In this section, we will see in detail what an ophthalmological examination is and how to follow the recommendations imposed by our trusted ophthalmologist, as well as the different types of ophthalmological tests that we can find and the importance of carrying out a good vision examination based on our age.
What is an ophthalmological review?
A complete ophthalmologic exploration depends on multiple factors:
- Age
- The date of the last revision
- Family history
- The presence of other diseases
Therefore, the visit to the ophthalmologist consists of a basic examination. This will be similar in most cases, and a complementary examination that may vary according to each situation. Some of the diagnostic tests are not performed directly by the ophthalmologist. For this, in Área Oftalmológica Avanzada we have opticians and specialized nurses in the center, who will report the results to the doctor.
Medical history
During the initial examination you should explain your medical and family history. This may include questions about your general health, allergies, medications and surgeries or past eye diseases. It is essential that the patient collaborates with the doctor, since if any information that could be important is omitted, it can cause diagnostic and therapeutic errors. Spanish legislation considers that the patient has the obligation to provide all the information requested by his doctor to establish a correct approach to the disease.
Types of ophthalmic tests
A comprehensive eye exam consists of several tests that allow you to explore the entire deep eye structure. There are many types of ophthalmological tests, but for a complete check-up the following are usually performed:
Visual acuity
This is the best known test for all patients. To perform this test, an optotype is used while the patient must read a chart (Snellen chart) to determine how much your eyes can see at different distances. This visual examination is performed monocularly, that is, in one eye first and the other later, and its objective is to determine if the patient has a visual acuity 20/20.
Refraction
To examine the refraction and determine the prescription of the glasses that the patient should wear, a phoropter. This apparatus it has many lenses inside that are rotated to the patient while he observes a reading booklet. You must indicate with which of the phoropter lenses you obtained a better vision.
Examinations of the eyelids
To examine the Eyelids a slit lamp and during the evaluation various aspects are studied, such as:
- La position of the eyelids. In its normal state, the edge of the eyelids are in contact with the eyeball and the lacrimal points are submerged in the lacus lacrimalis.
- As long as the eye is open and the patient maintains straight vision, the upper lid should cover the eye up to 2mm, from the edge to the cornea. The ampThe length of the eyelid cleft should be between 6 and 10 mm.
- Eyelid skin must be thin and with little fatty tissue subcutaneous.
- La conjunctiva palpebral can be checked through the reversal of the upper eyelid. This structure is normally smooth and shiny, without scars or protrusions.
Examination of the eye muscles
The extrinsic muscles of the eye are responsible for eyeball movement. The evaluation of these muscles is very important for the diagnosis of conditions such as amblyopia and squint.
To examine the muscles, the doctor asks the patient to stare at the pencil in his hand and follow the movement with his eyes without moving his head. Ocular displacement of the patient's eyes is a indicative of the state of health of the extrinsic muscles.
Tonometry
La Tonometry It is the diagnostic instrument that allows to measure the Intraocular pressure Of the eye (CHEEP). Eye strain is measured with the help of a tonometer, which shoots a puff of air into the patient's eye and performs the measurement immediately. Altered intraocular pressure values are associated with glaucoma, a chronic disease that causes progressive damage to optic nerve.
Scan with slit lamp
The slit lamp is a very important instrument in ophthalmology that is not only used to examine the eyelids. The slit lamp is a binocular microscope that has an intense light that allows the ophthalmologist examine the increasing eye structure and in detail.
Slit lamp eye examination allows obtain three-dimensional images of segments of the eyelids, iris, the cornea, the conjunctiva and the aqueous humor. To examine the entire eye with a slit lamp it is necessary to dilate the pupil in order to observe the crystalline, the optic nerve and retina.
Ophthalmoscopic examination
El ophthalmoscope It is an instrument very similar to a flashlight with different magnifying lenses. Using an ophthalmoscope we can illuminate the patient's ocular structure to see in detail the cornea, veins, arteries, lens and vitreous humor, among other parts. During the examination, the patient must stare into the ophthalmoscope while a beam of light penetrates the ocular structure. This test is almost always done with the dilated pupils, is painless and is used to detect many eye abnormalities, from changes in the retina to macular degeneration.
Campor visual
El campor visual is total vision achieved by one eye and therefore encompasses both central and peripheral vision. To quantify the campor visualization of a patient can be made using a tangent screen or a Goldmann perimeter.
