Eye Examination at the Ophthalmologist
Regular eye examinations are crucial for detecting and treating eye diseases at an early stage. Many vision problems develop gradually and often remain unnoticed for a long time, as our brain skillfully compensates for visual limitations.
Why Are Regular Eye Examinations Important?
Regular eye examinations are crucial for the early detection and treatment of eye diseases. Many vision problems develop gradually and often go unnoticed for a long time, as our brain adeptly compensates for visual impairments.
The Brain’s Role
Our brain is highly skilled at filling in missing or faulty visual information with familiar, expected, or known details, or by relying on input from the healthy eye. A striking example is the “blind spot”—a region in our visual field about 15° to the side of each eye where the optic nerve exits the retina, rendering that spot completely blind. Yet, we cannot perceive this blind spot without specific tests, even if we know its location. Similarly, individuals with glaucoma (green star) cannot detect early visual field defects on their own.
Unilateral Vision Impairment
People with significant vision loss or blindness in one eye often manage daily activities without major limitations because the visual system prioritizes input from the better-seeing eye. Conversely, this means that recognizing unilateral vision impairment early can be surprisingly difficult. We often encounter patients who, following a minor injury or conjunctivitis, notice for the first time that one eye sees worse than the other.
Gradual Vision Deterioration
Gradual vision loss can also be hard to notice. Many individuals with cataracts (gray star) experience a slow decline in vision over many years. Initially, there may be a decrease in contrast sensitivity or a need for more light when reading, which often goes unnoticed. Only when tasks like reading road signs or newspapers become challenging do they realize that something that was once easy is now difficult.
Elevated Intraocular Pressure as a Silent Risk
Another example is elevated intraocular pressure, which, like high blood pressure, often presents no symptoms. Only by measuring eye pressure and assessing the optic nerve can we evaluate the individual risk of developing glaucoma.
What Happens During an Eye Examination?
The scope and frequency of eye examinations depend on your individual risk factors. We are happy to discuss with you which types of examinations and intervals are appropriate for your situation. Important factors include:
- If you have been diagnosed with an eye disease (e.g., glaucoma)
- If you have an increased risk of developing an eye disease
- If there is a family history of eye diseases
- If you have undergone eye surgery
- Age: Some conditions can only be treated during childhood, making a one-time eye check-up around age 3 advisable. Other diseases become more common with age, so we often recommend more frequent check-ups for seniors. In young and middle-aged adults, regular eye examinations are usually not necessary.
During a brief consultation, the ophthalmologist will ask whether you have any visual symptoms or issues related to your eyes. We also discuss whether there is a family history of eye diseases, which could increase your personal risk.
A routine eye examination includes measuring your uncorrected visual acuity (without glasses or contact lenses) as well as determining the appropriate prescription for vision correction. Eye pressure is measured, and a microscopic evaluation using a slit lamp allows the ophthalmologist to assess the overall health of both eyes.
If you have specific symptoms (such as double vision) or noticeable findings (such as optic nerve irregularities or elevated eye pressure), your ophthalmologist may recommend additional diagnostic tests.
In cases of abnormal findings or symptoms suggestive of retinal disease, we may recommend a more detailed examination of the back of the eye using pupil-dilating drops. After this type of examination, your vision will be blurred for several hours and you should not drive.
Examination in Children
A preventive eye examination in childhood should always include an orthoptic assessment by a qualified specialist (orthoptist or pediatric ophthalmologist) and an evaluation of the eye’s refractive error after administering special eye drops.
Due to the time required for the drops to take effect, such an examination takes about 1.5 hours. During this preventive eye check-up for children, the team focuses on assessing visual development and identifying factors that could impair normal vision development. Congenital rare eye diseases should also be ruled out.
If your child shows no abnormalities and there is no family history of eye diseases, the ideal age for a preventive examination is before their third birthday.
Examination in Adults
In middle-aged adults, the focus is on detecting existing eye diseases that may not yet cause symptoms. This includes identifying risks for developing glaucoma (green star), which often becomes noticeable only when it is advanced and has already caused irreversible damage. Early detection can mitigate or prevent such damage.
In older patients, conditions like cataracts (gray star) or age-related macular degeneration (AMD) are more common. Cataracts can be corrected through a short surgical procedure, restoring clear vision. Since lens clouding progresses slowly, the gradual decline in visual quality (contrast, glare, sharpness) may not be immediately apparent. An eye examination can help recognize and quantify these limitations, allowing ample time to plan surgery.
AMD is a chronic degenerative disease of the retina. Microscopic examination and optical coherence tomography (OCT) can detect these changes before patients notice symptoms. If wet AMD is present, it must be treated with a special medication (anti-VEGF) injected directly into the eye. This treatment is highly effective in slowing the rapid progression of the disease. Early detection and consistent treatment are crucial.
For most seniors, check-ups every 1 – 3 years are advisable. If specific risks or diseases are present, more frequent examinations may be necessary.
Measuring intraocular pressure helps in the early detection of a significant risk factor for glaucoma. It’s important to understand that many people with glaucoma never had elevated eye pressure. Therefore, measuring intraocular pressure should always be combined with an assessment of the overall health of the optic nerves.
In children, glaucoma can be noticeable at birth or later. Signs of elevated intraocular pressure in infants include differences in eye size or unusually large eyes. This enlargement occurs because the eye tissue is still very delicate, and increased internal pressure causes the eye to grow. Cloudiness of the eyes or excessive tearing are also common signs of childhood glaucoma.
In most people, increased eye pressure develops later in life and often goes unnoticed for a long time.
Annual or more frequent eye examinations may be necessary if you have an eye disease or specific risk factors.