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John C Hagan III, MD, FACS, FAAO  
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Kansas City, MO

Specialties: Ophthalmology

Interests: Eye-Medical Blog

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General Information on Eye Exams

Dec 13, 2009 - 3 comments

The slit lamp is a bio-microscope usually used to examine the front of the eye. When you are in it your head is against the forehead rest and your chin is on the chin rest.  To examine the back of the eye a hand held lens can be used or one that is attached to the frame of the slit lamp (usually a Hruby Lens).  The most common of these lens is used to see the macula or reading part of the eye. It may or may not be necessary to have someone look in all directions.

Another type of lens can be used with the microscope to check the retina, especially the peripheral retina that is often hard to see and where many holes tears occur. An anesthetic drop is put in the eye and then the lens is put right on the cornea between the eyelids. This type of lens is called a "gonio" lens.


Now to check the retina for tears and detachments the most common method is none of the above. The instrument used is the binocular indirect ophthalmoscope. It looks like a miner's light and goes on the head of the ophthalmologist not the patient. The doctor uses a hand held lens while the patient sits in the exam chair and is usually tilted back. The light is very, very bright even when on the "low" setting. The patient is usually instructed to look up, down, left, right. Sometimes also diagonally in the oblique fields of view. Not infrequently an instrument called a "scleral depressor" is used to press on the edge of the eye to allow the ophthalmologist to see small holes and tears and search for "flat detachments". It is not always necessary to do scleral depression when doing an examination of the peripheral retina.

From your description I cannot tell what "Doctor 1 and Doctor 2" saw. Remember there several kinds of "eye doctors". Your best best to be sure you are competently examined is to see a eye physician (ophthalmologist or Eye MD). Then you are getting the following training: college 4 years, medical school 4 years, intership 1 year, ophthalmology residency 3 years, Fellowship (optional 1 to 3 years). So the ophthalmologist Eye MD will have 12 to 15 years of medical and surgical eye training. The other type of "eye doctors" optometrists have 7 or 8 years of non medical school non surgical training.



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by dids220, Oct 09, 2010
i have just had an eye exam i am 53 and was told that i have drusen spots it seems to give me a dark patch in the front of my  eye in a dark room at night  no problems in the day how can i expect this to progress

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by dids220, Oct 09, 2010
i have just had an eye exam i am 53 and was told that i have drusen spots it seems to give me a dark patch in the front of my  eye in a dark room at night  no problems in the day how can i expect this to progress

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by edgar20071985, Jun 30, 2012
Dear doctor
My 4 years old boy has Optic Nerve Partial Atrophy. I have heard about gene therapy. Could you advice a hospital that does this.
Thanks

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