All About Eyes

 

 

Eye Health Assessments

We routinely screen for conditions which can affect the eye such as glaucoma, cataract, retinal disease, diabetes, or squint. Treatments are available for many of these conditions especially if they are detected in the early stage and appropriately referred. The practice has a number of specialised instruments which help assess and monitor eye disease. These include :

  • Nidek Autorefractometer
  • Digital Retinal Camera
  • Henson Tinsley Visual field Analyser
  • Humphrey FDT Visual Field Instrument
  • Visioffice for taking accurate measurements during Dispensing
  • Colorimeter

Eye Examinations

Our Optometrists primary focus is a full assessment of your vision and eye health which takes between 30 and 45 minutes. They will use a series of tests to measure the strength of prescription lenses, if these are necessary for clear comfortable vision. They will assess the health of both the outside tissues of your eyes and eyelids and also examine the tissues inside your eyes

This will be followed by a detailed discussion of any abnormalities found and options for treatment or correction that are available to you. Some of these are:

  • Spectacles
  • Contact Lenses
  • Laser Surgery
  • Low Visual Aids
  • Visual Therapy
  • Tinted & Coloured Lenses
  • Various Spectacle Lens Designs
  • Sports Vision Enhancement
  • Referral to Other health Professional

Services that we provide are:

  • Child examination
  • Adult examination
  • Colorimeter exam
  • FDT Screening
  • Visual Field Examinations
  • Home Visits (not recommended but are possible for people unable to come into the practise)
  • Retinal Photography
  • Drivers licence forms (if needed can be included in the Eye Examination at no extra cost)
  • Pre and post laser surgery examinations
  • Irrigate tear ducts
  • Eyelash removals
  • Contact lens assessment (more details under contact lenses)
  • Gold card or community services card 10% off eye exam

Details required for eye examinations:

Any family history of eye disease or vision problems, your current spectacles or contact lenses, current medication, general health problems and previous treatment for your eyes should be mentioned.

Acuity testing

Acuity testing is simply testing vision sharpness. Distance and near vision are checked. You will be asked to read an eye chart with each eye. The smaller the letters that can be distinguished, the better your visual acuity. Your Optometrist will carefully test eye muscle balance to see how easily the eyes move and focus individually and together.

Refraction is the process in which the optometrist conducts a series of tests to determine the optical prescription required to correct vision at a particular distance.

Microscope examination

A non-invasive examination of the eye both inside and out is crucial in finding signs of disorder or illness.The cornea is regarded as the clear "window" of the eye. A ‘slit lamp’ microscope is used to examine the cornea. This microscopic examination of the cornea segment allows your Optometrist to check the general health of the cornea for irregularities. The test is external and completely painless.

Eye pressure test

A comprehensive eye health examination will include tonometry test for those over 40, a measure of the pressure of the fluid in the eye. If the pressure in the eye is too high there may be damage to the nerve at the back of the eye, one of the causes of glaucoma.

Keratometry examination

Keratoconus is a vision disorder that occurs when the normally round cornea becomes irregularly cone shaped. Using a keratometer your Visique optometrist checks the front curvature of the cornea's surface. This examination is particularly important for anyone interested in contact lenses. Like all other examination procedures the test is painless and without discomfort.Ophthalmoscopy examination

Using an ophthalmoscope, a non-invasive, hand held instrument, your optometrist can conduct an examination of the inside of the eye. The ophthalmoscope has a bright light, which illuminates and magnifies the interior of the eye. Cataracts, retinal problems, damaged blood vessels can be found in this examination. Damaged blood vessels may indicate diabetes or high blood pressure.Pupil dilation

Pupil dilation means temporarily enlarging the pupil. This is done with eye drops. Dilation allows a more complete internal view of the eye and is sometimes used when a more comprehensive examination is required. The pupil of the eye returns to normal when the drops wear off. Because of the time required for the drops to wear off varies from person to person, we recommend you have someone drive you home. Wearing sunglasses after pupil dilation relieves glare.

