What Can You Expect From an Eye Exam?

by Sep 28, 2022

Annual eye exams are recommended for everyone over the age of 6 months. But what should you expect from an eye exam? Believe it or not, there is much more involved with an eye exam that simply determining a glasses or contact lens prescription!

The objective of this article is to walk you through a typical eye exam and explain the reasoning and importance of each part.


History/In-take Sheet

One of the most commonly heard questions in an optometry office is “Why am I being asked to answer all of these questions? This does not have anything to do with my eyes.”

We get it! Filling out a patient intake sheet every year is annoying and can seem frivolous. However, it is actually very important for your eye doctor to know what is going on with your systemic health.

Many systemic diseases manifest in the eye, eye doctors need to know what is going on to monitor for these changes. Some such examples include diabetes, hypertension (high blood pressure), high cholesterol, multiple sclerosis (MS), sleep apnea, etc.

If you do not tell your eye doctor about these problems, he or she might worry something else is going on. It is best to save everyone the moment of panic by keeping your eye doctor updated with your overall health information.

Current medications and allergies are also very important to tell your eye doctor about. Just like systemic health problems, many medications manifest in the eyes and can even alter your prescription!

Some medications cause physical changes to the eye whereas others can cause symptoms such as a change in color appearance, dry eye/irritation, etc. Some such medications include antihistamines, antidepressants, antianxiety medications, erectile dysfunction medications, Amiodarone, Hydroxychloroquine (Plaquenil), Flomax, and many others.


Entrance Testing

There are a battery of entrance tests your doctor will use to see how you are seeing a quickly check for any major eye health concerns. Some examples of these tests include:

VA’s (Visual Acuities). This is when your doctor will put up a letter chart and ask you to read different lines of letters. These lines correspond to different letter sizes and help compare how you are seeing to age-matched norms.

Typically speaking, 20/20 vision is what is considered to be “perfect” vision. 20/15 or 20/10 vision is better than perfect, but few individuals will be able to read those lines. 20/25 and 20/30 lines are still considered good and acceptable vision. 20/40 or better is what most states require for their driver’s license exams.

Pupil Testing. Many doctors will check how your eyes respond to light in what is deemed “pupil testing”. Your pupil (the black part of your eye) should get smaller when exposed to light, and get larger in the dark. The response should be equal between both eyes.

Color Vision. There are various way to check color vision, and typically this will only be done at your first visit to see if you have a color deficiency.

Visual Fields. There are several quick screening tests to ensure you do not have a visual field defect (i.e. have good peripheral vision). One common screener test is a confrontation test. This test is one in which the doctor will hold up a number of fingers in your four quadrants of vision and check how you are seeing with each eye.



Refraction is the part of the eye exam in which your doctor determines your glasses/contact lens prescription.

Your doctor will use a tool called a phoropter (a machine that has many lenses built into it) to determine your prescription both subjectively and objectively to get you to see your best.


Intraocular Pressure Check

Intraocular Pressure, also known as IOP, is used to measure your eye pressure. This is an important measurement most notoriously taken as a glaucoma check.

There are several different methods for taking IOP including the “air puff test” (non-contact tonometry), iCare tonometry, Goldmann Tonometry, and many others.


Slit Lamp Eye Exam

Your eye doctor will want to look at the overall health of your eye. This includes using a special microscope called a slit lamp to look at both the anterior and posterior aspects of the eye.

This includes evaluation of the tear film, cornea, lens, conjunctiva, sclera, vitreous, and retina.



Debatably the most important part of an eye exam is a dilated fundus exam, or DFE.

Dilation allows your eye doctor to look at the health of the very back structure of the eye—called the retina.

The retina is the most important part of the eye as it is responsible for collecting wavelengths of light and transmitting them to the brain from image processing and formation.

Without a healthy retina, you would not be able to see.

Dilation allows for more than just an evaluation of ocular health for things like glaucoma and macular degeneration, but also systemic health, as many systemic health diseases such as diabetes, strokes, multiple sclerosis (MS), hypertension, and others can be detected from careful evaluation of the eye.


Other Eye Exam Tests

There are several other tests your doctor may want to run depending on the situation and their findings. There are also variations to each of the tests listed above which can be used for children or individuals who may not be the best responders.

Regardless of what is going on, your eye doctor is here to help you and has your best interest at heart. They will answer all of your questions and guide you towards the best possible treatment for your individual set of eyes.


Our eye doctors at Neal Eye Group in Conshohocken, PA excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrists at (610) 828-9701 or schedule an appointment online if it is time for your eye exam.  Our optometrists provide the highest quality optometry services and eye exams in Conshohocken, Norristown, Plymouth Meeting, Lafayette Hill, and Philadelphia.

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