Primary Care

Comprehensive eye examinations are provided in the Primary Care Clinic. High quality optometric services are provided in a manner and with the skill that is consistent with the best interest of the patient.

The goals of a comprehensive eye and vision examination are to:

• Evaluate the functional status of the eyes and vision system, taking into account special vision demands and needs
• Assess ocular health and related systemic health conditions
• Counsel and educate the patient regarding his or her visual, ocular, and related systemic health care status, including recommendations for treatment, management, and future care

A comprehensive history will be taken at your appointment to obtain specific information about your eye and vision status and important medical background information. During this initial component of the examination, the optometrist and student have the opportunity to identify and assess problem areas as well as become acquainted with you to establish a relationship of confidence and trust. The patient history includes:

• Nature of the presenting problem
• Visual and ocular history
• General health history
• Medication usage and medication allergies
• Family eye and medical histories
• Vocational and avocational vision requirements

Visual Acuity Measurement, to ascertain the clarity of the patient s vision or the ability of the visual system to resolve detail at all distances. A patient s visual acuity depends upon the accuracy of the retinal focus, the integrity of the eye s neural elements, and the interpretive faculty of the brain.

Preliminary Testing, to initially define the patient s visual function, ocular health, and related systemic health status. The preliminary tests include an assessment of ocular motility, binocular vision, and accommodation; the interrelationship of these functional aspects of vision is especially critical for clear, comfortable vision for reading and other close work. The following areas may be assessed:

• General observation of the patient s overall appearance and mobility
• Observation of external ocular and facial areas
• Neurological evaluation of pupil responses to light
• Extraocular muscle movements and eye tracking
• Binocular eye alignment
• Focusing skills
• Binocular depth perception
• Optomap retinal exam
• Color vision

Patients who present for a comprehensive examination may have an Optomap retinal exam completed. This cutting edge technology utilizes a scanning laser ophthalmoscope to record a 200 degree digital image of the retina so that any changes can be followed. The Optomap is an excellent educational tool since the digital image is available to the faculty doctor to more clearly explain any retinal changes to the patient. The Optomap represents a permanent digital documentation of each patient s retinal health.

Refraction, to determine the lens correction needed to provide optimal visual acuity for all viewing distances.? The refractive analysis may include:

• Measurement of the patient's most recent optical correction
• Measurement of the anterior corneal curvature (the shape of the front surface of the eye)
• Objective measurement of refractive status
• Subjective measurement of monocular and binocular refractive status at distance and near

Ocular Health Assessment and Systemic Health Screening, to contribute to the diagnosis of diseases and disorders that have ocular manifestations and to determine the impact of any systemic diseases on the eye and associated structures. It also includes assessment of the potential for ocular complications of medications used by the patient. Pharmacologic dilation of the pupil is generally required for thorough evaluation of the ocular media and posterior segment of the eye. The components of the ocular health assessment and systemic health screening may include:

• Evaluation of the anterior ocular segment and surrounding structures and tissues
• Measurement of intraocular pressure (one component of glaucoma testing)
• Evaluation of the lens for clarity or presence of cataract
• Evaluation of the ocular media
• Evaluation of the posterior ocular segment (including the retina and optic nerve)
• Visual field screening (peripheral vision and central vision awareness)
• Systemic health screening tests

Diagnosis and Treatment Plan, to assess and evaluate the data to establish a diagnosis and formulate a treatment plan. The treatment plan could include a recommendation for new eyewear, cosmetic or therapeutic contact lenses for the correction of refractive error and presbyopia, or refractive surgery. Vision therapy or prismatic spectacle corrections could be recommended for eye muscle problems. Therapeutic pharmaceutical agents for topical use in the eye could also be included in the treatment plan. In some cases, referral for consultation with or treatment by another faculty optometrist, the patient s primary care physician, or another health care provider may be indicated.

Patient Education, to review and discuss examination outcomes. Patient counseling and education may include:

• Review of the patient s visual and ocular health status in relation to his/her visual symptoms and complaints
• Explanation of available treatment options including risks and benefits
• Recommendation of a course of treatment with the reasons for its selection and the prognosis
• Discussion of need for any follow-up care and ongoing patient compliance of the treatment prescribed
• Recommendation for re-examination