Eyeglass Guide 2.0
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What to Expect in your Eye Exam
Taking care of your eyes and getting regular examinations can prevent many leading causes of blindness. Learn what you can do to preserve your sight at any stage of life. Many eye diseases and disorders become more common as we age. Advances in ophthalmology allow most people to maintain good vision as they grow older. Many eye problems can be prevented or corrected if detected in their early stages. Regular eye examinations by an ophthalmologist (Eye M.D.) are the best way to detect eye conditions early, while they can be treated. 
What to Expect
As with all medicine, early diagnosis and treatment can help people with their overall health. Just as with a physical, it makes sense to visit an ophthalmologist (Eye M.D.) for a routine eye exam. A series of tests will be performed to assess acuity, refraction and potential eye disease. Your Eye M.D. will begin by asking a series of questions about your medical and eye health history, including any noticeable eye problems. Next he or she will evaluate your visual acuity by determining the smallest letters you can read on a standardized eye chart.
Your Eye M.D. will also test for refractive errors. A refractive error means that the shape of your eye doesn't refract the light properly, so that the image you see is blurred. Although refractive errors are called eye disorders, they are not diseases.
There are four types of refractive error:
Myopia (nearsightedness): Close objects look clear, but distant
objects appear blurred.
Hyperopia (farsightedness): Where distant objects will look clear
but close objects are blurry
Astigmatism: Vision is blurred for both near and far objects.
Presbyopia: The eyes gradually lose the ability to change focus
from distance to near.
Many people will have one or more of these refractive errors.
To correct a refractive error, an Eye M.D. may recommend glasses, contact lenses, or refractive surgery.
In addition, an Eye M.D. will test:
- Eyelid health and function
- Coordination of eye muscles
- Pupil response to light
- Side, or peripheral vision
- Intraocular pressure, the pressure inside the eye
- Anterior segment of the eye, the area in from of the lens,
including the cornea and iris
- The interior and back of the eye, including the retina
After the examination your Eye M.D. will discuss the results with you. If there is any eye disease, treatments with medication, including eye drops, may be recommended.
In some cases, certain eye diseases require laser surgery or other surgical procedures. Some of the treatments are taken care of by your regular Eye M.D. Or, you may be referred to a subspecialist, such as a cornea or retina specialist.
Recommended Intervals for Regular Eye Exams
If you have any of these risk factors for eye problems, you may need to see your Eye M.D. more often than recommended below:
- Family history of eye problems
- African American over age 40
- Diabetes
- History of eye injury
Before Age 3
Since it is possible for your child to have a serious vision problem without being aware of it, your child should have his or her eyes screened during regular pediatric appointments. Vision testing is recommended for all children starting around 3 years of age.
If there is a family history of vision problems or if your child appears to have any of the following conditions speak to your Eye M.D. promptly about when and how often your child's eyes should be examined:
- Strabismus (crossed eyes)
- Amblyopia (lazy eye)
- Ptosis (drooping of the upper eyelid)
Age 3 to 19
To ensure your child or teenager's eyes remain healthy, he or she should have his or her eyes screened every one to two years during regular pediatric or family physician check-up appointments.
Age 20 to 39
Most young adults have healthy eyes, but they still need to take care of their vision by wearing protective eyewear when playing sports, doing yard work, working with chemicals, or taking part in other activities that could cause an eye injury.
Have a complete eye exam at least once between the ages of 20 and 29 and at least twice between the ages of 30 and 39.
Also, be aware of symptoms that could indicate a problem. See an Eye M.D. if you experience any eye conditions, such as:
- Visual changes or pain
- Flashes of light
- Seeing spots or ghost-like images
- Lines appear distorted or wavy
- Dry eyes with itching and burning
Age 40 to 64
As of July 2007, the American Academy of Ophthalmology has issued a new eye disease screening recommendation for aging adults.
The Academy now recommends that adults with no signs or risk factors for eye disease get a baseline eye disease screening at age 40the time when early signs of disease and changes in vision may start to occur. Based on the results of the initial screening, an ophthalmologist will prescribe the necessary intervals for follow-up exams.
For individuals at any age with symptoms of or at risk for eye disease, such as those with a family history of eye disease, diabetes or high blood pressure, the Academy recommends that individuals see their ophthalmologist to determine how frequently their eyes should be examined.
The new recommendation does not replace regular visits to the ophthalmologist to treat ongoing disease or injuries, or for vision examinations for eye glasses or contact lenses. Much like mammograms at 40 or colon screenings at 50, this new eye disease screening is a reminder to adults as they age that they need to maintain their eye health.
Why the New Recommendation?
A baseline evaluation is important because it may detect eye diseases common in adults aged 40 and older. The evaluation creates greater opportunity for early treatment and preservation of vision.
A thorough ophthalmologic evaluation can uncover common abnormalities of the visual system and related structures, as well as less common but extremely serious ones, such as ocular tumors. This evaluation can also uncover evidence of many forms of systemic disease that affect the eyes, like hypertension and diabetes. With appropriate intervention, potentially blinding diseases such as glaucoma, cataract and diabetic retinopathy often have a favorable outcome.
