Standard ophthalmic exam

  • Definition
    • A standard ophthalmic exam is a series of tests done to check your vision and the health of your eyes.

  • Alternative Names
    • Routine eye examination; Eye exam - standard; Annual eye exam

  • How the Test is Performed
    • First, you will be asked if you are having any eye or vision problems. You will be asked to describe these problems, how long you have had them, and any factors that have made them better or worse.

      Your history of glasses or contact lenses will also be reviewed. The eye doctor will then ask about your overall health, including any medicines you take and your family's medical history.

      Next, the doctor will check your vision (visual acuity) using a Snellen chart.

      • You will be asked to read random letters that become smaller line by line as your eyes move down the chart. Some Snellen charts are actually video monitors showing letters or images.
      • To see if you need glasses, the doctor will place several lenses in front of your eye, one at a time, and ask you when the letters on the Snellen chart become easier to see. This is called a refraction test.

      Other parts of the exam include tests to:

      • See if you have proper three-dimensional (3D) vision (stereopsis).
      • Check your side (peripheral) vision.
      • Check the eye muscles by asking you to look in different directions at a penlight or other small object.
      • Examine the pupils with a penlight to see if they respond (constrict) properly to light.
      • Often, you'll be given eyedrops to open up (dilate) your pupils. This allows the doctor to use a device called an ophthalmoscope to view the structures at the back of the eye. This area is called the fundus. It includes the retina and nearby blood vessels and optic nerve.

      Another magnifying device, called a slit lamp, is used to:

      • See the front parts of the eye (eyelids, cornea, conjunctiva, sclera, and iris)
      • Check for glaucoma using a method called tonometry

      Color blindness is tested using cards with colored dots that form numbers.

  • How to Prepare for the Test
    • Make an appointment with an eye doctor (some take walk-in patients). Avoid eye strain on the day of the test. You may need someone to drive you home if the doctor uses eyedrops to dilate your pupils.

  • How the Test will Feel
    • The tests cause no pain or discomfort.

  • Why the Test is Performed
    • All children should have vision screening in a pediatrician's or family practitioner's office around the time when they learn the alphabet, and then every 1 to 2 years afterward. Screening should begin sooner if any eye problems are suspected.

      Between ages 20 and 39:

      • A complete eye exam should be done every 5 to 10 years
      • Adults who wear contact lenses need yearly eye exams
      • Certain eye symptoms or disorders may require more frequent exams

      Adults over age 40 who have no risk factors or ongoing eye conditions should be screened:

      • Every 2 to 4 years for adults ages 40 - 54
      • Every 1 to 3 years for adults ages 55 - 64
      • Every 1 to 2 years for adults age 65 and older

      Depending on your risk factors for eye diseases and your current symptoms or illnesses, your eye doctor may recommend that you have exams more often.

      Eye and medical problems that can be found by a routine eye test include:

  • Normal Results
      • 20/20 (normal) vision
      • Ability to identify different colors
      • Full visual field
      • Proper eye muscle coordination
      • Normal eye pressure
      • Normal eye structures (cornea, iris, lens)
  • What Abnormal Results Mean
  • Risks
    • If you received drops to dilate your eyes for the ophthalmoscopy, your vision will be blurred and sunlight can damage your eye. Wear dark glasses or shade your eyes to avoid discomfort until the dilation wears off, usually in several hours.

  • Considerations
    • Many eye diseases, especially glaucoma and retinal detachment, are curable or can be treated if detected early.

  • References
    • American Academy of Ophthalmology Preferred Practice Patterns Committee. Preferred Practice Pattern Guidelines. Comprehensive Adult Medical Eye Evaluation -- 2010. Accessed February 26, 2015.

      Colenbrander A. Measuring vision and vision loss. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 5, chap 51.

      Olitsky SE, Hug D, Plummer LS, Stass-Isern M. Examination of the eye. In: Kliegman RM, Stanton BF, St. Geme JW III, Schor NF, Behrman RE, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 611.