Few things affect the quality of your life more than your eyes, so a routine eye exam is necessary for more than just vision correction. Dr. Fydell advises a comprehensive eye examination annually from toddlers up to the age of 19, for anyone over 65 years of age and for those with eye diseases. A bi-annual examination is standard for people aged 20-64.
A comprehensive eye exam is essential for protecting your vision and overall health and may provide early clues to detecting many different problems, conditions and diseases (e.g. hyperopia/farsightedness, myopia/nearsightedness, high blood pressure, cataracts, diabetes, heart disease, macular degeneration, etc.). Dr. Fydell reviews your family history and looks for signs and symptoms of such problems, conditions and diseases by performing a series of tests which takes approximately twenty minutes unless additional procedures are warranted.
Your Eye Exam and What to Expect
Dr. Fydell uses the most appropriate diagnostic technology as an integral part of his standard of care, assisting him to make the right medical assessments for his patients.
Your eye examination will begin with the following pre-tests, performed by his experienced optometric assistants:
An Auto Lensometer is used prior to an eye examination to obtain or confirm the prescription of your current eye glasses for comparison to Dr. Fydell's subsequent examination results. Therefore, it is important to bring your most recently prescribed eye glasses with you to the appointment.
An Auto-Keratometer/Autorefractor is a computer-controlled instrument used to measure the shape of the front surface of the eye (cornea) and how light changes entering your eye. This results is an initial approximation of your visual "impairment" and assists in determining if eye glasses and/or contacts are required.
An Auto tonometer is an instrument that measures eye pressure by blowing a very mild puff of air onto your eye. This is used as an initial screening test for glaucoma. Further glaucoma testing may be performed by Dr. Fydell during the examination.
Main Eye Examination
The next phase of your eye examination is conducted by Dr. Fydell who thoroughly assesses your vision and overall eye health using the pre-test results as an initial guideline.
Dr. Fydell will begin by checking the sharpness of your vision by using a digital eye chart. He will have you identify letters or shapes of varying sizes to determine how well you can distinguish them from across the room. The measure of your "visual acuity" (what you can see) can alert the doctor to changes in the health or optics of your eyes. To test your near vision, a smaller, hand-held chart is used.
During this test, the lights will be dimmed and Dr. Fydell will shine a light in each eye as you fixate on a large target. He will use a phoropter, which is an instrument used to place different lenses in front of your eyes in order to observe how the light reflects from them. This will give Dr. Fydell an objective measurement of what your eyeglass prescription should be.
This part of the comprehensive eye exam is extremely important and often understated to the patient. During this procedure Dr. Fydell uses a magnifying instrument (opthalmoscope) to see inside the eye looking for both ocular and systemic disorders (e.g. cataracts, macular degeneration, glaucoma, diabetes, hypertension, etc.), where so many health issues may eventually show some manifestation.
Optometrists play a key role in such retinal evaluations and in many situations often are the first health care specialist not only to detect changes in eye health but also in general overall health.
The two types of ophthalmoscopy performed are: 1) direct - where the doctor is very close to the patient providing a very magnified view of the retinal structure, and 2) indirect - where the doctor, at a more remote working distance, gets a wide field appreciation of issues that can occur inside the eye.
Whether or not eye dilation is necessary for your eye exam depends on your overall health and your risk of eye disease. If necessary, Dr. Fydell will use special eye drops to cause eye dilation which allows him to view, assess and diagnose many diseases and conditions. Eye dilation can be inconvenient since it makes your eyes light sensitive and may interfere with your ability to drive or work for a few hours after your eye exam.
This is the test that Dr. Fydell uses to finalize your exact eyeglass/contact lens prescription. As you look through the phoropter, Dr. Fydell will place lenses of varying strengths in front of each eye and ask which one you prefer. Your answers will help him refine the lens power based on his objective findings and your subjective opinion, to ultimately determine your final eyeglass/contact lens prescription.
This test is used to see how your eyes work together. Dr. Fydell will have you focus on a small object across the room, then alternately, cover each eye. The test is then repeated using a near point target. Proper binocular vision is essential for visual comfort, depth perception and effective and effortless reading and retention.
