Your first ophthalmologist exam: what to expect

Having your eyes checked by an ophthalmologist is an important part of caring for the health of your eyes. If you have never visited an ophthalmologist, here’s an overview of what you can expect in a typical eye exam.

An ophthalmologist will begin by examining your eyes, either with a handheld ophthalmoscope like the one used by an optometrist or with a similar device that uses a handheld lens and a light attached to a headband. The second method, called indirect ophthalmoscopy, allows a better view of the inside of the eye. The light is much brighter than in an ordinary ophthalmoscope, so you may see more after-images.

For detailed eye examinations, the ophthalmologist will likely use special drops to enlarge your pupils and allow for a better view. The drops may sting a little as they go in and cause a funny taste in your mouth because they mix with tear fluid that drains into your nose and then into your throat. But don't worry – this is normal.

During your exam, the ophthalmologist may use a test called a fluorescein angiogram, which also involves dilating the pupils and is used to check for some types of retinal disease. A fluorescent dye is injected into a vein in your arm and travels rapidly to your eye, where it stains the blood vessels. The ophthalmologist will then take a series of photographs of your retina using a very bright light. These photographs will reveal the state of your retinal blood vessels and give vital clues about conditions such as diabetic retinopathy and macular degeneration.

The ophthalmologist may examine your eyes with an instrument called a slit lamp – a binocular microscope tilted on its side. This instrument is used to investigate disorders related to the outside of the eye, such as corneal abrasions, excessive eye watering, dry eyes, conjunctivitis and eyelid problems, or to look inside the eye for cataracts or other complications that need an enhanced view. During this examination you will sit in a chair with your chin and forehead resting on supports as you look through a slit. The ophthalmologist will illuminate your eye with a variable beam of light from the instrument, which will provide a three-dimensional image of your eye.

It is always best to take someone with you to your ophthalmologist appointment. You will be told in advance if eye drops are going to be used to dilate your pupils because your vision will be blurred for a few hours afterward and so you must not drive. Also remember to bring sunglasses. Even if it's rainy and overcast, sunglasses will help you avoid becoming dazed after your appointment, which is a possibility since dilated pupils let in more light than normal.

While it may involve unfamiliar equipment and procedures, an ophthalmologist exam is nothing to be afraid of. Once you have undergone a detailed examination, you and your ophthalmologist will be able to begin planning the best course of action to protect your sight and preserve the health of your eyes.