Children's Eye Exams

Visual acuity tests measure the sharpness of your vision. This is the classic eye chart test. You are asked to identify characters on a projected eye chart to evaluate how well you see far away, and then repeat the exercise using a much closer chart to evaluate your near vision.

Your doctor will give you a screening test that checks your color vision to rule out color blindness. In addition to detecting hereditary color vision deficiencies, color blind tests also can alert your Focused Eye Care doctor to possible eye health problems affecting your color vision.

The cover test is a simple and commonly used method to determine if your eyes are working together to focus properly. During the test, you will look at a small object across the room while each of your eyes is covered alternately. The test is then repeated with you looking at a nearby object. Your Focused Eye Care doctor will observe whether the uncovered eye needs to move to pick up the target. Such movement could indicate strabismus (“crossed eyes”) or a more subtle binocular vision issue, which might cause eye strain or amblyopia (“lazy eye”).

Problems with eye movements can lead to eye strain and impact reading ability, sports vision and other skills. To assess movement issues, tests are conducted to evaluate how well your eyes can follow a moving object and quickly shift between and accurately fixate on two separate targets. In a common test for smooth eye movements (“pursuits”), you keep your head still and follow the slow movement of a handheld light or other target with just your eyes. If quick eye movements (“saccades”) are also tested, you will move your eyes back and forth between two targets positioned some distance apart.

Stereopsis is the visual perception of three dimensions (3D), also known as depth perception. There are various types of depth perception tests, but a common one involves wearing a pair of 3D glasses to view a booklet of test patterns. Your task is to identify which circle in each pattern appears closer to you than the others. If you can correctly identify the “closer” circle in each pattern, your depth perception is effective.

During this test, the room lights will be dimmed and you will focus on a large target (usually the big “E” on the eye chart). As you stare at the “E,” your doctor will shine a light at your eye and flip lenses in a machine – called a phoropter – in front of your eyes. This test estimates which lens powers will best correct your distance vision with impressive accuracy. It is especially useful for children and patients who are unable to accurately answer the doctor’s questions.

This is the test that your Focused Eye Care doctor uses to determine your exact eyeglass prescription. It determines your level of hyperopia (farsightedness), myopia (nearsightedness), astigmatism and presbyopia (aging eyes). During a refraction, your doctor asks you to view letters or symbols through different lenses on equipment called a phoropter and indicate which of the two lenses in each choice looks clearer. Based on your answers, your eye doctor will continue to fine-tune the lens power until reaching a final eyeglass prescription.

Your Focused Eye Care doctor may use an autorefractor to automatically estimate your eyeglass prescription. With this device, you rest your chin to stabilize your head while you look into the instrument at a pinpoint of light or a detailed image. Autorefractors are very accurate, and are especially helpful to determine eyeglass prescriptions for young children and other patients who may have trouble sitting still, paying attention, or providing the feedback that your Focused Eye Care doctor needs to perform an accurate manual refraction.

The slit lamp is a binocular microscope used to examine the structures of your eye under high magnification. During the slit lamp exam, you place your forehead and chin securely against the rests on the front of the instrument, and your doctor examines the structures of the front of your eyes — including your eyelids, cornea, conjunctiva, iris and lens. With the help of a hand-held lens, your doctor may also examine structures located farther back in your eye, such as your retina and optic nerve. A wide range of eye conditions and diseases can be detected during a slit lamp exam, including cataracts, macular degeneration, corneal ulcers and diabetic retinopathy.

You typically have no warning signs of glaucoma until significant vision loss occurs. Routine diagnostic tests known as “tonometry” often give the first indication that there is a problem. One common glaucoma test is non-contact tonometry (NCT), also known as the “puff-of-air” test, which measures eye pressure by directing a small burst of air at your open eye. High eye pressure can indicate a risk for glaucoma.

At Focused Eye Care, we often use an ICare tonometer, gently placed on your eye, or the puff-of-air tonometer, both of which are painless. Another method is applanation tonometry, commonly performed with a slit lamp-mounted instrument. This test involves numbing your eyes with yellow drops, which glow under blue light, and gently touching your eye’s surface with the tonometer to measure intraocular pressure (IOP). The process is quick and painless, usually causing only a slight tickling of your eyelashes.

To get a better view of the internal structures of your eyes, your Focused Eye Care doctor uses dilating drops to enlarge your pupils. It generally takes about 20 to 30 minutes for the drops to take full effect. Your eye doctor will then use various instruments to thoroughly evaluate the inside of your eyes.

When your pupils are dilated, your eyes will be sensitive to light (the larger the pupil is, the more light it allows in) and you may have difficulty focusing on objects up close. These effects can last for up to several hours, depending on the strength of the drops used. You should bring sunglasses with you to your eye exam to minimize glare and light sensitivity on the way home. If you forget to bring sunglasses, we will give you a disposable pair.

Your Focused Eye Care doctor may use a visual field test to check for blind spots in your peripheral vision, which can originate from eye diseases such as glaucoma or help identify specific areas of brain damage caused by a stroke or tumor. In a simple visual field test, your doctor or a trained assistant holds up different numbers of fingers within your peripheral field of view and asks how many you see while you continue to fixate on the doctor’s or assistant’s eyes. If an eye disease is suspected, you may need to undergo more comprehensive, formal types of visual field testing.

A contact lens fitting is an additional part of a comprehensive eye exam for every contact lens wearer. Your Focused Eye Care doctor will verify that your eyes are still healthy enough to wear contacts, that the contacts are fitting you correctly, measure your vision with your contact lenses on and adjust your prescription as needed. For more information, ask for our free “Your Annual Contact Lens Evaluation” brochure when you visit our offices.