There are several tests that Dr. Fydell will use to further evaluate the muscle alignment of your eyes. Good vision is not only about seeing clearly at all distances but also seeing very comfortably. These types of tests include: assessing eye alignment, stereopsis (depth perception), eye tracking and other eye movements which allow him to evaluate your potential for muscular eyestrain issues that might present themselves in learning, occupation or hobbies/activities.
Accommodative (Focusing) Test
Focusing on various objects/letters/tasks at “intermediate” distances (e.g. computer screens, automobile dashboards, GPSs, supermarket shelf prices, etc.) or focusing on “near point” objects/letters/tasks (e.g. school work, reading, cell phones, needlework, electronics repair etc.), is crucial to an efficient and effective lifestyle.
Assessing your vision for both comfort and clarity at both of these important distances is a major part of the eye exam especially as we reach the late thirties and older. Dr. Fydell will evaluate your requirements as they pertain to day to day living, your lifestyle, occupation and hobbies/activities.
Slit-lamp Bio-microscope Examination
Routine slit lamp exams are performed to evaluate the eye under high three dimensional (3-D) magnification for signs of disease or conditions that may affect vision or general health. This highly magnified view can reveal signs of injury, problems, infection and disease (e.g. foreign bodies, cataracts, glaucoma, macular degeneration, etc.).
Color Deficiency Test
Dr. Fydell will, if he deems necessary, perform this test to rule out colour deficiency, which although is usually hereditary, can help him identify or exclude certain acquired eye diseases. There are several different types of such tests. Most commonly, the inability to differentiate colours on confusing backgrounds can lead to suspicion of problems that may hinder the learning curve in young children or alter the safety or suitability in various career choices.
The Visual Field Analyzer, an ancillary test, allows Dr. Fydell to measure your peripheral vision by presenting flashing lights of variable intensities so the sensitivity of the optic pathway can be investigated. This can be helpful in diagnosing and monitoring a spectrum of ocular diseases and neurological disorders such as glaucoma, strokes, tumors, etc.
Dr. Fydell promotes eye health by endorsing the current scientific research indicating that many common eye diseases are strongly linked to diet, environment and lifestyle.
Amongst others, some of the nutrients found in foods necessary to promote eye health are:
- Lutein and zeaxanthin - found in kale, spinach, orange peppers, other leafy greens, eggs, fruits and other fruits & vegetables (e.g. kiwi, cantaloupe, avocado, brussels sprouts, broccoli, peas, green beans)
- Omega-3 fatty acids - the best source by far is found in cold water fish (e.g. salmon, sardines, rainbow trout) and some plant oils (e.g. flax seed, flax seed oil, walnuts, walnut oil, wheat germ, extra virgin olive oil), beans and lentils (i.e. romano beans, black beans, soybeans/edamame), eggs
- Vitamin C - found in fruits and vegetables (e.g. kiwi, avocado, berries, oranges, etc.)
- Beta-Carotene - found in fruits and vegetables (e.g. raw carrots, sweet potato, winter squash, 100% canned pumpkin, cantaloupe)
- Vitamin E - found in oils, nuts (e.g. almonds, sunflower seeds, pine nuts, dry-roasted soybeans, etc.), eggs, some fruits and vegetables
- Zinc - found in seafood, lean meat and turkey, nuts (e.g. cashews, pumpkin seeds), whole grains (e.g. brown rice, quinoa, pearl barley, whole wheat pasta, etc.), fortified breakfast cereals (i.e. bran cereal, oatmeal)
- Fiber - found in whole grains, fruits and vegetables
Dr. Fydell recommends the recently published book entitled ‘Eyefoods - A Food Plan For Healthy Eyes' by Dr. Laurie Capogna, OD and Dr. Barbara Pelletier, OD to patients who want the necessary knowledge to make the right food and lifestyle choices that will help them preserve their eye health and fight disease. Information on 'Eyefoods' can also be found at: www.eyefoods.com