What Does an Eye Exam Consist Of?

What does an eye exam consist of or what is a routine eye exam is what we will discuss here. I will dive into what diseases can be detected during an eye exam. Along with other common questions like what not to do before an eye exam. This is a topic that was discussed quite a bit in 2018 during the November election in the SQ 793 vote.

An eye exam consists or should consist of 5 main areas of concern;

  • Monocular or one eye visual analysis of each eye
  • Eye teaming or binocularity
  • Health analysis of the front of the eye
  • Health analysis of the back of the eye
  • Check for glasses prescription

Monocular visual analysis

So, the first thing that we will discuss is the eyes working independently. This will be done by checking your vision off in the distance. This is the 20/20 or 20/50 type reading letters of the exam. The top number is referring to how far away you are from the letters and the bottom number is referring to how far the average person can see that letter. In other words, if you see 20/50 then if you are 20 feet away from the letter then the average person can see that letter 50 feet away.

Eye Teaming or Binocularity

Your eyes will be checked to make sure they are working together. In other words your eyes should be checked to make sure the eyes not only work well on their own, but that they can also work good with each other. This will be done by having you follow some objects and covering and uncovering the eyes. Sometimes if there are problems noted on those tests then some more extensive checks will be gone with glasses.

Health Analysis of the front of the eye

There will be several things looked at on the front part of the eye. The Doctor will look at the surface for signs of dryness, inflammation, and irritation using a microscope. The Eye Doctor will also look for cataracts and inflammation on the inside towards the front of the eye. This again will all be done with a microscope called a slit lamp. Sometimes the inflammation found can be caused by diseases like rosacea, arthritis, lupus, sjogrens, ankylosing spondylitis, or multiple sclerosis to name a few. The analysis of the front of the eye may be done with or without any dyes or eye drops. There are more diseases that are checked for, but thankfully most have healthy eyes.

Health Analysis of the back of the eye

Nowadays almost every Doctor has the ability and medical equipment to take an image of the back of the eye. If the person you are having check your eyes doesn’t have that equipment I would encourage seeking out someone else. That is pretty standard clinic and could be a big red flag that the Eye Doctor isn’t up to date on new developments and current research. Most places will charge a small fee to do the images of the back of the eye, but the data given is well worth the small fee.

However, if you choose not to do the images or scans they can still dilate the eyes to get a look at the back of the eye or the retina and optic nerve. This is where the Optometrist or Ophthalmologist can look to find things like Diabetes, glaucoma, macular degeneration, or sometimes even brain tumors. Thankfully of the roughly 30,000 examinations I have done in my career I have only diagnosed 1 brain tumor, but that is still 1 more than I would have liked to find. I do however see a thing called pseudotumor cerebri fairly regularly. That is usually remedied with some oral medications, but something that I have seen 100’s of times already.

Check for Glasses During Eye Exam

At some point during the eye exam they will check to see if glasses would help the vision. The Eye Doctor will make sure that the glasses work good for both off in the distance and up close. The Eye Doctor will also make sure they don’t need to add anything special to the glasses to help with the eyes working together. The glasses portion is all about physics and won’t make the vision better or worse they will just clear up the vision.


This is just a quick over view of some of the things found during an eye exam. We also talked broadly about what an eye exam consists of. Thank you for reading. Lastly, if you would like to make an appointment with us we would love to check your eyes.

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Dr. Thirion

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