Eye Exams Explained: What to Expect and What Your Doctor Looks for
Eye exams can feel mysterious—even intimidating—especially if you’re not sure what all the tests are for. Many people assume an eye exam is just about getting glasses, but in reality, it’s a comprehensive evaluation of both your vision and your eye health.
What Happens During Comprehensive Eye Exams
During an eye exam, your doctor isn’t just checking how clearly you see. They’re also assessing how your eyes work together, how well they focus, and whether there are early signs of conditions that may not cause symptoms yet. Some eye diseases develop silently, and an exam is often the only way to catch them early.
Understanding what happens during an eye exam—and why—can make the experience more comfortable and help you take a more active role in your eye health. Here’s what to expect, step by step, and what your eye doctor is really looking for along the way.
Intake Forms: YES They Matter!
The intake form is often your first chance to communicate with your eye doctor. This form will typically cover your demographic information such as your address and age, but will also include important questions about your health such as:
History of past illnesses or surgeries
Current ocular and medical conditions
Current medications
Whether or not you’re on birth control (yes this matters)
Other question that your eye doctor feels are important
Pre-Testing Machines
Some hospitals and doctor’s offices have a technician who will walk you through the initial testing before you ever see your doctor. In smaller offices, your doctor may do everything themselves. These tests generally measure:
Your vision with/without glasses at distance and near
Help obtain an estimate of your glasses prescription (this is the one with the house)
Help get an idea of how your eyes work together as a team
Check your eye pressure
Help your doctor get a general idea of your eye health
Some offices use imaging to help obtain detailed photos and scans of the back of the eye.
The exact amount and sequence of pre-testing can vary depending on the reason for your visit.
The One-of- Two
This part—called the refraction— is the part where your doctor has you look through lenses and asks you which one is better or worse, while also having you read some letters. The refraction is where your eye doctor uses the estimate as your starting point to fine-tune your glasses prescription.
The Health Check
Your eye doctor starts assessing your vision as soon as they look at your intake form and continues to gather information via the pre-testing. To get a better look at the different parts of your eye your doctor will have you sit behind a biomicroscope called the slit-lamp. This allows your eye doctor to get a magnified view of ocular structures and to assess everything from the back of your eye (using a specialized lens) to whether or not you have Demodex mites in your eyelashes—- many people do!
While the examination might not seem like it’s taking a long time, your eye doctor is really assessing every part of your eye including your ocular surface, lens, iris, and optic nerve. In some cases, your eye doctor may perform additional assessment or testing based on their initial findings.
What Happens During a Contact Lens Exam?
During a contact lens exam, your eye doctor will generally first perform a comprehensive exam including all of the above components. However, a contact lens exam will also include selection of contact lenses based on your needs and previous experience.
If you are a new contact lens wearer, the contact lens exam will include training to help ensure that you can safely insert and remove your lens.
If you are an experienced contact lens wearer, your eye doctor will ask you about the type of lenses you wear now and what you like or don’t like about them.
During a contact lens exam, your eye doctor will also evaluate your eyes for contact-lens-related complications such as corneal ulcers, or neovascularization. If these are present you may need to take a break from contact lens wear.
Finally, your eye doctor will select a contact lens for you to try that best matches your prescription and assess that lens on the surface of your eye. Here, your eye doctor is looking to ensure that the lens is sitting properly on your eye and moving appropriately.
If all is well, your eye doctor will either write you a contact lens prescription that day, or recommend a short trial period so that you can experience how the lens feels in your eye throughout the day.
What Happens During Focused Exams
A focused exam is different from a comprehensive eye exam in the sense that your eye doctor will generally focus on one specific issue. Examples of reasons for a focused exams include:
Dry eye evaluations/ dry eye follow-up exam
Suspected foreign body in the eye
Red eye
Suspected eye infection
Sudden vision changes where your eye doctor is working to promptly identify the cause
Low vision evaluation and follow ups
Vision therapy evaluation and follow ups
Examinations focused on a previously diagnosed ocular disease such as glaucoma, diabetic retinopahy or age-related macular degeneration
