Q: I am one of those people who puts off my eye exam because I just hate that air puff test and when my eyes are dilated, my whole day is ruined. Any suggestions?
A: Yours are very common concerns. You may be surprised to learn that most eye clinics now no longer use the “dreaded air puff” test for glaucoma! Some do, so you may need to call ahead to be sure your eye doctor’s office is not “behind the times”. Now days, a more accurate measurement of eye pressure is obtained with a new instrument that has no air puff, and causes no feeling of anything touching your eyes! This hand held instrument does not require any anesthetic eye drops, and can be used for anyone...even kids or people unable to get up into the exam chair.
Secondly, while we do still use eye drops to dilate eyes for certain diseases, generally most people now can opt for a better option. We, like many offices, recommend “retinal scanning” to give us a full interior image of each eye...without any eyedrops at all! These retinal scans provide a large “edge to edge” view of the interior of your eyes, and give us the option to zoom in for more detail in certain areas like the optic nerve. This technology also allows us to selectively “see” through different layers of the retina, unlike traditional photos or dilation that only show us the surface of the retina. The bottom line: you can usually finish your eye exam and go on with your day with normal pupils (no more painfully bright sunlight ) and with normal focusing ( no more blurry vision up close for an hour or more).
I should add, we do still use dilation eye drops to enlarge the pupils for a better view when caring for patients with certain eye diseases and for eye effects of systemic disease. Common examples would be for diagnosis and/or treatment of patients with macular degeneration, some glaucoma cases, and for many patients with diabetes (as that can cause blood vessel leakage or bleeding inside the eye). Generally, we try to provide an initial eye exam without dilation first so each patient can plan for dilation drops on a day that would be less disruptive. Some people even prefer to come with someone to drive them home, if their vision is too blurry afterwards to drive safely.
In these days when not all eye exams are the same, I would advise to call ahead and ask a few questions before you schedule your exam. You may find that the scope and depth of medical testing varies quite a bit in an “eye exam” from one office to the next. Eye exams should be easy and informative, and not a dreaded process you avoid.