“What exactly goes on in a comprehensive eye exam?” you ask. Here is the most raw and first hand account on what happens behind closed doors...
I’d welcome you into my exam room. We may chat about that film you recently watched at VIFF. I would ask you what is bothering you about your eyes or vision. I know you secretly think that you are going blind from staring at the screen too much. Usually that’s not the case and I’d offer my professional words of comfort to calm you down.
First, we determine what your vision is, physiologically not philosophically, although sometimes we do get into that. Then, the riddle comes. I put you behind this device and ask you repetitive questions. I give you two choices that are similar and ask you which one looks better to you.
Sometimes, you start experiencing shortness of breath and sweaty palms. It's like your first school dance all over again. You're afraid to be rejected, that I would tell you that you made all the wrong choices or that you are horrible at this game that no one likes to play.
The truth is: there is no right or wrong. You are not stuck with a bad glasses prescription because you thought you did badly. It is my job to make sure that it is not the case. Don't think of it as a challenge that you need to "pass". Think of it as a dance, the pleasant kind, where you just take my lead and we can both have fun.
After our dance, we would have the discussion whether or not you should get the dilation eye drops. This conversation sometimes can be like a child negotiating to eat vegetables or not. “It’s good for you! I would check the health of the back of the eye to make sure there are no retinal tears or breaks and that all the blood vessels are healthy!” I’d tell you. You’d counter with the argument that you need to go back to work or you are horrible with eye drops. We usually reach a deal where I promise the eye drops would be instilled as quickly as superhumanly possible or we would reschedule the dilation for another time where you bring a driver or support animal with you. It is true. The eye drops knock out your focusing ability that prevents you from seeing things clearly, especially for things close up. I am not giving you any ideas but I’ve seen it being used as an excuse to get out of work or dates.
I would also do that air puff test that you love so much for eye pressure. Sometimes, negotiation happens here too. Usually, it happens so quickly that it’s already done before you know it. After your pupils are nicely dilated like those of festival goers, I then proceed to look deep into your eyes with this bright light. It’s blinding like the truth. It’s yellow in colour and sometimes I’d switch between blue and green light too. I would take a deep look into your eyes as you look in different directions like I’m peaking into your soul. Sometimes, you’d ask me curiously or nervously, “What are you looking for?”. The truth is: I don’t want to find anything. This is the only time you want to be “unremarkable”. I want to find your macula being immaculate with no deposits, no tears/breaks on your retina, and your optic nerve looks like a healthy donut. As an eye doctor, I want to be able to tell you that we don’t need to worry about cataracts, glaucoma, retinal changes etc. Usually everything is good despite your last eye exam being more than 2 years ago (lucky you!). Sometimes, I could find little buggers during your eye exam that need extra attention. Not to worry. I would just treat, follow up or refer to specialists as needed. Either way, the outcomes of our visits are usually cheerful where you share with me how your passion project is taking off and I show you the new Samba vinyl I got.
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