Eye Examination and Consultation

Eye examination and consultation is a series of tests carried out to check visual acuity and visual field, and diagnose eye diseases to plan their treatment appropriately. Eye examinations and consultations have quite varied forms of tests, which aim to evaluate all aspects of vision quality. Eye tests are generally recommended routinely to do, although there are no complaints. The reason is because eye diseases or health problems can appear without showing any previous symptoms. In this case, the eye examination plays an important role to determine the existence of eye disorders early on. So if the patient is indicated to have eye disease, it can be treated immediately.

Eye Check and Consultation Indications

Patients with the following complaints, should undergo eye examinations and consultations:

• Red eye and pain
• Blurred vision
• Double vision
• Light sensitive
• Small objects float on the sight (floaters)
• A flash of light appeared

Apart from complaints, it is also recommended to conduct regular eye examinations and consultations regularly. How often eye examinations and consultations are done, generally depends on age:

• A toddler. The initial eye examination is performed on infants and children under the age of 3 years. The aim is to examine eye disorders that are prone to occur at this age range, such as lazy eye (amblyopia), squinting eyes and nearsightedness. Then, the eye examination can be done again when the child is 3-5 years old.
• Children and teenagers. Eye examinations are generally done before the child enters school age. The doctor will suggest how often the schedule of eye examinations is based on the results of previous examinations. In the condition of the eyes that are otherwise healthy, it is still recommended to take an eye examination 1-2 times a year.
• Adult. Eye examination and consultation for adults whose eyes are otherwise healthy, generally as follows:
  - Age 20-39 years: every 5 or 10 years.
  - Age 40-54 years: once every 2-4 years.
  - Age 55-64 years: every 1-3 years.
  - Age 65 years and over: once every 1-2 years.

In addition to the above recommendations, eye examination and consultation need to be done more frequently if there are conditions such as the following:

• Use glasses or contact lenses.
• Diabetes.
• High blood pressure (hypertension).
• Family history of glaucoma.
• Taking drugs that affect eye health, such as corticosteroids, tamsulosin, birth control pills, cholesterol drugs, antihistamines, diuretics, and antidepressants.

Warning:

• Tell your doctor if you are taking drugs, including supplements and herbal products, during eye examination and consultation.
• Also tell your doctor if you have an allergy to certain substances.
• Before the examination, the doctor can drip eye drops to dilate the pupils. These drops can make the eyes become sensitive to light.

Before Eye Examination and Consultation

The eye examination and consultation will be done by an eye doctor. There is no specific preparation for meeting with an eye doctor. However, patients are encouraged to prepare questions that they want to ask the doctor, in order to get the most complete information. In addition to preparing drug data that is routinely consumed, for patients who have previously used glasses or contact lenses, it is advisable to bring it along with prescription eyeglasses beforehand if any.

Eye Examination and Consultation Procedure

The eye examination and consultation can take half an hour to several hours. The length of the eye examination depends on the method of examination carried out and the overall condition of the patient's eyes. The eye examination begins with a consultation session. Patients are encouraged to inform their perceived complaints, whether related or not with the eye. The eye doctor will also ask about the patient's and family's medical history, including the history of eye disease. Next the doctor will conduct an eye examination by observing the possibility of abnormalities of the eyelid, a transparent layer that covers the front of the eye (conjunctiva), eye membrane (cornea), the whites of the eyes (sclera), and iris (iris). Eye examinations are generally painless. Furthermore, the examination can be continued with tests, such as:

• Visual acuity test and refraction test

In a visual acuity test, also called an eye vision test, patients are asked to see a chart of varying size letters, called a snellen chart. The patient will be seated 6 meters from the snellen chart. The doctor will ask the patient to mention the numbers designated by the doctor. If the sharp test of vision is not normal, the doctor will do a refraction test to determine the correct size of glasses or contact lenses. Refraction tests are carried out using a special device called a phoropter. Through this tool, the doctor will make corrections to the lens so that patients can clearly mention the letters. When the examination is running, the doctor can ask about the object that the patient sees, whether it is clearer or more invisible. From the patient's answer, the doctor will determine the additional lenses needed. This test is useful for detecting refractive disorders, such as nearsightedness (myopia), farsightedness (hypermetropy), old eyes (presbyopia), and cylindrical eyes (astigmatism).

• Field of View Test

This test is useful for measuring how wide a person's eye view is compared to a normal eye field. The doctor will ask the patient to look at an object located in the midline from the patient's face. While looking at the object, the patient is asked to tell the doctor about other objects moving sideways. How far the other object can still be seen by the eye, without moving the eyeball, from where the doctor assesses how broad a person's field of view. This visual field test is useful for measuring the range of vision decreased due to glaucoma or stroke.

• Tonometry

Tonometry or eyeball pressure tests can be done using a doctor's finger to feel the consistency of the eyeball, but this is subjective. Or use a device called a tonometer, a device that exhales air, and calculates eyeball pressure from the gusts of air, objectively. This test helps the doctor diagnose glaucoma.

• Slit lamp test

Slit lamp is a device that can shoot rays shaped like a small dot into the eye. When using a slit lamp, the doctor can see abnormalities in the eye more clearly, such as damage to the cornea, abnormalities of the lens of the eye (such as cataracts), retina (such as retinal detachment), and macular degeneration. Sometimes, doctors give eye drops to dilate the pupils, so that the part of the eye that is deeper than the pupil, is seen more clearly.

• Ultrasonography (USG) of the eye

Ultrasound of the eye uses sound waves to give a picture of the structure in the eye. This test is useful for evaluating eye tumors, cataracts, or bleeding in the retina.

• Corneal and retinal topography

This test uses a computer to map the cornea or the surface of the retina. The doctor will analyze changes in the corneal arch, such as swelling or scratches, which can cause astigmatism. Corneal and retinal mapping tests are also useful for evaluating a patient's vision before undergoing LASIK, corneal transplantation, or choosing the right contact lenses. In addition, topography is also used to diagnose retinal disease.

• Fundus photo

The ophthalmologist will take an eye fundus photo using a special digital camera to monitor the back of the eye to an angle of 200 degrees. Fundus photographs can provide a broader picture of the condition of the retina compared to other tests, and without the need for anesthesia.

• Fluorescein angiogram

Fluorescein angiogram aims to determine the flow of blood in the retina. This test is useful for diagnosing eye diseases, such as diabetic retinopathy and retinal detachment. In this test, a special dye (contrast) called fluorescein is injected into the blood vessels of the arm. This substance will move quickly to the blood vessels in the eye. After reaching the eye, a special camera is used to photograph the movement of fluorescein that runs in the veins behind the eyes. Fluorescein angiogram makes it easy for doctors to detect blood flow disorders, as well as abnormalities in the blood vessels of the eye, such as swelling or leakage.

After Eye Examination and Consultation

The doctor will inform the test results to the patient. From the test results it can be concluded whether:

• Patients need vision aids, both glasses and contact lenses, or not.
• Whether there is a change in the condition of the eye and the quality of the patient's vision, which will determine whether or not to replace the eyeglass lenses or contact lenses that have been used.
• Whether or not advanced treatment needs to be done, other than glasses.