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As a patient, understanding the role and the services offered by each of these three eye care
professionals will help you get the specific eye care you need, know what questions to ask, and work
with your health care provider to determine appropriate solutions that work for you.

Optometrists

Optometrists perform eye exams to check the overall health of your eyes and issue prescriptions for contact lenses or glasses, or low vision devices. The optometrist will perform a number of tests including visual acuity (how well you can see letters/symbols from a distance and near), your ability to see colour, your depth perception, retinal health, the pressure inside your eyes etc. The optometrist may use eye drops to dilate your pupils to help them detect conditions such as glaucoma, cataracts and macular degeneration and more.

Ophthalmologists

An ophthalmologist is a medical doctor who specializes in eye health and related diseases. Ophthalmologists undergo post-graduate training that qualifies them to treat eye diseases both medically and surgically. Ophthalmologists provide surgical solutions to common eye problems such as cataracts, and monitor eye conditions like glaucoma as well as perform laser corrective surgery.

Opticians

Opticians fit, adjust and dispense prescription and non-prescription eyewear. They do not perform eye exams nor prescribe but can assist with filling your prescription, adjusting glasses, and ordering new/replacement contact lenses.

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Having an annual eye exam is a great way to not only take care of your eyes but your overall health as well. Eye exams can detect early signs of conditions such as diabetes and high blood pressure. Here are some tips to help you make the most of your next visit!

What to think about:

  • Have I noticed any eye problems such as blurry vision, flashes of light, floaters, redness, or double vision?
  • Are my daily activities being affected by my vision?
  • How do I take care of my contact lenses or glasses
  • Have I had any surgeries or injuries in my eyes that I could let the doctor know about?
  • Any family history of eye conditions such as glaucoma?

What to bring:

  • Your current glasses or contact lenses even if you have multiple pairs for different tasks
  • A list of your medications/supplements you are taking
  • Have someone who can drive you home or a method of transportation ready for if you have your eyes dilated. This happens often in yearly eye exams and can make you sensitive to light and have blurry near vision (~4-6 hours)
  • Vision and health insurance information

Questions to ask:

  • Differences between contacts and glasses for you and how this compares to surgery options as well?
  • If anything has changed in my ocular health since the last visit?
  • What any symptoms you may have mean and what you can do to prevent them from getting worse or resolve?
  • When should I return for my next visit?

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Cosmetic contact lenses or colored contact lenses may seem harmless but can lead to severe eye problems or loss of vision if not fit by an eye specialist. You need to have a prescription for contact lenses as they are deemed medical devices by the U.S. Food and Drug Administration (FDA). Non- prescription contacts can create problems due to issues such as poor fitting or unclean packing/creation.

When contact lenses not specifically fitted and sized for your eyes are worn, the cornea may be scratched, potentially leading to the following:

  • Painful corneal abrasion
  • Decreased vision
  • Redness, soreness, itching
  • Sensitivity to light
  • Allergic reactions
  • Corneal ulcers

Eye infections are also very common in non-prescribed contact lenses and may lead to the following:

  • Persistent eye pain
  • Decreased vision
  • Sensitivity to light
  • Discharge from the eye (this could be green/yellowish mucus like or more watery)

Discussing your options and proper contact lenses hygiene with an eye care professional, having the
proper measurements of your eyes taken, and getting a valid prescription is an easy way to avoid these
potentially life changing complications.

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Your visual field refers to the area in which you can see objects in all directions as you focus on a single central point. This test of your peripheral vision is simple, painless, and vital in diagnosing and tracking the progress of health conditions.

Are there different types of Visual Fields?

Confrontational Visual Field Test: The patient looks at an object in front of them with one eye covered. While looking at this object the patient will be asked how many fingers they see the doctor holding up in the patient’s periphery.

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Automated static perimetry test: The patient looks in the center of a bowl-shaped instrument called a perimeter. Lenses are placed in front of the patient’s tested eye while the other is covered with an eye patch. While looking at the center target, several flashes of light will appear in the patient’s periphery at which point they will use a clicker to indicate when they see them.