The retinal camera is a recording tool that takes a photo which enhances the early detection of any abnormality or eye disease. This technology allows detailed colour digital images of the pigment layer, major blood vessels, optic nerve head and other structures at the back of the eye to be recorded for immediate assessment and future reference. The digital images can be viewed immediately on a computer screen, if you are interested your optometrist will be happy to show these to you and explain the various structures. The photograph assists in the early diagnosis of disease, in monitoring the outcomes of treatment and in patient education with respect to sight threatening changes caused by general health problems. A photograph can assist in the detection and management of:

  • Glaucoma
  • Macular Degeneration
  • Hypertension
  • Diabetic Retinopathy
  • Retinal Detachments
  • The retinal health can also tell us a lot about your general health. For those people who have diabetes or blood pressure that is undetected, the change to the blood vessels that these conditions can cause can be seen on the retina.

Field of vision testing

Visual field testing involves checking the peripheral or 'side' vision. We recommend 'screening' of everyone's visual field function using the FDT screener.

Visual field screening can help with detection of certain diseases such as:-

  • Glaucoma
  • Neurological conditions such as brain tumours
  • Retinal problems
  • Stroke

On occasion further more extensive testing may be needed either using the FDT machine or another field analyser. The optometrist will explain the reason for further testing requirements. These may include:-

  • Family history of Glaucoma (grandparents, parents, blood relatives or siblings)
  • Suspected Glaucoma in someone who currently does not have Glaucoma
  • Unexplained headaches
  • Renewal or application of a Driving License
  • To provide a base line for future reference
  • Unexplained visual symptoms
  • Poor refraction end point
  • Reduced Vision
  • Recent stroke
  • Age related macula disease

Frequency of eye examinations:

Regular eye examinations are important. After your examination your optometrist will recommend a recall appropriate to your eyes and vision. This is likely to be at least every two years, although we like to see our contact lens wearers at least once a year. Our computer system allows us to send you a reminder when your next visit is due - let us share the responsibility for your eyes and vision!

 

Symptoms of vision problems

 

Some of the symptoms that may indicate that an individual is experiencing vision problems include:

  • Rubbing eyes repeatedly
  • Dislike and avoidance of close work
  • Holding head at an angle when looking at an object
  • Shutting or covering one eye to focus
  • Excessive blinking
  • Holding books closely
  • Using a finger as a place mark when reading
  • Sitting too close to the television
  • Developing red eyes

Reading & Learning Difficulties

VISION ASSESSEMENT OF THOSE WITH LEARNING DIFFICULTIES Research shows that 46% of those identified with reading problems, dyslexia, attention deficit disorder or learning difficulties can be helped by certain vision treatment.

A number of children and adults with learning difficulties have a visual problem which contributes to their learning difficulty. Very often these problems can be corrected with appropriate spectacles and visual training.

We use the Behavioral Optometric approach to examining and prescribing. We also screen for Meares-Irlen Syndrome and prescribe Coloured Lenses for this condition. We are the first New Zealand Optometrists to use Colour Lens Technology and Diagnostic Instrumentation.

Clinical research trials by the British Medical Research Council have shown that people who experience visual distortion when looking at a page of print have much clearer vision when wearing a coloured lens that has been prescribed following assessment on the Intuitive Colorimeter.

Children’s examination:

It is important to recognise that most children with visual defects are unlikely to complain about their vision, thinking everyone else sees the same. Because of rapid growth and subsequent vision changes, school age children should have their eyes examined annually to ensure potentially serious disorders are detected.

Does your child suffer from any of the following symptoms?

