Dilated Eye Exam: Procedure, Effects And Benefits

What is a dilated eye examination? 

A complete eye exam includes a dilated eye exam as part of which an eye doctor tests your vision, establishes your vision prescription (if required), and evaluates the health of your eyes. 

When your pupils are dilated during the dilated portion of the eye exam, your eye doctor can use magnifying glasses and special lighting to get a better look at your retinas and optic nerves.

Why have an eye exam?

A crucial component of your routine health maintenance program should be an eye check. Testing sessions for the eyes can identify conditions unique to the eyes, such as glaucoma, cataracts, impaired vision, and age-related macular degeneration.

However, eye exams do more than just identify eye problems. "The eyes are the window to the soul," according to an old saying, and when it comes to health, the eyes may also indicate potential problems. The American Academy of Ophthalmology (AAO) claims that a routine eye exam can identify a number of health issues.

Among those health problems are:

• illness of the thyroid, which may cause vision loss or loss of vision, dry eyes, or bulging eyes.
• Marks left by a stroke in the eye, which are indicative of heart problems.
• Inflammation of the optic nerve is a symptom of multiple sclerosis.
• The rear of the eye's blood vessels may flex or bleed, which is a sign of high blood pressure.
• Diabetes-related retinopathy, which affects the retina's blood vessels and can result in blindness, can impair vision.

How is a dilated eye exam conducted?

Your optometrist will administer several eye drops after evaluating your visual acuity. Your pupils will be stimulated by these drops and will either enlarge or contract. The enlarged "windows" allow your doctor to see more of the rear of your eyes since the drops prevent the pupils from constricting (becoming smaller).

The entire action of most dilating drops takes 20 to 30 minutes to manifest. Your doctor will use a variety of tools to evaluate the condition of the back of your eyes when your pupils have fully dilated. The retinas and optic nerves may be seen more clearly thanks to these technologies. 

The procedure to enlarge your pupils is uncomfortable yet painless. You will become sensitive to sunlight and suffer hazy vision once your pupils have dilated, mainly while looking at close-up things. 

Your eye doctor will examine the back of your eye and evaluate the condition of your eyes during a portion of the eye exam. However, this does not allow for a full view of the retina and the exam process may be hampered because pupils contract when exposed to light. 

Your eye doctor will have the best of all worlds when you dilate your pupils: a bright vision and a big pupil to examine the back of your eye.

Your eye's retina, optic nerve, and blood vessels are all located at the very back and should all be routinely checked for any indications of potential health issues. 

The retina and its blood vessels might show clinical symptoms of diseases including diabetes and high blood pressure. Your eye doctor can examine your eyes in great detail thanks to dilation.

When do I need a dilated eye exam?

During an eye exam, you are not required to have your pupils dilated. In the recent decade, technological advances have introduced alternatives to pupil dilation. Previously, pupil dilation was just part of the regular eye exam, but optometrists now have additional choices. Retinal photography, for example, may record pictures of the retina that were previously only visible with dilatation. 

It's becoming more typical for eye physicians to schedule a dilated exam if they're concerned about the possibility of certain significant eye disorders, such as: 

• Glaucoma 
• Diabetes-related retinopathy
• Cataracts
• Macular degeneration as we age

If you are at a higher risk of acquiring any of these problems, you may require extra treatment.

How frequently should you have your eyes examined?

Adults should undergo a thorough eye checkup once in their 20s and twice in their 30s, according to the AAO. But after you're in your 40s, you should have your eyes checked every five to ten years. Every one to two years, older persons should normally undergo an eye checkup. If you wear glasses or contact lenses, have had eye surgery, have sustained eye damage, or have a history of eye disease in your family, you may require eye exams more frequently.

If you have diabetes, how often of your eye checkups may vary. The American Diabetes Association suggests that persons with type 1 diabetes get a full eye checkup within five years of being diagnosed. Once diagnosed, those with type 2 diabetes should undergo an eye checkup. Following that, everyone with diabetes should have a comprehensive eye exam at least once a year, and more frequently if there are any problems.

Optomap eye examinations

The Optomap retinal exam is the most common alternative to a dilated eye exam. This allows your doctor to examine the back of your eyes without dilating them. 

A laser is used in optomap technology to digitally take a picture of your retina. This is superior than a dilated eye exam because the photos provide your doctor with a more lasting view of your eye health. These photos may be used in future eye health exams to track the advancement of a variety of visual disorders. 

Optomap examinations are not usually covered by vision insurance, so check with your insurer and your doctor to see which choice best fits your plan and health needs. 

Why are diabetic eye examinations so important?

Your health care physician or diabetes care team has most likely strongly advised you to get an annual diabetic eye exam (also known as a dilated or complete eye exam) at least once a year, if not more frequently. One of the key reasons for this suggestion is that patients with diabetes are at risk for a devastating condition known as diabetic retinopathy.

According to the National Eye Institute (NEI) of the National Institutes of Health (NIH), "Diabetic retinopathy is an eye condition that can cause vision loss and blindness in people who have diabetes." It damages blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye)."

An yearly eye exam can help detect diabetic retinopathy early on, even before symptoms appear. Diabetic retinopathy can also lead to other significant complications, such as:

• Diabetic macular edema is a condition in which blood vessels in the retina leak into the macula, producing visual impairment.

• Neovascular glaucoma occurs when aberrant blood veins develop out of the retina and obstruct fluid drainage from the eye, resulting in glaucoma.

• Scars from retinopathy pull the retina away from the back of the eye, resulting in retinal detachment.

There are therapies for diabetic retinopathy, according to the Joslin Diabetes Center, but the sooner it is discovered, the more successful the treatment is at preventing vision loss. This is why annual thorough eye examinations are so critical for diabetics.

 Also read: Dry Eye: Causes And Treatment

What effect does dilation have on your vision?

Your pupils will normally remain dilated for four to six hours, much beyond the duration of your eye test. This involves navigating the bright outside environment when your eyes are still dilated.

While the pupils remain dilated, the dilating drops used inhibit your focusing system, resulting in blurred vision up close. 

Because your large pupils let in more light, you will be more sensitive to bright sunlight. Bring sunglasses to wear after your consultation to assist you cope with the light sensitivity. If you forget, your doctor can provide you with temporary sunglasses to wear at home. 

If their hazy vision and light sensitivity make driving difficult, some patients prefer to have someone drive them to their eye visit.