Eyesight test by an ophthalmologist or optician?

Therefore, it is important that you regularly check whether your eyesight has changed. Perhaps you are squinting your eyes to watch television or drive, or perhaps you have difficulty reading labels in the supermarket. You may also experience tension headaches and sore neck muscles during the day. This could be a sign that you are tense because your eyesight is not as it should be.

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Eyesight test by an optician or an eye care specialist?

In short, the biggest difference between having your eyesight examined by an optician or an eye care specialist (ophthalmologist) is that an eye care specialist focuses on the health of your eyes, while an optician focuses on the optimal function of your eyesight. If you experience that your eyesight is no longer optimal, you can start by consulting an optician. If the optician cannot help by giving you glasses or contact lenses, you should always see an eye care specialist.

Both the optician and the eye care specialist will start by measuring your eye's optical strength with a so-called autorefractor.

The optician

The optician can help you decide whether you need glasses or contact lenses, and if so, what kind. Many opticians offer free eyesight tests. Others charge a fee, which in many cases will be deducted from the price of the glasses if you buy a pair after your test.

You usually need to book an appointment for an eyesight test in advance, and you can often do this online. Before your eyesight test, the optician will ask about the problems you are experiencing with your eyesight, and what you would like to get out of your visit. Then, the actual eyesight test will begin, and the optician will determine your visual acuity, how well you can expect to see, and the strength of the glasses you may need.

Eyesight test by an optician

The optician will use a so-called decimal chart to assess your eyesight. This is a chart with numbers and letters in different rows, with the largest letters and numbers at the top and the smallest at the bottom. You look at the chart through an instrument called a phoropter which measures your eyes' visual acuity, identifies astigmatism and determines whether your are short-sighted or long-sighted using various lenses. The optician will also measure the distance between your pupils to assess where the eyeglass lenses are to be placed in the frame. If necessary, the optician will do more tests, and if the optician comes across any problems that he or she cannot help you with, the optician will recommend that you consult an eye care specialist (ophthalmologist).

The eye care specialist

The country in which you live will determine the rules for when you are to see an eye care specialist. In some countries you have to pay for a consultation with an eye care specialist. In other countries it is part of the public health service. No matter whether you have to pay, you will have one or several of these eyesight tests and examinations when you consult an eye care specialist.

Different eyesight tests by an eye care specialist

Visual acuity and visual field
Eye care specialists use an eye chart to measure visual acuity, also known as visus, acute vision or central vision. Visual acuity is not the same as optical strength, and reduced visual acuity does not necessarily mean that you need glasses. Reduced visual acuity may also be caused by different types of eye disease.

After measuring visual acuity, the eye care specialist may examine your vision field, also known as ambient vision and peripheral vision, if there is a suspicion of any disease. In short, you use your central vision when reading a book, and your ambient vision enables you to register what is behind the book, even though you are not focusing on it. In other words, ambient vision enables you to "see out of the corner of your eye", and central vision enables you to see details.  The eye care specialist will test how far you can follow a finger or a pen, for example, without moving your eyes. In some cases, the eye care specialist will use a special instrument for the examination.

Slit lamp examination

A slit lamp is a microscope with a slit-shaped light source that can rotate. The eye care specialist uses the slit lamp to examine the mucous membrane, tear film, cornea, iris and lens of the eye as well as the front of the vitreous body, and with a special lens, also the inner part of the eyeball, especially the retina.

Measuring fluid pressure inside the eye

Various diseases, such as glaucoma, can cause the fluid pressure (intraocular pressure) in the eye to rise. You rarely feel the increased fluid pressure in your eye, which at worst can cause damage to the optic nerve if not discovered and treated in time.

The eye care specialist can measure the pressure in your eye in two ways: Either by first applying a local anaesthetic (eye drops) and then gently pressing on the cornea of your eye using a special instrument, or by measuring the pressure in your eye using a tonometer that puffs air onto the cornea. Both methods are painless and take only a few seconds.

Ophthalmoscopy

An eye care specialist uses an ophthalmoscope to examine the eye's retina and optic nerve. The ophthalmoscope sends light through the pupil, so the eye care specialist can see inside the back of the eye. The eye care specialist will often use a strong lens together with the slit lamp to see the structures of the eye in 3D.

Photographing the retina

Photographs of the retina are taken with a fundus camera – often after dilating the pupils with eye drops. In addition to photographing the retinal surface, it is often possible to take a cross-sectional scan image of the retina using an OCT scanner.