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The eyes have it                                                                        June 2009

The Eyes Have It

Eye testAs we get older, our eyes and our eyesight change. Someone once told me an optician can virtually pinpoint the age of a person by checking their eyes and vision. I don’t think it is quite that simple as eyesight varies so much from person to person, but one thing we all definitely have in common is that we should get our eyes checked on a regular basis.

An eye examination will identify problems with our vision, but it can also identify current and potential health problems, so booking that eye test is really important.

Eye examinations today are incredibly sophisticated; they are also quick and easy. If it is your first visit, you will be asked a few basic questions about your eyes, your vision and some aspects of your medical history. This gives the examiner a good basic idea of your health. Depending on your age and the early assessment of your vision and health, there are a number of tests that will then be suggested for you.

Retinoscopy and refraction

A retinoscopy is one of the first tests usually given. You will be asked to look at a single target while the optometrist shines a bright light into your eyes and studies the reflection, usually while passing a different lens in front of it. This gives a good idea of any prescription needed and this information is supported by a refraction test which will confirm how long or short sighted you are plus indicate astigmatic or presbyopic problems.

Visual acuity

Visual acuity is that well known test when you are shown an eye chart, usually letters of an alphabet, and asked to read from lines in different sizes. This gives a good idea of your vision.

Visual field or perimetry test

This can be done with a modern machine where you stare at a light in the centre of your field of view while lights flash around the periphery. This measures your peripheral vision and can help to detect the onset of open-angle glaucoma.

Checking your eye muscles

Your optometrist will look at your eye movements to check that the muscles which control your eyes are working well

Slit lamp

This is where an instrument called a ciomicroscope is used to let the optometrist look closely at the inside of your eye. You position your chin on a special rest and stare at a point suggested by the optometrist while he looks at your cornea, iris, conjunctive, retina, optic nerve and macula. This can identify a number of problems including cataracts, macular degeneration and corneal ulcers.

Amsler grid

This is a pattern of line squares with a spot in the middle and you are asked to stare at the dot and comment on any waviness or variations in the lines. This test pinpoints problems in your central vision and also the onset of age-related macular degeneration.


This is a funny little test when a puff of air is whooshed into your eye. It doesn’t hurt at all, usually just three quick puffs of soft air; but it is a valuable tool as it measures the pressure inside your eye. It works by calculating the pressure on the basis of your eye’s resistance to the puff of air. It is mainly used as a test for glaucoma.


Dilating drops are popped into your eye to open the pupil, the black centre of your eye. With a larger pupil, the optometrist will be able to make a more detailed examination of the inside of your eye. The drops usually take up to half an hour before they are fully effective and they are also slow to wear off, so you may be unable to drive home if you have had these drops.

Colour vision test

An easy test for colour blindness is looking at Ishihara plates, showing numbers made up of coloured dots set among a lot of different coloured dots. You will be asked to identify the numbers you can see.

The term eye test is not helpful because it encourages people to mask some deficiencies. Be totally honest at an eye test to ensure you get a correct diagnosis of your current eye health and also an accurate prognosis of what might happen.

There are a number of major brand names in the high street these days who all offer an excellent eye check service. For anyone that is housebound, most Primary Care Trusts can offer a home visit by an optometrist.

If you are over 60, your eye check should be free of charge.


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