Eye Tests

The expression “eye test” conjures up the idea of what the nurse did at school. The pupils were called out of class and had to line up in a queue to see the local nurse, who had pinned up an eye test chart on a door at the end of the corridor. Each pupil would have to stand at the other end of the corridor and with one eye covered (put your hand over your left eye boy!) and read the letters out aloud. The process was then repeated with the other eye. Of course no cheating was allowed. You weren’t allowed to peep through your fingers with your covered eye, or memorise the letters or ask your friends what was on the bottom line.

Jokes would of course be made “The bottom line says “Made in China”, Miss”. Or “ I can not only read the fifth line but I can tell you where he lives, he’s a Polish friend of my dad’s”.

As an optometrist (new word for optician), I’m a bit of a snob and don’t like to think of my work as doing “eye tests” rather performing an “eye examination”. It involves so much more than asking “Johnny” to read the letters on the chart.

We’ll want to know a lot about you (we’re a bit nosey!). For instance what do you do for a job, what are your hobbies. It’s all important if we are going to suggest what sort of spectacle lenses (or contact lenses) might be most useful to you. We are going to want to know about your health and medication as so many illness can show up in your eyes and lots of tablets prescribed by the doctor can have affect the way your eyes work.

Further questions will be about what has happened to your eyes in the past, maybe you had a squint operation 20 years ago, perhaps a bang to your head at the rugby game last week. It’s all relevant.

Eventually we might get around to letting you read a few letters. Then the interesting bit where we can play around with lots of lenses to see if you can get down to the bottom of the chart, where it says “Made in China”.

Well we’re not finished yet! There are muscle balance tests to seeing if your eyes are working well as a team. May be a visual field test to see if there are any “holes” in your vision and then there is always my favourite where I get to “shoot” the patient with a tonometer (it’s only air and it really doesn’t hurt!) and find out how the eye pressure is.

Still not finished! One of the most important parts of the eye examination is to make sure the eye is healthy. Years ago we would do this with an ophthalmoscope. This is where the optician moves in very close (I was never allowed a curry the night before a work day!) with a very bright light and looks inside the eye. Nowadays, there are several way of doing this. I often use my “slit lamp” which is a type of microscope. I can use it to look at details at the front of the eye or using a special lens (Volk lens) I can look at the back of the eye and I can see it all in 3D ( even after Chicken Madras the night before!).

Better still I can take a photograph of the back of the eye so that you can see your own retina on the computer screen. I’ve picked up lots of things that I might have missed before and it is great for diabetics who are prone to problems on the retina. The latest thing is an OCT. This machine enables us to get a 3D image of the retina. You can even get to see individual rods and cones…amazing!

See, I told you it was a bit more than  “test”.