity to light;
• angioscotomas. They are in direct connection with the blind spot. The large retinal blood vessels, which resemble tree branches, lack photoreceptors.

Physiological scotomas are compensated by binocular vision. With monocular, they may also not be observed due to involuntary micro-movements of the eyeballs and the presence of a blind spot in the paracentral region.

Formed in case of physiological disorders in cattle. As a result of damage to the retina, choroid, visual pathways and centers, various pathological processes occur that reduce visual acuity. The internal classification of outliers is as follows:

1. Positive and negative. The first can be seen by the patient himself, and the second can be detected only with a special examination.
2. Absolute and relative. The division occurs taking into account the density of the scotoma. The former are characterized by a complete absence of visual perception, and the latter by its partial weakening, which can be expressed in a decrease in the brightness of the object.

It should be said that the shape of pathological spots can determine a particular disease. For example, a hereditary and rather rare visual impairment – retinitis pigmentosa – is characterized by scotoma in the form of rings. And with glaucoma, which occurs with increased eye pressure and leads to the cessation of the functioning of the optic nerve, spots in the form of an arc are most often observed.

What contributes to the appearance of a defect

Restriction of visual perception in a particular area of ​​the eyeball may indicate the presence of various diseases. Deviations may affect the vitreous body. It fills the space between the lens and the retina and acts as an anatomical magnifying glass. It helps the eye to focus. So why do dark spots appear? Through the vitreous body, light enters the nerves located in the central part of the macula. When it becomes cloudy, the fibers stick together. The nerves responsible for clear image reproduction lose their function. The luminous flux cannot reach the required place, where it is usually differentiated, resulting in blackouts. They differ in size and shape. The main causes of dark spots include deviations that occur:

• in cranial nerves responsible for eye convergence;
• in the vessels, which is associated with sclerotic changes that cause clouding of the vitreous body. Phacosclerosis is characterized by dehydration, as a result of which the lens loses its elasticity;
• as a result of changes occurring in the intervertebral discs and cartilaginous tissues, cervical chondrosis and other pathologies develop. They, in turn, contribute to spasm of the eye vessels;
• in the endocrine system. So, in patients with diabetes, vision begins to deteriorate greatly. This is due to disruption of the blood vessels. This complication is called “diabetic retinopathy”.

Some people develop dark spots in the eye due to prolonged exposure to harsh weather conditions. For example, they include extremely low or high air temperature. The risk group also includes those who constantly experience unbearable physical and mental stress. Provoking factors also include bad habits, such as smoking and overeating.

The disease is diagnosed mainly after a person has passed the age of 40. However, most studies have shown that pathologies are much more likely to affect women. This is due to the highly variable hormonal background. The body undergoes severe stress at different periods of life, especially such as pregnancy and menopause.

Diagnosis and treatment

Restoration of the visual apparatus is possible only if the root causes of scotoma are eliminated. Diagnosis is carried out in several ways:

1. Perimetry. The nature of the field of view is determined using a test object. This can happen using both a special device and a computer. The bottom line is that the test object is placed on the surface of a spherical shape. The procedure determines the localization of the defect due to the increased sensitivity of the retina to different colors.
2. Campimetry. It differs from the previous method only in that the object is placed on a flat plane.
3. Ophthalmoscopy. The doctor examines the fundus to determine the condition of the optic disc and retina.

They also use computed tomography of the brain, ultrasound of the eyeball, measurement of arterial and intraocular pressure. More information about modern methods of computer vision diagnostics can be found on this page.

It is impossible to get rid of scotoma on your own, especially when resorting to traditional medicine recipes or other dubious methods from the Internet. If the exact cause of the appearance of a dark spot is not determined, then the ophthalmologist cannot prescribe a course of treatment. At the same time, it is impossible to call universal complex therapy. For example, urgent surgical intervention is performed when retinal detachment or oncological formations are detected. If the nerve fibers in the retina are damaged or a pathology is detected in the brain, then the treatment occurs according to the following scenario:

1. Eliminate the root cause. So, poor blood circulation in the retina is caused by disorders in the vessels, therefore, it is necessary to start treatment with them. When healthy tissues of the body are attacked by autoantibodies that the immune system itself produces, the help of various specialists may be required, and not just an ophthalmologist – a dermatologist, neurologist, rheumatologist, endocrinologist and others.
2. Stimulation of regeneration. Magnetic therapy or the use of peptide agents may be quite effective. Current discharges transmitted along the nerve pathways can cause their restoration.

