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As we grow older, the risk of being diagnosed with a vision loss condition increases. Regular exams at the ophthalmologist are vital to ensure detection and treatment of such conditions, including wet macular degeneration1,2. With so many tests available, it can be overwhelming to keep track of the most important ones. Below is a brief list of some of the most common and critical eye examinations for vision loss conditions like wet macular degeneration.

First things first: what happens during a visit to your ophthalmologist before testing?

Picture: Man receiving eye exam from ophthalmologist
Stock photo. Posed by model.


When you first arrive for your appointment you will typically be pre-examined by a medical technician before speaking with your physician. In the case of wet degeneration, this pre-examination may include an Amsler grid test which can help detect and monitor wet macular degeneration3.

After meeting with a medical technician, you will speak with your physician about specific vision challenges or other conditions, like diabetes or high blood pressure, which may affect your vision. During the discussion, the ophthalmologist determines further eye exams to be performed. The methods your ophthalmologist uses for your exam depend on your individual patient history4.

Standard eye exams: vision tests

Picture: Eye test chart with rows of letters of various sizes, called an ETDRS vision chart, hanging on wall
Picture: Eye test chart with C-shaped rings, called Landolt rings

Exams with your ophthalmologist typically begin with classic vision tests. The ophthalmologist will use a vision chart showing letters or numbers of decreasing sizes (called an ETDRS vision chart). You will be asked to read the lines of letters or numbers, while covering one eye and stand facing the chart at various distances. They may also show you a chart with C-shaped rings (Landolt rings). The C-shaped rings will be in different positions and sizes, and during the test you will be asked which side of the ring is open4.

Examinations of the retina

Picture: O.C.T. scan of retina with fluid

If damage to your retina is suspected, the ophthalmologist will initiate further testing. This can include the following methods:

  • Funduscopy: Using a special ophthalmoscope and a magnifier, the physician examines the back of the eye and the retina. Here, drusen (deposits below the retina), which are commonly present with wet macular degeneration, may be detected5.
  • Fluorescein angiography: Fluorescein dye is injected used to show the fine structure of the retina, to detect newly formed blood vessels indicative of wet macular degeneration or other retinal conditions6.
  • Optical coherence tomography (OCT): During this exam, images of the retina, including the macula, are taken. For wet macular degeneration, these results are used to detect fluid in this area6.

In case of a retinal condition diagnosis, your ophthalmologist will perform regular vision tests and OCT exams to inform treatment decisions. Fluorescence angiography is usually only performed at diagnosis6.

After visiting your ophthalmologist: What you can do at home?

You should periodically check your vision in between appointments to monitor for any differences to report to your doctor. Amsler grids are simple to use at home so that any changes can be addressed quickly7.There are even cell phone apps that can remind you to test your vision.

It is important to take advantage of every single ophthalmologist appointment to optimize your treatment and help maintain your independence. For tips on preparing for appointments, click here.

 


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References

  1. Bressler NM. Early detection and treatment of neovascular age-related macular degeneration. The Journal of the American Board of Family Practice, 2002;15(2):142-152
  2. Schmidt-Erfurth U, et al. Guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA). Br J Ophthalmol 2014;98:1144–1167. doi:10.1136/bjophthalmol-2014-305702
  3. Schwartz R, Loewenstein A. Early detection of age-related macular degeneration: current status. Int J Retin Vitr (2015) 1:20. 2015. DOI 10.1186/s40942-015-0022-7
  4. Turbert D. Eye Exam and Vision Testing Basics. American Academy of Ophthalmology, 17 Mar. 2020, ⦁    www.aao.org/eye-health/tips-prevention/eye-exams-101.
  5. Schneiderman H. The Funduscopic Examination. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 117. Available from: https://www.ncbi.nlm.nih.gov/books/NBK221/
  6. Kang SW, et al. The correlation between fluorescin angiographic and optical coherence tomographic features in clinically significant diabetic macular edema. Am J ophthalmol 2004;137(2):313-322.
  7. American Academy of Ophthalmology. Have AMD? Save Your Sight with an Amsler Grid. Available at: https://www.aao.org/eye-health/tips-prevention/facts-about-amsler-grid-daily-vision-test. Accessed July 2019.
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