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Kinetic visual field test: Similar to above but now moving light targets are used instead of blinking lights.

Who needs a Visual Field Test?

Visual fields can be helpful in diagnosing, treatment plans for, and monitoring various conditions such
as:

  • Glaucoma
  • Multiple sclerosis
  • Thyroid eye disease
  • Strokes
  • Finding blind spots (scotomas)
  • Diabetes
  • Hypertension

Depending on your situation you may be recommended to take a visual field test again in a few weeks, a
few months, or a year.

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Almost everyone is guilty of spending an excessive amount of time on a screen and it is very common to feel symptoms of eyestrain and fatigue associated with digital use; this is known as Computer Vision Syndrome (CVS) or digital eye strain. As the name implies, excessive screen use causes stress on your eyes after reading or staring at a digital device for hours at a time. Some common symptoms of computer vision syndrome include eyestrain, headaches, dryness of the eyes, neck pain, and blurred vision over time.

Since it is unrealistic for us as optometrists to expect patients to avoid computers or excessive screen time, what are some ways to alleviate symptoms and avoid exacerbation of CVS? It is helpful to assess your desk or workstation for proper lighting and working distances. It is also important to be mindful of one’s posture throughout the day and ensure you are wearing proper visual correction such as glasses or contacts to avoid further eyestrain.

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Tips for avoiding eye strain

  1. Decrease the brightness of your screen
  2. Avoid letting yourself get closer to the screen throughout the day
  3. Take breaks (every 20 minutes look at something 20 feet away for 20 seconds)
  4. Wear an office or anti-fatigue lens while working
  5. Remember to blink consistently
  6. Stay hydrated

Following these simple tips will not only improve the way your eyes feel, but will naturally improve productivity, efficiency, and well-being throughout the day.

It’s not the most comfortable experience, but…

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Dilation is a crucial component of your eye exam. Dilating drops enlarge your pupils to allow more light to enter the eye, giving the doctor a better view of the interior and back of your eye. Think of it as looking through a keyhole – the larger and wider the keyhole, the more you can see into the room behind the door.

Why is dilation important?

  1. It enables your optometrist to more accurately determine your prescription by unmasking the effect of accommodation.
  2. It helps to identify eye conditions in children, such as amblyopia (lazy eye).
  3. It helps detect retinal conditions, glaucoma, and other neurological conditions
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If it’s so important, why isn’t it done in every eye exam?

Although it is recommended for everyone, dilation is not absolutely necessary for all patients and situations. Dilation can cause blurry near vision and light sensitivity for several hours after the drops are applied. To determine if dilation is needed and appropriate, your optometrist considers several factors:

  1. Age. The risk of eye diseases increases with age, so dilation is highly recommended for adults/seniors. In children, it helps to determine a more accurate prescription that is not masked by their accommodation system.
  2. Ocular history/ Family history. Having a history of eye diseases can predict your risk for developing certain conditions. Genetics plays a role in many ocular diseases.
  3. Overall health. Diabetes, high blood pressure, and other systemic conditions increase the likelihood of developing eye problems.
  4. Presenting symptoms. Symptoms that draw patients into the exam room may warrant a dilated exam. Flashes, floaters, or curtain veil over vision warrant immediate dilation, as they can be a sign of a serious condition.
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Uveitis is inflammation inside your eye that usually occurs when your immune system fights an infection. It can also happen when your immune system attacks healthy tissue in your eye. Uveitis affects the middle layer of the eye, called the Uvea, resulting in white blood cells and proteins leaking. It can affect one eye or both eyes. Uveitis can affect anyone, but it is most common in people aged 20 to 60.

What are the symptoms of uveitis?

  • Blurry vision
  • Decreased vision
  • Eye pain
  • Red eyes
  • Sensitivity to light
  • Floaters

There are different types of uveitis.

  1. Anterior Uveitis: affects the iris (colored part of the eye) and is the most common type that affects the front of the eye
  2. Intermediate Uveitis: affects the middle of the eye
  3. Posterior Uveitis: affects the back of the eye
  4. Panuveitis: affects all parts of the eye

What causes uveitis?

