The next stage is to examine the health of your eye, firstly the external eye will be assessed; the whites of your eyes (sclera), as well as the eyelids, pupils and eyelashes. Your binocular function and ocular balance will be checked, this involves a variety of tests conducted to investigate how well the eyes work together. Balanced, co-ordinated eyes are crucial for comfortable and sharp binocular vision. During this group of tests your optician will be looking for abnormalities such as strabismus (commonly known as a squint or turn in the eye), accommodation and convergence issues (focussing problems), eye muscle problems which may cause diplopia (double vision), all which may affect quality of vision.
From here we move on to the internal structures of the eye;
Special eye drops will dilate, or open, your pupil, which allows your optician to observe the inner parts of your eye, such as the retina and optic nerve. This can help to detect subtle changes of the optic nerve in persons without any visual symptoms and potentially lead to early detection of disease. Internal ocular health can be checked using a hand held microscope known as a direct ophthalmoscopy. This allows very detailed, binocular and magnified views of the back of the eye. The optician will inspect the optic nerve, macula, blood vessels and so on, looking for problems such as glaucoma and macular degeneration. We also use a Digital Retinal Camera to take a photograph of the back of your eye. Retinal photography is used to document retinal health at a particular point in time in a quick, objective and highly detailed manner. This enables accurate comparisons of eye health over time and meticulous monitoring of various eye conditions such as glaucoma, age-related macular degeneration and diabetic retinopathy. This is particularly beneficial when communication may be limited due to ongoing health issues.
Furthermore, we will check the pressure of the fluid within eyes. We use an instrument called a tonometer to do this. Tonometry is the measurement of tension or pressure within the eye. It is advisable for adults, particularly those over 40 to have their intraocular pressure (IOP) measured routinely as elevated IOP’s can lead to optic nerve damage. The optic nerve is a crucial part of the visual system; it collects all the visual information gathered by the photoreceptors of the retina and transmits this information to the brain, where the signals are interpreted as vision. Optic nerve damage can lead to decreased peripheral vision (tunnel vision) and loss of nerve tissues. Elevated IOP’s can commonly occur without symptoms, meaning like many other eye conditions the individual may be unaware there is a problem. Elevated IOP’s is associated with Glaucoma; as a result tonometry is important in diagnosing and monitoring Glaucoma.