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Your eye health is our priority. Since the original practices first opened we have adopted the policy of providing patients with a comprehensive and unhurried eye examination. This policy continues at Webb & Lucas. As a practice, we provide continuous training for all staff members ensuring you receive the very best service at all times.
For loyal patients, some of our staff will be familiar faces having worked in the practice for many years, For new patients, we welcome you and assure you of our best endeavours.
THE EYE EXAMINATION
During an eye examination you can expect to have some or all of the following procedures carried out. The actual procedures carried out for each individual person will be determined by the Optometrist, taking into account your age, any symptoms you may be experiencing, your occupation, hobbies and any special visual requirements, also any medical or family history that could be relevant.
HISTORY AND SYMPTOMS
This is a very important part of the eye examination.
We need to find out why you have come for an eye examination.
Are you experiencing any symptoms or having any problems with your vision?
What are your visual requirements? ie occupation, hobbies, do you drive?
Have you had any problems in the past (ocular history )?
Are there any ocular problems in the family which may be hereditary?
Do you have any medical problems which could affect the eyes?
VISION AND VISUAL ACUITY
When you view the sight test chart the lowest line of letters you can read is noted.
VISION is the lowest line read without spectacles
VISUAL ACUITY is the lowest line read with spectacles or correcting lenses
The line read is recorded as a fraction eg 6/12, 6/9, 6/6 this is known as Snellen acuity
The largest letter on the Snellen Chart is usually 6/60
The smallest letters are usually 6/5
The top number, usually 6, means the distance at which the test was carried out ie 6metres. The bottom number is the smallest size of letters that you were able to see.
NORMAL VISION is 6/6 and is usually the next to bottom line (or on some charts two lines up from the bottom) (in USA normal vision is called 20/20).
OCULOMOTOR BALANCE
This determines whether the eyes are co-ordinated and working together properly as a pair.
This may be assessed with you either looking into the distance and/or looking close-up
MOTILITY
This checks whether each eye is able to look in every different direction and if the eyes remain co-ordinated in all directions.
It is used to detect a defect in one or more of the eye muscles or the nerves which make them work.
PUPIL REFLEXES
This examines the reactions of the pupils to light
If the pupils do not react to light correctly it could indicate neurological problems
EXTERNAL EXAMINATION
The external eye can be examined with a light, or in more detail with the magnification of the SLIT LAMP.
The eyelids, conjunctiva, cornea, iris (coloured part) and lens are examined. A slit-lamp is also used for binocular indirect ophthalmoscopy (looking at the back of the eye in 3D) and`for some types of tonometry (measuring the pressure inside the eye to check for Glaucoma) and anterior eye photography.
INTERNAL EXAMINATION
The internal eye is usually examined with the OPHTHALMOSCOPE. Sometimes drops are used to enlarge the pupils and enable a better view.
This allows the Optometrist to look to the back of the eye inside.
By examining the various parts of the eye an overall picture can be obtained of the condition of the eyes and also your general health in some cases.
OCULAR PHOTOGRAPHY
This is a technique which we often use. A special camera takes photographs of the back of the eye. These can be used to keep a precise record of the health of the eye for future reference. This forms a standard part of our private eye examination and is available to our NHS patients at a small cost. Comparing photographs over time can indicate changes related to the health of the eyes
PRESCRIPTION ASSESSMENT (REFRACTION)
This determines whether you are long-sighted, short-sighted, astigmatic, presbyopic, or have no optical error at all (emmetropic)
If you have a refractive error then the lenses needed to correct this will be determined
OBJECTIVE TESTS
An objective test is one that helps the Optometrist to choose the first lenses to use as a starting point before asking you questions. This kind of test can also be used to determine a prescription in patients who are unable to read the chart eg very young children, or people with communication or learning difficulties
Either a RETINOSCOPE or an AUTOREFRACTOR could be used
SUBJECTIVE TESTS
These are used after the objective tests have provided a starting point. The Optometrist asks the patient with which lenses they can see better.
INTRAOCULAR PRESSURE (IOP)
This measures the pressure of the fluid within the eye using a TONOMETER
This can indicate the possible presence of GLAUCOMA
A NON-CONTACT tonometer is usually used which blows a puff of air at the eye. Several readings are normally taken to obtain an average.
Alternatively a PERKINS or GOLDMANN tonometer is used which actually touches the eye and so requires the use of an anaesthetic drop first. This is sometimes referred to as the 'blue light' test because the instrument shines a blue light. It is similar to the test used in hospitals.
VISUAL FIELD SCREENING
This can indicate neurological problems and also detect the presence of GLAUCOMA. The patient's 'all round' vision is assessed and the Optometrist is looking for any areas where the patient cannot see or where the eye is not as sensitive as it should be. These areas are called FIELD DEFECTS. There are different types of test including special tests used by the DVLA to decide if a persons vision is fit for driving.
COLOUR VISION
This can indicate problems with colour vision. Colour 'blindness' is normally a hereditary condition where certain shades of colours are more difficult, or impossible, to tell apart. It is almost invariably only found in males. Rarely colour vision problems can occur because of health problems or as side effects of medication.
STEREOPSIS
This test is used to determine and measure how well a person can see in 3-D.
It is used mainly in children and can show up if the child has a 'lazy eye'.
Both eyes must work well and be working together to have 3-D vision.
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