What it is
In short: a comprehensive eye examination checks how well you see and the health of your eyes. It can find some problems before you notice symptoms. Allow about 90 minutes to two hours for a first visit. If dilating drops are used, they blur your sight for a few hours, so do not drive yourself home.
The examination combines your symptoms and medical history with a range of checks. It can show whether you need glasses, find signs of eye disease, or show that more tests are needed. The examination itself is an assessment, not a treatment.
Reading a letter chart is only one part of it. Dr Chin may also examine the front of the eye, the lens, the retina and the optic nerve. The retina is the layer at the back of the eye that senses light. The optic nerve carries what you see to the brain. Different tests look at different parts of the eye and how they work.
Some eye conditions cause few symptoms early on. So an examination can be worthwhile even when your sight seems fine, especially if your age, diabetes, family history or another eye condition raises your risk. Dr Chin will discuss how often you need an examination and what it should include.
Symptoms
Reasons to have your eyes checked include:
- blurred vision that comes on slowly
- difficulty reading
- glare
- colours looking different
- distorted vision
- changes in your side vision
- discomfort, redness or double vision
It helps to tell Dr Chin when the problem started, whether it comes and goes, and whether one eye or both are affected.
An eye that feels comfortable can still have a problem. Glaucoma, for example, can damage the optic nerve without early symptoms, and it may affect your side vision before you notice. Your history and the examination give information that you cannot get from how your eyes feel.
When it is urgent
Do not wait for a routine appointment if you have:
- sudden loss of sight
- a new curtain or shadow across your vision
- a sudden shower of floaters with flashes
- a very painful red eye, especially with blurred sight, nausea or vomiting
A sudden rise in eye pressure is one possible cause of that last group of symptoms.
Call the clinic at +65 6694 0400. Outside clinic hours, call the 24-hour answering service at +65 6535 8833, or go to a hospital A&E with eye services. If any of these symptoms start after you have had dilating drops, get urgent care. Do not assume they are just an effect of the drops.
What the assessment involves
Before the checks
The visit starts with a talk about your symptoms, your eye history and your general health. It helps to bring your current glasses and a list of your medicines. Mention any previous eye operations or injuries, and any eye disease in your family. Tell Dr Chin about practical difficulties, such as recognising faces or reading medicine labels.
The checks
- Vision: each eye is tested separately.
- Refraction: checks how your eyes focus and which lenses help.
- Other checks: these may include how your pupils react, how your eyes move and your side vision.
- Eye pressure: measured with an instrument suited to your situation.
- Slit lamp: a microscope with a light, used to examine the front of the eye.
- Dilating drops: these widen your pupils so that Dr Chin can examine the retina and optic nerve. They may sting briefly, and take 20 to 30 minutes to work.
Photographs, OCT scans or a visual field test may be added when the findings call for them. An OCT scan uses light to show the layers of the retina. A visual field test maps the area you can see, including your side vision. These tests answer specific questions, and you will not need all of them at every visit.
An eye-pressure reading on its own cannot confirm or rule out glaucoma. The optic nerve and other findings matter too.
Treatment options
What happens next depends on what is found:
- A focusing problem may lead to a glasses prescription.
- If nothing needs treatment now, you may simply need another examination at an agreed time.
- An unclear finding may need another test or a repeat measurement.
If an eye condition is found, Dr Chin will explain what it is, the options, and what would happen if you chose to wait. Depending on the diagnosis, options may include medicines, laser or surgery. For example, glaucoma can be treated with pressure-lowering eye drops, laser or an operation, depending on the findings and any past treatment.
Good questions to ask:
- Which finding explains my symptoms?
- Is anything that was found unrelated to my symptoms?
- What is the next test or treatment meant to find out?
- What changes should make me come back sooner?
You do not have to agree to any procedure until Dr Chin has explained what it is for, and its pros and cons.
Recovery and follow-up
If dilating drops are used, they have short-term effects. For a few hours, your vision may be blurred, especially up close, and bright light may bother you. Sunglasses can help with glare. Arrange for someone to drive you home, and do not drive until your sight is back to normal.
When you need your next examination depends on your age, your risk factors and what was found. A normal result describes your eyes on that day, so new symptoms still need checking. If any results are still to come, ask how you will hear about them. If you are given treatment, follow those instructions as well as the advice about the drops.