Routine Eye Exams in Central Texas

How do I know if I need an eye exam?

That is an answer that depends on many factors. The American Academy of Ophthalmology recommends that asymptomatic healthy patients should receive periodic eye examinations. Under the age of 40, it is recommended to have an exam every 5-10 years. From 40-54, every 2-4 years. From 55-64, every 1-3 years, and over the age of 65, every 1-2 years.

These recommendations change, based on symptoms, previous eye history, medical problems, and significant family history. For example, patients who wear glasses or contact lenses need yearly eye examinations to update their prescriptions. A patient with Diabetes should have a full, dilated eye examination at least once yearly to check for signs of diabetic retinopathy. This should start at the time of diagnosis. If there are risk factors for glaucoma, such as strong family history, it is recommended to have an exam every 1-2 years starting at the age of 40. If an ocular disease is found on your examination, follow-ups may need to be more frequent, and your doctor will advise you of the recommended time interval for re-examination.

What are we looking for?

During your exam, your doctor is examining your whole eye. Routine eye examinations check for glasses (refractive error), glaucoma, macular degeneration, cataract, and overall health of the eye. It is not uncommon for your ophthalmologist to find things on an eye examination that lead to the diagnosis of systemic diseases such as diabetes, high blood pressure, or even cancer. If your doctor has any concerns for your eye or overall health, he or she will discuss it with you at the time of the examination and create a medical plan for you. Your ophthalmologist works extremely closely with your other medical doctors to coordinate the best possible care for your body. It is important to realize that early stages of many eye disease produce no symptoms and that early diagnosis and intervention can lead to improved outcomes particularly when concerning cataracts, glaucoma, macular degeneration, and diabetic retinopathy.

How do I maintain healthy eyes?

We often get this question during routine eye examinations and health screenings. The most important thing you can do for your eyes is maintain good general health. Eye disease is more common among patients who smoke, have conditions like diabetes and high blood pressure, and who take certain medications such as steroids, medications for autoimmune conditions, and medications for certain infections. It is also extremely important to wear the proper eye protection. In general, polarized sunglasses are recommended while outdoors to protect the eyes from UV light. Damage from UV light can contribute to many different eye problems, including cataract, macular degeneration, pterygium, and ocular cancers. Eye protection is also required during high impact sports, such as racquetball, as well certain hobbies or professions, such as welding, grinding, and construction work.

Diabetic Retinopathy

Diabetes can affect the eyes in many ways. Patients with elevated blood sugars can have swelling of the lens inside the eye, causing fluctuating or blurred vision and changes in refraction. Patients with diabetes also have a higher incidence of both cataract and glaucoma. Prolonged elevation in blood sugar can cause damage to the small blood vessels of the eye, causing a condition called diabetic retinopathy. Early on, the blood vessels can become weak, causing bleeding and/or swelling that leads to non-proliferative diabetic retinopathy. In more advanced cases, new blood vessels can form, a condition called proliferative diabetic retinopathy. Active bleeding and/or swelling requires more treatment for your eye with lasers, injections, or surgery. Many early signs of diabetic retinopathy are asymptomatic, and, therefore, it is important to get yearly eye exams (at minimum) for screening.

Macular Degeneration

Age Related Macular Degeneration affects a particular part of the retina called the macula. The macula is responsible for the central part of your vision. There are two types of macular degeneration, dry and wet. The dry kind of macular degeneration is a common finding amongst older adults. Early changes include thinning of the macula and deposits, called drusen. Early stages of dry macular degeneration are often asymptomatic, while more severe changes can cause central vision loss. There is no definitive treatment for dry macular degeneration, but, depending on the stage of the disease, AREDS 2 vitamins may be recommended to slow the progression. Wet macular degeneration tends to have a more profound effect on a patient’s vision. New blood vessels form, which can bleed or leak eventually causing scar formation and central vision loss. This can often be treated with intraocular injections. As with many eye diseases, outcomes are improved with early detection. It is important to get regular eye examinations to check for macular degeneration. Patients who smoke or who have a strong family history are at higher risk. If you have been diagnosed, it is also important to monitor your vision regularly with amsler grid testing. Your doctor will also discuss supplementation with AREDS 2 vitamins.

Refraction

A refraction is the part of the exam that measures the optical focal point of your eye and provides the information needed to prescribe eyeglasses or contact lenses. You will have a phoropter device placed in front of your eyes (one at a time) and be asked to tell us which lens makes the vision more clear. Your ophthalmologist may also do a test called retinoscopy that is an objective way of determining your best possible vision. After testing a combination of lenses, we are able to write a prescription for glasses or contact lenses. The refraction also helps us to determine if you are a candidate for laser vision correction, or other types of refractive eye surgery.

Contact Lenses

Contact lenses require a specific exam to ensure good fit of the lens as well as good vision. Additionally, the health of your cornea must be assessed to see if you are a candidate for contact lenses. The refraction is used as a starting point to fit contact lenses. There are different types of contact lenses available, including 1 day, 2 week, and 4 week disposables as well as hard lenses. We will discuss which lens may be the best option for you. We will also spend time to educate you about proper lens use and replacement as well as good hygiene. It is important to remember never to sleep, shower, or swim in your contact lenses.

Dilation

Dilation is often part of the comprehensive eye examination. Patients are given eye drops that cause the pupil to enlarge. When the pupil is larger, the doctor is able to see to the back of the eye. This allows detailed examination of the lens, optic nerve, and retina. This is often necessary to ensure the good health of the eye. After dilation, patients may notice blurred vision, more noticeable for close ranges. The eyes will also be sensitive to bright lights. Therefore, it is important to wear sunglasses. The effects may last up to 4-6 hours.

Myopia

Myopia is also known as nearsightedness. This is a type of refractive error where objects up close appear clear but objects in the distance are blurry. This can be corrected with glasses, contacts, or refractive eye surgery.

Hyperopia

Hyperopia is also known as farsightedness. This is a type of refractive error. Hyperopia is a bit of a misnomer because for a symptomatic patient, the vision is often not clear at any range. It may not be symptomatic until later in life. This can be corrected with glasses, contacts, or refractive eye surgery.

Presbyopia

Presbyopia is a type of refractive error that causes objects up close to be blurred. This is caused by age-related changes of the eye and usually becomes symptomatic after the age of 40. At first, one may find that holding the object farther away brings the object into focus. Using reading glasses can bring the object into focus without having to hold it farther away. Presbyopia can be corrected with glasses, contacts, or refractive eye surgery.

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