It is possible to get rid of the dark spot with the help of drugs:

• biogenic stimulants;
• vitamin complexes;
• vasodilators;
• nicotinic acid.

To normalize the condition of the visual organs in chondrosis, you will need a more active lifestyle – daily physical activity. With arterial hypertension, it is necessary to normalize the pressure indicators. Patients may feel completely healthy. Vessels are capable of adapting to high pressure, while the heart and blood vessels most often experience excessive stress. Be attentive to the symptoms, which are expressed not only by a headache, but also by the appearance of “flies” before the eyes, the image becomes blurry.

Prevention can be effective in preventing visual field distortion. As doctors say, the disease is always easier to prevent than to cure. Therefore, be attentive to any signals of your body.

• Control your psycho-emotional state.
• Practice good eye hygiene to avoid infection.
• Measure your blood pressure.
• Always seek medical attention promptly if dark spots appear in the eye.

Flies, stars and spots before the eyes

Flies, stars and spots before the eyes – the causes of the disease ! Currently, complaints of this kind remain the most common at the appointment with an ophthalmologist.

In an extensive clinical study conducted by a British doctor, among the interviewed patients of ophthalmology offices, about 80% of people experience inconvenience associated with this particular phenomenon. With severe discomfort, this can cause a depressive state and a significant decrease in the quality of life.

So why do they appear, why is it dangerous, and most importantly, how to treat?

Cause in the vitreous body (VT) is a gel-like substance that fills 2/3 of the entire volume inside the eye and is not capable of regeneration. When it is lost, the space is replaced by intraocular fluid. The vitreous body maintains a constant shape of the eye and is involved in the refraction of incoming light to the light-perceiving membrane of the eye – the retina. In terms of composition, ST is 98% water, 2% are glycosaminoglycans, collagen proteins and other structural substances. Between the fibers, the space is filled with hyaluronic acid molecules, which do not allow collagen to thicken, thanks to which the vitreous retains its transparency.

Risk factors – high myopia, metabolic disorders of the body (diabetes mellitus, atherosclerosis), high blood pressure, history of head and eye injuries, ophthalmic surgeries, physical exhaustion, etc.

Types of opacities.

1) Idiopathic floating opacities are primary opacities. Under the influence of various factors, the structure of hyaluronic acid changes, which leads to its decrease. Collagen fibers are no longer separated by anything, they connect with each other and, thickening, lose their transparency. The most common cause is age-related changes – usually 40-60 years. Opacities become especially noticeable against a bright background, periodically falling into the field of view and moving according to eye movements. May appear in both eyes, but not synchronously. Small vitreous floaters are not a pathology, but large spots, falling into the field of view, cast a shadow on the retina and cause significant visual discomfort.

2) Secondary opacities are not associated with a change in the structure of the vitreous body. These are always opaque molecules from the outside.

• Retinal detachment or tear – may cause similar complaints – floating flies, spots before the eyes. Sensation of curtains, flashes and lightning, decreased visual acuity are additional symptoms. This pathology is very serious, it can threaten with complete and irreversible loss of vision. Any delay is dangerous! Therefore, if a complex of symptoms occurs, an urgent appeal to an ophthalmologist is necessary.

• Vitreous hemorrhage – hemophthalmus. It occurs spontaneously, against the background of already existing changes in the fundus due to diabetes mellitus or arterial hypertension. Also, 18% of all hemorrhages are caused by blunt trauma to the eye or penetrating injury.

When retinal vessels rupture, blood elements penetrate into the eye cavity. The vitreous body loses its transparency within a few minutes. Depending on the intensity of the bleeding, the loss of vision may be partial or complete. If the hemorrhage is mild, then this is manifested in a slight blurred vision. In the future, the blood coagulates and a cord can form from the retina into the vitreous body. This strand, exerting a strong pulling effect, can later cause a rupture or detachment of the retina. Therefore, early treatment of hemophthalmia will ensure the rapid resolution of blood clots and the prevention of further complications.