During both tests, the patient must stare at a screen or a spherical device, while an object moves from different points on the screen or the sphere, from the peripheral zone to the central zone of the campor visual La Amsler grid It is the most widely used instrument to study the central vision of the campor sight. This grid is a black card containing a white grid and a white dot in the center. Ideally, the patient can observe the entire grid without finding any distortion in the lines, or manifesting the existence of a blind spot in their vision.
Interpretation of the result of ophthalmological exploration
The data obtained in the sections that we have just seen must be evaluated by an ophthalmologist. This is a doctor who, after completing his degree and passing the MIR entrance exam, has specialized in this branch. This specialization lasts a minimum of 4 years and is related to vision and the ocular apparatus, both in physiological, optical and pathological aspects. Therefore, he is the only trained to decide the results of the examination carried out. Only he will be able to report what is happening in his eyes, as well as establish the best guideline to solve his problem. There must be good communication between the ophthalmologist and the patient, so that the patient has all the information necessary to make a completely free decision about the course of action to follow.
The ophthalmologist is obliged to transmit, in a clear and intelligible way, all what the patient requests about their disease, and respect the patient's dignity as a person, as well as their freedom to make decisions. When these principles are respected and a relationship of trust is established, which is reflected in the signing of the informed consent, the proposed treatment can be established.
Vision screening according to age
From birth and until the end of adolescence, the eyes are in constant development. In fact, the eyeball stops growing at approximately 18 years of age. Periodic eye exams are very important to detect any visual problems early and attend to it in its initial stage.
Review in babies
It is very important to carry out a complete study of the vision and ocular structure of newborns. Ideally, a pediatric ophthalmologist will examine the newborn's eyes and vision to determine that everything is going well, that the eyeball is at its correct stage of development, and that there are no ocular mobility problems. The first mandatory check-up of a baby is recommended 6 months after being born.
From the 3 years
When the child has reached three years of age You must attend your first compulsory ophthalmological consultation, especially if your parents suffer from a refractive error. At this age the child can already cooperate during vision tests, so it is much easier to diagnose visual defects and lazy eye.
From 4 years to 8
If the child has refractive errors it is important that you come every year ophthalmologist to check your vision and detect changes in refraction. During school age it is very important for parents to be attentive if the child has difficulty reading, seeing the blackboard, studying or concentrating. In the event of any symptoms related to sight, the ideal is to go to the ophthalmologist as soon as possible to detect any vision problem in time.
During adolescence
During adolescence the sight should be examined once a year if there is any refractive error. It is also important to attend a routine check-up, as long as it has been more than three years without checking the ocular structure.
Between the 20 and the 40 years
If there are no refractive defects, it is advisable to review the ocular structure every 3 years as a routine check. From the age of 20 you can opt for refractive surgery to permanently treat a visual defect.
From the 40 years
The fourth decade of the human being is very important for the visual system. Check vision and eyes at age 40 it is mandatory, because during this age the visual problems associated with aging begin to appear, such as presbyopia. In addition, it is important to highlight that, from the age of 40, the risk of suffering from glaucoma. Checking eye health at this age is important to address major diseases in their early stages.
From the 60 years
The elderly is a stage where it is very important to closely monitor any changes in vision. From the age of 60 it is recommended go to the ophthalmologist once a year to rule out the presence of Cataracts, glaucoma and age-related macular degeneration.
Why is vision screening important?
There are many eye-related diseases, and they all have one very important feature in common: Early diagnosis is key to preserving vision. There are silent diseases like glaucoma, or alarming like retinal detachment, but the truth is that they can all be prevented if you visit the ophthalmologist regularly.
Ideally, patients do not allow more than two years between one medical check-up and the other. Why? Because the ocular structure is always changing, it degenerates over the years, eyesight becomes tired, the lens becomes opaque and chronic conditions can occur that it is better to attend to in time.
It is also important be aware that many systemic diseases, like diabetes and multiple sclerosis, cause silent damage to the eye structure that can be controlled if detected early. Diseases like Diabetic retinopathy, macular degeneration, glaucoma and syndrome Dry Eye they can have a more positive prognosis if they are detected early.
When was your last visual checkup? If you can't remember it, then it's time to attend a new control. In Área Oftalmológica Avanzada we have the latest technology to examine the sight and the entire ocular structure. Get in touch with us, make an appointment and take your eye health seriously. We'll be waiting for you!
Phone: 935 51 33 00
Direction: Edifici Jardi 0 Plant, Gran Via de Carles III, 71, 08028 Barcelona
Email: [email protected]
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