  • Blurring of words when reading
  • Holds reading material closer than normal
  • Difficulty with copying from the blackboard
  • Poor or variable handwriting, often slow
  • Loss of concentration, poor attention span
  • Reading accuracy and speed below age
  • Loses place or line when reading
  • Uses finger to maintain place when reading
  • Misses out words or letters when reading
  • Reverses letters and numbers
  • Makes phonetic spelling errors
  • Can learn spelling for tests but cannot remember later
  • Homework takes longer than it should
  • Poor visual memory
  • Poor at balls skills and team games
  • Tends to rub their eyes a lot
  • Has headaches
  • Turns or tilts head to use one eye only

It is very important to test children’s vision from an early age. Children learn mostly with their eyes, and clear and comfortable vision is necessary for a child to learn successfully. Reading, writing, whiteboard / blackboard work, computers are all hard work if you can not see clearly. Short-sightedness is common in children, especially when there is a family history of short-sightedness. If your child has poor vision this may cause them to fall behind in class at school and perform poorly.Another reason to test a child’s eye is that one eye may be seeing better than the other. If this is happening and it is left untreated then it can lead to a lazy eye, known as Amblyopia. When this occurs the brain does not acknowledge the image seen by the Amblyopic eye and the child suppresses the image. If the suppression of the image from the blurry eye has already begun, then your child will not even notice that their vision is blurry.

If you have any doubt at all about your child's vision have their eyes examined even if they have not started school. This is particularly important if there are vision problems in the family, if one eye seems to turn in or out, or if your child seems to be having trouble learning to read.

Clear eyesight is not all that is needed for efficient vision. Children must develop scanning, focusing and eye movement skills in order to be able to read comfortably. Eyes must focus quickly from distant to near objects and back again, and accurately follow moving targets. Eyes must scan instantly from one word to the next when reading, while keeping in perfect alignment. Without two well balanced eyes and good vision, judgment of distance is impaired.

If a child is to end up with good vision some vision defects must be corrected as early as possible while the visual system is still developing. In some cases the child may not have to wear spectacles all the time and may not necessarily need them as an adult.

Your child will be more comfortable reading if you:
-Make sure lighting on homework and books is good

-Encourage regular breaks from concentrated reading. Occasional relaxation will reduce fatigue

-Watching TV or using a computer will not cause vision problems but for best comfort make sure your children are not sitting or lying too close to the TV or computer.

-Discourage them from holding reading or writing too close - 30cms is close enough

-Discourage your child from slouching over the table or desk, or reading while lying on the floor. This brings the work too close to the eyes for comfort

If you have a Community Services card, your child may be eligible for government subsidy towards examination, frames and lenses once a year.

 

Laser surgery/LASIK:

Laser refractive surgery is the reshaping of the front surface of the eye (the cornea) using a computer controlled laser to permanently change the focusing power of the eye. The procedure involves removing a small amount of tissue from the cornea (up to 20%) and reshaping it to correct distance vision.

Laser in-situ keratomilensis or LASIK has become the most popular form of refractive surgery internationally and is available in New Zealand. LASIK is used to treat myopia, hyperopia and astigmatism. A thin flap is made on the surface of the cornea using a microkeratome or IntraLase laser. The excimer laser is then used to reshape the cornea under the flap which is then put back into place. There is minimal discomfort and rapid visual recovery.

Laser refractive surgery is suitable for most healthy adults who wear glasses or contact lenses for normal distance vision. For high corrections the corneal thickness may limit the improvement possible, i.e. because there is a limit to how much corneal tissue can safely be removed if you have a high correction and a thin cornea a full correction may not be possible. Any potential problems of this sort will be discussed by the surgeon or his clinic staff during the pre-operative screening processes.

Laser surgery may not be suitable if you:

  • Are under age 21
  • Have needed a change in your spectacle or contact lens correction in the last 12 months
  • Have corneal disease such as keratoconus or herpetic keratitis
  • Have an eye condition such as glaucoma, cataracts or macular degeneration
  • Are pregnant or breast feeding

Laser surgery will not prevent any normal age related progression in your distance prescription. If your vision does change you may need spectacles or contact lenses at some stage in the future. Laser refractive surgery does not correct near vision

 
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