General
eye health

Your ophthalmologist will take a detailed history, including family history of conditions such as diabetes, high blood pressure or heart disease. You will be asked about any vision problems you are currently experiencing, as well as any that you have had previously. If you use prescription glasses or contact lenses, make sure you take these to your appointment.

The comprehensive eye examination includes tests to determine the health, function and appearance of different parts of the eye.

These may include:

• Visual acuity test to check how well you can see from a set distance using a Snellen chart. This chart contains rows of letters, which decrease in size from the top line to the bottom line.
• Eye muscle test to check the function of the muscles responsible for moving the eye. Your ophthalmologist will hold up and move a pen or object and ask you to follow it with your eyes without moving your neck.
• Refraction test to determine if your vision is normal or if you need corrective lenses. Your ophthalmologist may use a digital refractor or retinoscope to direct a beam of light into your eye and assess how effectively it can focus light. If you have a refractive error, fine adjustments for prescription lenses are made by getting you to look through a phoropter, a mask-like device with multiple lenses which are quickly switched to find out which ones give you the sharpest vision.
• Visual field test to assess your peripheral (side) vision. You may be asked to look into a special instrument and press a button when you see a flashing light. Alternatively, you may be asked to keep your head still, cover one eye and report at what stage you see the ophthalmologist’s moving hand.
• Colour-vision test using multi-coloured dot patterns. Certain colour deficiency will prevent you seeing particular patterns.
• Slit-lamp examination allows your ophthalmologist to examine the cornea, lens, iris and anterior chamber of the eye. You are asked to sit and rest your chin and forehead on a device that combines a microscope with a bright, intense light. Fluorescent eye drops may be used to look for cuts, foreign objects or infections of the cornea.
• Retinal examination to check for diseases of the retina and optic nerve at the back of your eye. After applying eye drops to dilate the pupil, your ophthalmologist uses an ophthalmoscope, slit lamp or bright light mounted on their head to examine each eye. These eye drops cause blurred vision and sensitivity to light for a few hours after the test.
• Tonometry to measure the internal eye pressure, using a device called a tonometer. Eye drops are often used to numb the eye first.
• Pachymetry uses ultrasound waves to measure the thickness of the cornea and look for signs of increased intraocular pressure. Eye drops are used to numb the eye first.
• Neurological exam to check the function of your cranial nerves. This may be required in some situations.

The results of most tests are available straight away, but some may take a few days.

Note: If you have had pupil-dilating drops during the examination, you will have blurry vision and sensitivity to glare and bright light for approximately 4 to 6 hours. You will not be able to drive home and should make other arrangements.

If you have a refractive error where the shape of your eyeball prevents light focusing properly (resulting in blurred or distorted vision), your ophthalmologist will prescribe corrective glasses.

If an eye disease is detected or suspected, you may need to have further diagnostic tests before a treatment plan can be recommended. In certain situations, a general ophthalmologist may also refer you to another ophthalmologist who has subspecialised in a particular part of the eye (e.g. a corneal or retinal specialist).

1. Good Vision for Life. 90% of vision loss can be prevented or treated with early detection [Internet]. Australia: Optometry Australia; [date unknown] [cited 2021 Jan 28]. Available from: https://goodvisionforlife.com.au/better-vision/