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What should you expect during a visit to the ophthalmologist? A visit to the ophthalmologist usually starts with calling the doctor's office to set an appointment. You will probably be asked for the reason for the appointment in order to match your complaint to the right ophthalmologist. Ophthalmology has evolved and become super specialized - sometimes your problem is best addressed by a specific subspecialty in ophthalmology. You may also be asked at the initial phone conversation for the type of insurance coverage you have (in case that particular office does not take your insurance or if a referral is needed.) Some offices may ask for your address so that they can send you forms to be filled in at home. This will save you time at the office. It is always preferable to arrive 10 minutes early for your appointment so that all preliminary issues are settled, such as the completion of forms, copying your insurance card etc. There are usually three forms - the first asks for your demographics, meaning name, date of birth, emergency contact, address, phone number, etc. The second form is a medical questionnaire (your medical history, medications, family history, allergies, etc.) The last form is the "privacy" form mandated by congress through the HIPPA laws, to ensure your privacy. Co-pays are also collected before the exam is performed. In most ophthalmic offices, an ophthalmic technician will perform some preliminary tests, such as an auto-refractor to measure your estimated prescription and auto-keratometer to measure the corneal curvature (the cornea is the front of the eye). These measurements give a good estimation as to how you see with and without your glasses. If you wear glasses, the technician will likely measure the prescription in the glasses. The technician will then take you into an exam room and ask questions about the purpose of your visit and your medical history. He or she will then test your visual acuity (measures how well you see looking at an eye chart), and test your pupils and field of vision for the brain function as it relates to the eye. They may also measure your eyes for the glasses (called refraction). If you are older than 16 years, they will test the pressure in your eye for glaucoma (a silent disease that robs you of your vision gradually starting from the periphery, and eventually destroying the center of the eye.) Finally, they will use dilating drops in your eyes to allow the ophthalmologist to look at the eye from the front to the back. The eyes takes between ten and twenty minutes to dilate, so may sit in the waiting room for that period of time. Once your eyes are dilated, you will come back to the exam room where the ophthalmologist will go over the findings of the technician, and examine your eyes with a microscope called a "slit lamp" which enlarges the eye tremendously. He will start from the cornea, which is the front of the eye, and proceed to examine the eye all the way to the retina and the optic nerve (at the very back of the eye.) The lights that are shined in your eyes are pretty intense, but most if not all patients manage to tolerate them without difficulty. In fact, as the "light show" finishes, the patient may have trouble seeing anything for about 2-3 minutes - this is very temporary. The doctor will then go over his findings, and recommend a follow-up if necessary. If glasses are recommended, the Doctor will give the patient a glasses prescription. Near/reading vision may be blurred while the eye is dilated, but this only lasts about 2-3 hours. Dr. Michael E. Rom, MD Dr Rom is the Web Sight MD recognized Ophthalmologist for Lake County and Geauga County, Ohio
YOUR EYES IN WINTERWhile most people imagine that their allergies are gone the day the first frost hits, many allergy-like symptoms do occur in the winter months. First, the atmosphere is much drier, so there is less humidity in the air. This makes the eyes feel drier, and a dry eye begins to burn and itch, not unlike an allergic eye. Also, because of the dry air, any allergens encountered outdoors or indoors, get stirred up more easily are more likely to present themselves to stimulate an allergic response. We live in environments that are not sufficiently humid. In the summer we have air conditioning, and in the winter we have heat. Even with a "whole house" humidifier, there is little humidity that is in indoor air during the winter when the windows are kept closed. With the cost of heating fuel (gas, oil, electricity) as high as it is and has recently been, most people keep their windows very firmly shut all winter long. For people who do suffer from dry eye symptoms, a humidifier that puts a gallon of water into the air over a 12-hour period can be very helpful. These may be purchased in a drugstore without prescription and it can also reduce the incidence of sore throats, dry nose, other dry skin problems, etc. Even people who do not need to wear spectacles for vision correction often benefits from wearing glasses outdoors in the winter. The wind helps to dry the eyes quickly, the cold air makes the eyes tear more quickly, and the irritation can last quite a while. The key is to prevent irritation, because recovery from irritation is much more difficult than prevention. Sometimes, frequent artificial tears available over-the-counter are effective lubricants that will minimize or eliminate dry eye symptoms, though often an eye examination is needed, depending on severity of symptoms. Because the days are shorter and nights are longer and it is dark before 5 p.m., cataract symptoms might become more prominent. Sometimes, the first symptom of the cataract is glare, especially with nighttime driving. This is similar to the steamed‑up windshield effect: If you are driving on a road without any outside lights, your steamed up windshield might seem perfectly clear. However, as soon as oncoming traffic or other lights appear, the windshield will light up with glare. Similarly, most cataracts will present with a glare symptom. The earlier it gets dark, the more likely you are to be exposed to the cataract-induced glare. Of course, for nighttime driving, clear vision is even more important than it is in daytime driving. By cleaning your spectacles and your windshield you can only go so far if the cataract is the cause of the glare. We can always look forward to spring with its associated set of symptoms, but at least spring symptoms are associated with springtime, rather than dead of winter. Samuel M. Salamon, M.D. F.R.C.S.C.F.A.C.S. SMS/spd/ssh |
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