Once we have gathered the data during the “Entrance Testing” step of your exam, I then put all of that data to work in the exam room. I review the data from the 3D wAve using software that allows me to view all of its information at any computer in the office. This data tells me what type of Rx to expect each patient to need, whether their night time vision is adversely impacted by a change in Rx from normal light to dim light conditions and how well I can expect the patient to see when I have gotten to their optimal Rx. All of this data allows the patient and I to complete the portion of the exam devoted to determining what Rx to use for distance and near vision (referred to as the Refraction). We can usually complete this process much faster than with older technology, usually in a minute or two.
The technology that greatly speeds up the refraction and makes the whole process easier and more comfortable for the patient is referred to as our “Total Refraction System” or TRS for short. By combining the information from the 3D Wave, the Lensometer and the patient’s vision with their current vision correction, the TRS allows me to control the entire refraction process from a digital control panel. All of the lens changes, changes in eye chart and testing conditions are managed via this control panel. The TRS has an advanced testing mechanism for the astigmatism portion of the patient’s Rx. Instead of showing alternating views of a chart to determine the astigmatic power and orientation, the TRS shows the patient both lens choices simultaneously, allowing you to make a direct comparison between the two Rx’s. This really speeds up the refraction process and makes the decision between “lens #3 and lens #4” much easier for the patient.
After the refraction is complete, its time to get down to the ocular health evaluation portion of the eye exam. I examine the front portion of the eye (the cornea, lens, iris, conjuncitva, eye lids etc) with a bio-microscope that provides me with magnification ranging from 10x up to 40x which allows me to detect any ocular disease of the front portion of the eye.
Once I’ve evaluated the health of the front portion of the eye, its time to check the pressure inside the eye. The Intraocular Pressure (or IOP for short) can be an indicator of Glaucoma. I never use the “air puff” test, in fact, I haven’t used it in 18 years of private practice. I instill a numbing drop into each eye to make this test easy and comfortable and then use a device called an Applanation Tonometer to measure the pressure inside the eye. After this quick and painless test, it takes less than 10 seconds to measure the IOP in both eyes, I instill the dilating drops and you’re on your way out to the lobby to await that final portion of your eye exam, the evaluation of the internal structures of the eye.