WHAT TO EXPECT AT THE EYE DOCTOR

A mix of new technology and old standbys is helping prevent and diagnose vision problems.

T here’s good news if you’re heading to the eye doctor, says Rishi P. Singh, M.D., an ophthalmologist at Cleveland Clinic’s Cole Eye Institute. “Technology has really improved the eye exam experience.” There are still low-tech aspects to even the best exams, but for the most part the eye check has become more efficient and effective. Here’s what you need to know.

1. Be prepared for questions.

Exams typically start with a brief medical and family history. “Just tell us as much as you know,” says Glenda B. Secor, O.D., an optometrist in Huntington Beach, Calif. “I have patients who say something like ‘Well, my aunt used eye drops all the time.’ They can’t remember what their aunt had. That’s OK. Even that info gives us clues.” You should disclose preexisting health conditions, such as diabetes or high blood pressure, and any medications you take.

2. The eye chart is still a thing.

The Snellen chart, named after the scientist who developed it, is still alive—with a twist. Most eye docs use a high-tech computer version. You’ll read the chart on a wall-mounted flat screen while the doctor changes the picture with a remote. Same concept of “What is the smallest line you can read?”— but much slicker.

3. A newer way to check your prescription.

The oldschool retinoscope, the instrument the doctor used to shine a light in your eyes, measured how light changes as it enters your eye. That’s called the refractive error, and it helps determine prescriptions for glasses or contact lenses, says Julie Tyler, O.D., associate professor at Nova Southeastern University College of Optometry in Fort Lauderdale, Fla. Now a machine called the autorefractor does the same thing and is more objective than a human. “That means getting your correct prescription may happen more quickly,” says Tyler.

There’s still the fine-tuning process where your doctor will use a series of slightly different lenses in front of your eyes to check which help you see better, she says. 4. Don’t fear the air puff. Increased eye pressure is a red flag for glaucoma, a group of diseases that damage the eye’s optic nerve and lead to vision loss. During most eye exams, docs use a tonometer—that’s when you feel the quick puff of air—to measure the pressure inside your eye. It’s painless, but if things don’t check out, you’ll be referred for more testing.

5. Your doc can get a closer look with digital images.

With technology called optical coherence tomography (OCT), doctors can take digital images of each of the retina’s layers, mapping and measuring thickness. (The retina, at the back of the eyeball, contains cells that are sensitive to light and that trigger nerve impulses that pass through the optic nerve to the brain, allowing for vision.)

“Now images are so good they’re almost like looking at a biopsy of the tissue,” says Cleveland Clinic’s Singh. The measurements help determine if you have a healthy retina or serve as a tip-off for conditions such as diabetic eye disease or age-related macular degeneration (AMD), which is a leading cause of blindness. 6. Dilation is a maybe. While OCT has improved imaging, your doctor may still need to dilate your eye using special eye drops to enlarge pupils. Don’t skip this step if it’s recommended. Yes, it’s a hassle because it takes extra time and can blur vision for an hour or more after the appointment, but it’s the only way to get a true picture of the back of the eye. It allows doctors to look for indications of trouble, like a form of cellular debris called drusen that’s a sign of dry macular degeneration, the most common form of AMD.

It also can help identify the blood vessel changes indicative of wet macular degeneration, the most debilitating type of the disease. Doctors can often detect these changes—as well as signs of health problems like diabetes, high cholesterol, hypertension or thyroid disease—long before you notice symptoms.

7. Your exam may be free.

While eye exams are reasonably priced, especially if you have vision coverage, regular health insurance does cover some checkups. “This is especially true if you have a health condition like diabetes,” says Singh.