America’s Best’s Guide to Eye Exams

From booking your appointment to finding the right prescription, here’s what to expect at your upcoming eye doctor appointment.

Chances are you wouldn’t go more than a few years without seeing your primary care doctor. That same rule should apply to your eye doctor.

The reason: Vision is essential for your quality of life, says Johnny Morette, O.D. He’s an optometrist with Crystal Clear Eye Associates in Winter Garden, Florida, located inside America’s Best Contacts & Eyeglasses. In fact, going blind was consistently rated the worst disease or ailment that could happen to someone, according to a study published in October 2016 in the journal JAMA Ophthalmology.

That’s where regular eye exams come in, Dr. Morette says. “You don’t want to go blind today because of something that could have been prevented,” he says. Here’s when you should schedule an eye exam, and what you can expect during the appointment.

What’s an Eye Exam?

An eye exam is an evaluation of your vision. It’s conducted by an eye doctor, either an optometrist or ophthalmologist. “Your optometrist is the PCP for your eyes,” says Dr. Morette, referring to a primary care physician. During the exam, your doctor will check the status of your vision, up close and far.

“We want to make sure you’re seeing well,” he says.

More important is checking for eye disease. Your eye doctor will use special equipment called a slit lamp to look at the outside and inside of your eye to check for symptoms of eye diseases — some of which don’t have any warning signs until they’re in their later stages. Specifically, a doctor can check for:

Glaucoma, which occurs when the eye’s optic nerve becomes damaged, most often due to a buildup of fluid in the front part of your eye. Glaucoma is the second-leading cause of blindness worldwide, according to the Centers for Disease Control and Prevention. There’s no cure, but with the right treatment, you may be able to prevent vision loss from it.
Diabetic retinopathy, an eye disease that can develop in people who have diabetes. When blood sugar levels rise too high, the blood vessels in the back of the eye can swell or leak, causing vision loss. Often there are no symptoms in the early stages of diabetic retinopathy, but it’s possible to reverse it — and regain some or all of your vision — by lowering your blood sugar levels.
Age-related macular degeneration (AMD), an eye disease in which the macula (an area in the back of the eye) becomes damaged, causing blurry central vision. In the early stages of AMD, there usually aren’t any symptoms. But in the later stages, it can cause straight lines to look wavy. Certain types of AMD can be treated with medication injected into the eye or lasers.
Cataracts, a clouding of the lens in the eye that can cause blurry vision. Cataracts are common. According to the National Eye Institute, more than half of all Americans ages 80 and older have either had cataracts or have had surgery to remove them.

Eye exams are an essential part of your health care routine. Book an appointment with your America’s Best optometrist today!

Who Should Get an Eye Exam?

The short answer: everyone — eventually. But some people need to schedule eye exams more often than others.

If you’re in your 20s or 30s, are healthy, and have good vision, you should schedule an eye exam every other year, says Dr. Morette. But if you wear contact lenses or have diabetes or a family history of eye disease, ask your doctor if you should schedule more regular (or earlier) exams.

Starting at age 40, adults should have a complete eye examination yearly, in part because this is when early signs of eye disease tend to crop up. It’s also when many people start to experience changes in their vision, such as presbyopia (a loss of nearsighted vision).

People who have eye disease or risk factors for eye disease (diabetes, high blood pressure, a family history of eye disease) should also ask their doctor how often they need an eye exam because they may need to come in more frequently.

People ages 65 and older should have their eyes checked every year. “For the most part, the older you get, the more you will probably need to go see your eye doctor,” says Dr. Morette.

How to Book an Eye Exam Appointment

The easiest way to schedule an eye exam is to book your appointment online — just go to americasbest.com and click on “schedule an exam.” You’ll be asked to enter some personal information, including your contact details and your date of birth. Your age is an important piece of information, since patients under 7 and over 70 may need more time to be thoroughly evaluated. You’ll receive a confirmation text or email right away. America’s Best will also send you a reminder on the day of your appointment.

You can also book an exam by calling your local store directly. (Click here to find an America’s Best near you.) An associate will ask you some basic questions that cover the information mentioned above.

If English isn’t your first language, the receptionist may book a longer appointment slot for you to allow plenty of time for you to properly communicate with your doctor. Many optometrist’s offices have eye care professionals who are fluent in multiple languages.

Do you have health issues such as diabetes or high blood pressure? Are you interested in contact lenses, eyeglasses, or both? Please indicate this while booking your exam. This way, the doctor will have a good idea of your needs in advance of your appointment.

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What You Need for Your Eye Exam Appointment

You should arrive a little early for your appointment in case you need to fill out any paperwork (especially if you’re a new patient). Many of the required forms, including your medical history form, can be completed ahead of time online. (Wondering why so many health questions are on the forms? Read 4 Things Your Optometrist Needs to Know About Your Health here.)

If you have vision insurance, bring your card as well as a list of current medications. Make sure you know the main points of your medical history and your family’s medical history. All this information helps the optometrist know what to watch for and whether any specialized assessments may be needed.

If you wear glasses, bring your current pair. If you wear contacts, bring your contact lenses box or a copy of your recent prescription. This helps your doctor compare your new prescription, if needed, with your old one. It’s also a good idea to bring your backup pair of eyeglasses, too.

What Are the Eye Exam Pretests?