Several common eye diseases can impact people 40 and older without them knowing there is any problem with their eyes.
Age 65 and Over
Seniors age 65 and over should have complete eye exams by their Eye M.D. every one to two years to check for cataracts, glaucoma, age-related macular degeneration, diabetic retinopathy and other eye conditions.
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Understanding Your Prescription
Once you completed an eye exam and your vision needs correction your Eyecare Professional will help you choose lenses which are right for you. Eyeglass prescriptions are typically hand-written and full of abbreviations and numbers that are meaningful to Eyecare Professional but not all doctors format prescriptions the same way. The best way to understand your specific prescription is to go over it with your Eyecare Professional.
Abbreviations you may see on your prescription and what they stand for:
D.V. = distance vision
N.V. = near vision
O.D. = oculus dexter (Latin for right eye)
O.S. = oculus sinister (Latin for left eye)
SPH = sphere (numbers that indicate the degree you are near-sighted
or far-sighted)
CYL = cylinder (numbers indicating the amount of astigmatism you have)
AXIS = numbers indicating the orientation of your astigmatism
Prism = prescription element added if your eyes need help working more
effectively together or staying in proper alignment
PD = pupillary distance (measures the distance between your pupils to
ensure your prescription is properly placed in your frames.
Seg Height = measures where your lenses and frames sit relative to
your pupils when fitting multifocal lenses.
We recommend you discuss your specific prescription with your Eyecare Professional so you fully understand the prescription and its implications.
Common Correctable Vision Conditions
Some vision conditions are correctable through eyeglass lenses. The most common of these are:
Myopia (near-sighted) vision condition that results in clearly seeing objects near to you, but seeing objects far away less clearly
Hyperopia (far-sighted) vision condition that results in clearly seeing objects in the distance, but seeing objects close-up less clearly
Astigmatism the result of an irregular curvature in the eye that affects the way the eye processes light resulting in slightly blurred vision
Presbyopia this progressive condition is a natural part of aging and is generally believed to be caused by a gradual lack of flexibility in the eyes lens. Presbyopia is a decrease in the ability to focus sharply on nearby objects and often results in the need to use magnifying reading glasses,
bifocals, or progressive lenses
Other Vision Conditions
While not all correctable through eyeglass lenses, some other vision conditions to be aware of include:
Amblyopia (lazy eye) in young children, is reduced vision in one eye from poor transmission between that eye and the brain
Color Deficiency (color blindness) is a lack of ability to distinguish certain colors. The most common form is the inability to distinguish shades of red and green
Nyctalopia (night blindness) is impaired vision in dim light or darkness
Strabismus (crossed eyes) in young children is a lack of coordination between the eyes, such as one or both eyes turning in, out, up or down
Photophobia (light sensitivity) also called this condition can have many underlying causes and can be prompted by many medications. Protection from UV radiation is critical for anyone with this condition
Prism is a prescription element added if your eyes need help working more effectively together or staying in proper alignment
We recommend you discuss your specific vision condition with your Eyecare Professional so you fully understand if it can be corrected with eyewear or refered for further evaluation.
Be Safe and Prevent Eye Injury
More than one million people suffer eye injuries each year in the United States. Appropriate protective eyewear could prevent ninety percent of these injuries. Choose protective eyewear with "ANSI Z87.1" marked on the lens or frame which means the glasses, goggles, or face shield meets the American National Standards Institute (ANSI) safety standard.
Follow these tips to protect your eyes:
In the house
When using household chemicals, read instructions and labels carefully, work in a well-ventilated area and make sure to point spray nozzles away from you. Many chemicals are extremely hazardous and can permanently destroy the surface of your eyes, resulting in blindness.
In the workshop
Think about the work you will be doing and wear protective eyewear to shield your eyes from flying fragments, fumes, dust particles, sparks and splashing chemicals. Many objects can fly into your eyes unexpectedly and cause injury.
In the garden
Put on protective eyewear before you use a lawnmower, power trimmer or edger and be sure to check for rocks and stones because they can become dangerous projectiles as they shoot from these machines.
In the workplace
Wear appropriate safety eyewear for your job. Many of the thousands injured each day didn't think they needed eye protection or were wearing eyewear inappropriate for the job.
Around the car
Battery acid, sparks and debris from damaged or improperly jump-started auto batteries can severely damage your eyes. Keep protective goggles in the trunk of your car to use for those emergencies and everyday repairs.
During sports and recreation
Boxing and full-contact martial arts pose an extremely high risk of serious and even blinding eye injuries. There is no satisfactory eye protection for boxing, although thumbless gloves may reduce the number of boxing eye injuries. Contact lenses offer NO PROTECTION, and contact lens wearers require additional protection when participating in sports.
Protect Your Eyes From the Sun
Like your skin, your eyes never forget UV exposure. Studies show that exposure to bright sunlight may increase the risk of developing cataracts and age-related macular degeneration (AMD), both leading causes of vision loss among older adults. UV exposure, wind and dust can also cause pterygia, benign growths on the eye's surface. Select sunglasses that block ultraviolet rays. Don't be deceived by color or cost. The ability to block UV light is not dependent on the darkness of the lens or the price tag.
Learn more about UV damage and your eyes
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