Do you hold reading material further away, struggle to see clearly in the distance or notice that colours seem less vivid? An eye examination can help identify what is causing these changes. As well as checking your prescription, it can detect early cataracts, raised pressure inside the eye or retinal disease. We have put together an overview of what to expect at your appointment and which symptoms deserve an eye doctor’s attention.

Checking your prescription and choosing suitable glasses are only part of looking after your eyesight. An ophthalmologist also examines the structures of the eye, the retina and the optic nerve. In people with high blood pressure or diabetes, they monitor changes in the retina and blood vessels that could lead to further complications if detected late.

What to Expect at an Eye Examination

A basic vision check forms part of a preventive check-up with your GP. They primarily assess your distance vision and carry out a basic check of your peripheral vision—what you can see at the edges of your field of view. If they identify a problem, they will refer you to an ophthalmologist for a more detailed examination.

A standard examination by an ophthalmologist includes:

  • Measuring the pressure inside your eyes. One method uses a device that directs a brief puff of air onto the eye.
  • An initial prescription measurement. You look into a device and focus on an image.
  • A slit-lamp examination. The doctor examines the front structures of the eye, including the cornea, iris and lens.
  • An examination of the back of the eye. The doctor checks the retina and the point where the optic nerve leaves the eye.

To assess how clearly you can see, the doctor may also ask you to read letters or numbers of different sizes on a chart. To check near vision, you read short passages at a normal reading distance. The doctor or optometrist then uses trial lenses of different strengths to determine the appropriate prescription.

Cloudy Vision May Be a Sign of Cataracts

Cataracts are a common eye condition primarily associated with ageing. The lens gradually becomes cloudy, making it feel as though you are looking through foggy or dirty glass.

Colours may appear less vivid, and distance vision may deteriorate. During cataract surgery, the doctor replaces the cloudy lens with an artificial intraocular lens. The procedure takes place under local anaesthetic.

When Straight Lines Start to Look Wavy

The risk of macular degeneration also increases with age. This retinal condition affects the area responsible for the sharpest vision. Your vision may become blurred or distorted, straight lines may appear crooked, and blurred or wavy letters can make reading difficult.

Some risk factors, such as age and genetic predisposition, are beyond our control. Other factors listed in the source material include:

  • smoking,
  • high blood pressure,
  • diabetes,
  • atherosclerosis,
  • a poor diet and lack of physical activity,
  • UV radiation.

If you receive treatment for high blood pressure or diabetes, the source material recommends an annual examination by an ophthalmologist. Regular examinations help detect changes in the retina early.

A Simple Check You Can Try at Home

An Amsler grid provides a basic way to check for changes in your vision. It consists of a grid with a central dot that you focus on during the test.

Test each eye separately. While looking at the central dot, check whether all the lines appear straight and evenly spaced. If you notice any distortion, arrange an appointment with an ophthalmologist as soon as possible. This type of change may indicate retinal disease.

Symptoms That Should Not Wait

Do not wait for your regular preventive appointment if you develop new or sudden symptoms. See an ophthalmologist, particularly if:

  • you see a grey curtain, mist, “falling soot”, flashes, sparkles or rainbow-coloured rings around lights,
  • parts of your visual field disappear or you suddenly lose vision in one eye,
  • you experience double vision or distorted images,
  • your eye hurts, especially if you also feel nauseous,
  • a pupil dilates unexpectedly, for example in just one eye,
  • you sustain an eye injury, including a blunt impact,
  • you develop shingles near your eye.

Seek immediate medical attention for sudden vision loss or an eye injury. You should also visit an ophthalmologist before getting your first prescription for glasses or contact lenses.

How Often Should You Have a Preventive Eye Examination?

A preventive eye examination is advisable every one to two years. The appropriate interval depends on your age, other medical conditions and family history of eye disease.

A prescription check at an optical practice does not replace an examination by an ophthalmologist. While a vision assessment determines the appropriate prescription, an ophthalmologist also checks for diseases affecting the retina, nerves and blood vessels. According to the source material, you do not need a GP referral for a routine preventive appointment with an ophthalmologist in the Czech Republic.

Source: Dr Věra Němečková, Preventive Eye Examination.