• Vitreous inflammation. Caused by an infection, such as toxoplasma or cytomegalovirus infection. Due to the presence of inflammatory elements in the vitreous body, dense strands appear, which will reduce visual acuity. The inflammatory process covers not only the transparent structure, but also neighboring areas (the retina, choroid), therefore, in addition to the “flies” before the eyes, patients often feel pain, loss of entire areas of the field of view.

• Eye migraine. At the same time, the patient suffers from bouts of visual impairment, the process may be accompanied by a headache, it may proceed without it. With this pathology, there is no organic damage to the eyes. At risk are young patients, mostly women with a high level of stress and physical activity. Symptoms from the organs of vision: “flies” before the eyes, lightning, flashes of light, flickering dots. Usually, after such symptoms, a recovery period occurs within a few hours and vision returns.

Diagnosis.

When should you see a doctor?

If the number of opacities increases, other visual symptoms are noted – lightning and flashes before the eyes, loss of lateral vision, eye pain – all this is a sign of a serious pathology.

If there is already a history of trauma or surgery on the eyes, the appearance of opacities may indicate a deterioration in the condition and the presence of a complication.

In all these cases, an examination by an ophthalmologist is necessary!

At the reception.

Appointment begins with an anamnesis: the doctor will clarify the time of onset of symptoms, the speed of their development, the degree of discomfort, whether there have been previous injuries or operations. It is necessary to tell the doctor about chronic existing diseases. Test results can also help find the cause of clouding.

Physical examination.

It is necessary to conduct a complete examination of the condition of the patient’s organ of vision. For this, visual acuity is checked according to special tables, visual fields are examined, and the movement of the eyeballs is assessed. With the help of a special microscope, an external examination of the eyes is carried out, intraocular pressure is also measured. The most important part of the examination is the study of the fundus in conditions of a dilated pupil. To do this, a remedy is instilled, the effect of which persists for 3-4 hours after the examination. With the help of special lenses, an examination of the state of the vitreous body and retina is carried out.

Additional research methods necessary to clarify the diagnosis are usually prescribed by a doctor after the examination, based on the data obtained. For example, in case of inflammation, a microbiological examination may be required; in case of hemophthalmia or detachment, ultrasound eyes are prescribed. With ocular migraine, a consultation with a neurologist is necessary.

Treatment.

Treatment of age-related changes in the vitreous body does not require conservative intervention. Usually patients get used to small floaters, and they do not cause significant discomfort. Treatment of secondary opacities is based on the exclusion of the pathological conditions that caused these symptoms.

If treatment is still required, modern doctors have both conservative and surgical methods in their arsenal.

1) Conservative treatment

Pharmacological vitriolisis is the liquefaction and dissolution of dense opacities with the help of special preparations. The method is promising, but little studied, its application is not so widespread.

2) Surgical treatment

• AG – laser vitreolysis. Treatment of opacities in the vitreous has become possible only recently, thanks to the improvement of the technical features of laser systems. With laser exposure, spot removal of turbidity occurs. Due to the small size of the opacification and its location in the posterior region, the accuracy and experience of the surgeon is important in this method. Therefore, this method is associated with risks of complications and is not recommended for small opacities. The literature describes cases of laser treatment for extensive hemorrhages. The efficiency reached 70%, which is a high result.

• Vitrectomy. The most radical method of treatment. It consists in the removal of the vitreous body with opacities. In this case, the volume of the removed substance is completely filled with a transparent saline solution. This method allows to achieve the highest clinical results. Of the minuses of the method is invasiveness (i.e. the need to perform punctures of the eye), which increases the risk of postoperative complications, the most common of which are clouding of the lens, retinal detachment and intraocular inflammation. Vitrectomy is considered the last recommended method when vitreous opacities significantly reduce visual acuity.

Numerous studies and articles state that more than 70% of patients with floaters recognize it as more of a nuisance than a condition requiring treatment. Over time, the flies that appear due to age-related changes cease to be noticeable.

If these symptoms occur, dangerous conditions must be ruled out and a decision can then be made based on the impact of opacities on the patient’s quality of life.