The cause of uveitis is not always known. Infections, systemic inflammatory diseases, or an eye injury can all cause uveitis. Smoking cigarettes can increase the risk of uveitis.

How is uveitis treated?

Your optometrist will most likely prescribe two eye drops: a steroid to reduce inflammation, and an eye drop to dilate the pupil to help with the pain and swelling. Uveitis can lead to permanent vision loss; therefore, early diagnosis and treatment are essential to prevent complications and preserve vision.

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Macular degeneration is a condition that affects our macula – the spot on our retina responsible for crisp central vision and color vision. As we age, debris can build up in the macula and create deposits known as ‘drusen’. The drusen are the first signs that macular degeneration are present and can cause blurry vision and distortion to one’s vision.

Symptoms to look out for:

  • Visual distortion (straight lines seem bent)
  • Trouble adapting to low light (eg. when entering a dark room)
  • Reduced intensity/ brightness of colors
  • Need for brighter light when reading/working
  • Blurriness of printed words
  • Difficulty recognizing faces
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Who gets macular degeneration?

This condition is most common in patients over 60 years old. Some other risk factors are those with high blood pressure, family history, smokers, Caucasian patients, cardiovascular disease, and obesity.

How can I prevent macular degeneration?

Maintaining a healthy lifestyle, including diet and exercise is the best way to ensure your eyes stay healthy for as long as possible. The AREDS 2 study has shown that certain vitamins are beneficial in preventing the progression of macular degeneration, however, these vitamins have the best effect in patients who have already began to show signs of macular degeneration.

It is important for everyone to get their eyes examined yearly in order to be able to see as clearly as possible, as well as check for any signs of eye disease or conditions that can affect one’s overall health in addition to the eyes.

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What is a cataract?

If we are lucky to live long enough, we will develop cataracts. A cataract is a clouding of the lens in our eye. Think about the process of cooking an egg, instead of being clear, the egg becomes white and cloudy.

Similarly, our lens becomes white and cloudy due to damage from the sun and UV rays. This is why it is important to wear sunglasses, hats, and UV protection when we are outside. These preventative measures can slow or delay the process of developing cataracts.

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How will I know when it’s time to remove a cataract?

When vision is substantially affected, usually 20/40 or worse, or when it becomes difficult to drive at night due to glare from headlights, along with the appearance of the cataract itself, is when your optometrist will recommend surgical removal of the cataract.

Can cataracts be prevented?

Unfortunately, there is no way to predict who will get cataracts at what age, and how fast they will progress, but the best way to delay the development of cataracts is to wear sunglasses, and use UV protection when outdoors. Fortunately, cataract surgery is an elective surgery that is not urgent. Overall, cataracts are very common diagnoses and are not a big cause for concern.

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Blinking is an involuntary reflex which does not require much thought throughout our day. Even though blinking seems simple, it is very important. And believe it or not, there is a correct way to blink.

Why is blinking so important?

  • Protects our eyes from debris and foreign objects
  • Creates a smooth surface for light to enter our eye and land on our retina for clear vision
  • Keeps our eyes moist and spreads tear film evenly

The 20/20/20 Rule

Our blinking pattern can be disrupted throughout the day when we are staring at a screen for too long and doing continuous near work. Optometrists recommend the 20/20/20 rule for everyone, especially those with too much screen time. The 20/20/20 rule means taking a break every 20 minutes to look 20 feet away for 20 seconds.

There is a right way to blink

We want to ensure that when we blink, it is a complete blink. This means that our top eyelid should touch our bottom eyelid. It is very common for people to blink only halfway or not close their eyes completely while asleep. This can be a problem since it exposes the bottom half of our eye and does not allow our tears to be expressed as efficiently. As you may guess, this leads to dry eye symptoms.

Incorporating the 20/20/20 rule and being more conscious about the way we blink can go a long way in helping our eyes feel less dry throughout the day.