Your optometric technician will perform a few pretests before your eye doctor examines you. During this stage, the technician gathers more information about your eye health and then will give the data to your doctor, says Dr. Morette. These pretests include:

Visual acuity test

When you think of an eye exam, the image of the classic eye chart, with a large “E” at the top, probably comes to mind. (Fun fact: It’s called the Snellen test.)

You’ll cover one eye and read the smallest line of letters that you can comfortably read. Next, you’ll repeat this while covering your other eye, and then you’ll do it again using both eyes together.

You’ll do this with and without your glasses. This test can determine how sharp your vision is.

The automatic refraction/auto keratometry test

This test uses a machine called an autorefractor/keratometer. The autorefractor shines light into the eye to provide a rough estimate of your prescription. The keratometer measures the curve of your cornea.

Non-contact tonometry test

While you stare at a light, a machine blows a small puff of air on your cornea. This test measures your eye pressure and can tell you if you’re at risk for glaucoma.

Color test

To determine whether you’re color-blind, you’ll look at a book or an image of colored dots and be asked to pick out numbers that are hidden in different colors.

Stereo test

This measures your depth perception and the ability of both eyes to work together.

Eye Muscle Evaluation

The optometric technician will hold up an object and move it from side to side while you follow it with your eyes (not your head). There may be an additional fee for this test.

Visual field test

This test checks for blind spots in your peripheral (side) and central vision. A loss of peripheral vision can be an early warning sign of glaucoma.

Digital retinal imaging test

A digital retinal camera (or fundus camera) takes a picture of the central portion of the back of your eye. The images can be saved and used to compare the health of your retina from year to year. There may be an additional fee for this test.

After the tests are complete, your optometric technician will record the results on your chart and give your doctor the information needed to start the exam.

What Are the Components of an Eye Exam?

When the pretests are complete, you’ll meet with your optometrist who will perform a comprehensive eye examination. This will take place in a room with a large chair, an array of instruments, a machine that looks like an enormous pair of eyeglasses (called a phoropter), and maybe even a model of the human eye.

Your doctor will then perform a series of tests to examine your eye health. “There are different types of instruments that we use in the office to look inside your eyes,” says Dr. Morette. “You cannot [evaluate your eyes] using home equipment or anything online. You have to go to a doctor for that.”

Your doctor may also give you dilation eyedrops to dilate, or widen, your pupils, which will help your doctor get a better view of the inside of your eye, says Dr. Morette. This is especially the case for first-time patients and those who have conditions such diabetes. It also applies to patients who notice symptoms such as floaters (small dark spots that float across your eyes and can be signs of eye disease).

Here are the tests that your eye doctor may perform.

Pupil test

Your doctor will shine a light into your eye to see how your pupil responds. If your pupil widens or doesn’t respond, that may signal an underlying eye problem.

Extraocular muscle test

Shining a flashlight from side to side, your doctor will watch your smooth eye movements as you follow the light with your eyes. This test can show if you have any weakness in your eye muscles.

Confrontational visual field test

While you cover one eye, the doctor will hold up a hand and ask you how many fingers you see. You’ll then cover your other eye and repeat the test. This screening can help your doctor check your side vision and make sure you don’t have any major blind spots.

Cover test

Your doctor will swing a paddle back and forth in front of your eyes to see if your eyes are properly aligned.

Refraction test

Your doctor will use a machine called a phoropter, which contains many different lenses, to measure your prescription up close and far away. The doctor will keep flipping the lenses to find the best pair for your vision.

Slit lamp evaluation

Using a table-mounted instrument that looks like a microscope (the slit lamp), your doctor will examine the inside and outside of your eyes, including your eyelids. If necessary, the doctor will use special eyedrops containing a yellow dye that helps highlight possible problems. The test checks for cataracts or scratches to your cornea, as well as many other eye conditions.

Dilated retinal exam

For this optional part of the exam, your eye doctor will use the slit lamp after dilating your eyes to see the back of your eye, where the retina and optic nerve are. The doctor will look for signs of a torn or detached retina, diabetic retinopathy, age-related macular degeneration, and glaucoma.

When the tests are done, your doctor will wrap up the findings with you and let you know if you need any further exams or treatment. You can expect the entire exam, from check-in to checkout, to be about 45 minutes or longer, says Dr. Morette.

What to Expect After the Eye Exam: Eyeglasses Fitting and Shopping

If you need eyeglasses, or simply want a new pair, an optician in the office can help you select new frames. You can find the frames in the display case on the wall. You can also be fitted for contact lenses at this time and sign up for a class to learn how to take care of your contacts (if you’re a new contact lens wearer).

If you order glasses or contact lenses, you can pay for them at this time. You’ll get an estimate of when they’ll be available for pickup — usually between seven and 10 business days. You can also pay for the exam here.

If you have a Flexible Spending Account (FSA) or a Health Savings Account (HSA), you can use the money you’ve set aside toward your eye care needs and eyewear. America’s Best also accepts many vision insurance plans. An associate can help you compare the value of your insurance plan against our everyday offers.

Scheduling a Follow-up Appointment

After your exam, the doctor or optometric technician will likely tell you when you need to return for a follow-up appointment. If you need to see a specialist — for example, an ophthalmologist who specializes in glaucoma or other eye disease — you’ll be referred to an outside doctor.

Has it been a while since your last eye checkup? Now’s the time to book an appointment!