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FAQs

EYE TEST

WHAT IS A VISUAL FIELD EXAMINATION?

A  visual  field  examination  is  a  test  designed  to  find  out  how  well  your  peripheral  vision  is  functioning.  Reading  an  eye  chart  tests  how  well  your  visual  system  is  working  in  the  central  area  but  provides  little  information  about  your  side  vision.  A  visual  field  examination  tests  both  your  central  vision  and  your  peripheral  vision  by  measuring  the  sensitivity  of  your  visual  system  in  various  positions.

Why  is  peripheral  vision  important?

Central  vision  allows  you  to  see  the  fine  details  of  the  objects  at  which  you  are  looking  directly  but  peripheral  vision  is  used  to  find  objects  and  detect  threats,  and  is  important  for  general  orienta­tion  and  balance.  For  example,  if  you  have  poor  vision  on  one  side,  you  may  tend  to  bump  into  doorframes  and  driving  may  be  very  dangerous  if  you  cannot  see  traffic  in  the  next  lane.

In  sport,  peripheral  vision  is  necessary  to  be  able  to  locate  other  players  on  a  court  or  field  and  to  see  the  ball  out  of  the  corner  of  your  eye.

Peripheral  vision  is  also  important  For  other  tasks  such  as  reading.  A  person  with  poor  vision  on  the  right  side  may  find  it  difficult  to  read  a  line  of  type,  as  they  cannot  see  the  next  word  in  the  line.  A  person  with  poor  vision  on  the  left  side  may  be  able  to  read  along  the  line  but  can  have  problems  finding  the  start  of  the  next  line.

What  causes  visual  field  defects?

Visual  field  defects  can  be  caused  by  anything  that  damages  or  interferes  with  any  part  of  the  visual  system.  Causes  of  visual  field  defects  include  injuries  or  diseases  of  the  retina  (the  light­sensitive  layer  of  cells  at  the  back  of  the  eye),  and  diseases  such  as  glaucoma,  which  damage  the  optic  nerve  that  carries  signals  from  the  eye  lo  the  brain.  Other  causes  are  strokes  and  other  brain  injuries  that  damage  the  regions  of  the  brain  involved  with  processing  vision.

Damage  to  different  parts  of  the  visual  system  causes  different  types  of  visual  field  defects.  This  makes  visual  field  examinations  a  very  useful  way  of  detecting  and  diagnosing  many  diseases.

How  does  a  visual  field  examination  work?  There  are  several  ways  of  testing  visual  fields  but  most  commonly  a  computerised  instrument  called  an  automated  perimeter  is  used.  This  consists  of  a  concave  bowl  with  a  system  that  allows  lights  to  be  flashed  at  various  points  inside  the  bowl.  The  brightness  of  the  lights  varies  and  is  controlled  by  a  computer.

When  your  visual  fields  are  being  tested,  you  sit  facing  into  the  bowl  with  your  head  resting  on  a  support  so  that  your  head  will  not  move.  One  eye  at  a  time  is  tested,  so  an  eye-patch  is  worn  over  the  eye  not  being  tested.  You  look  directly  at  a  light  in  the  centre  of  the  bowl  and  press  a  button  any  lime  you  see  a  light  flash  elsewhere  in  the  bowl.  The  computer  varies  the  bright­ness  of  the  test  lights  and  notes  whether  you  saw  the  lights  and  responded  by  pressing  the  button.  This  allows  the  sensitivity  of  the  visual  system  at  each  point  to  be  measured.

Tips  for  visual  field  examinations

Remember  to  keep  looking  at  the  light  in  the  centre  of  the  bowl.  This  will  keep  your  eye  still.  If  your  eye  is  moving  around,  it  is  not  possible  to  tell  which  part  of  the  visual  field  is  being  tested.

Do  not  worry  if  you  do  not  seem  to  be  seeing  many  lights.

To  test  the  sensitivity  of  your  visual  system,  the  instrument  has  to

flash  some  lights  that  are  too  dim  for  you  to  see.  A  person  with  completely  normal  visual  fields  usually  will  not  see  about  one­third  of  the  lights.

Press  the  response  button  any  time  you  think  you  see  a  light  in  the  bowl.  It  is  better  to  respond  immediately,  even  if  you  are  wrong,  than  to  be  too  cautious  and  not  press  the  button  when  the  light  flashes.

Remember  to  blink  occasionally  to  ensure  that  your  eyes  do  not  become  dry.  The  best  time  to  blink  is  just  after  you  have  pressed  the  button  to  show  that  you  saw  a  light  flash.  There  will  be  a  short  delay  before  the  next  light  is  presented.

Medicare  rebate

The  Federal  Government  recognises  the  importance  of  visual  field  testing  for  the  long-term  health  of  your  eyes  and  pays  a  Medicare  benefit  for  examinations.

HOW LONG DOES AN EYE TEST TAKE?

This depends on the sort of eye test you are having.

If you are having a full comprehensive 35 point eye test will take about 45 mins.

If you are having your pupils dilated you will need to refrain from driving for at least an hour after this.

DOES THE EYE TEST HURT?

No.

During a full eye test we will be putting some drops in your eyes along with using some bright lights. The drops might sting a bit and your eyes may feel a bit unusual.

DO YOU BULK BILL EYE TESTS?

While nearly all of our services are covered by Medicare they are no longer Bulk-Billed. Please refer to the link below;

See Payment Methods for details.

WHAT DO I NEED TO BRING WHEN I COME IN FOR AN EYE TEST?

Please bring a copy of your old prescription or your current glasses and a list of your medications.

If you are coming in for a full test we may also want to dilate your pupils, so it is a good idea to bring sunglasses and a driver, or plan to spend about an hour after your test before driving.

If you are coming in for a contact lens aftercare, please wear your contact lenses; but bring your glasses and a contact lens case as we will probably need to take them out during the consultation.

WHY DO I NEED TO HAVE MY EYES TESTED EVERY 2 YEARS?

The most important part of your eye test is having the health of your eyes tested.

Some eye diseases have very few symptoms until the late stages, so it is important that you have this checked regularly to ensure your eyes stay healthy and consistent.

WHAT DO THE EYE DROPS DO?

There are three eye drops we use during the test.

The first is a local anaesthetic, which will make your eyes numb for about 15 mins and the second is yellow dye. We use these first two drops to check the pressure in your eyes and also the health of the front surface of your eyes.

The last drop is the one that dilates your pupils so we can properly check on the health inside of the back of your eye; this is the drop that makes things a bit fuzzy and a bit blurry.

WHY DO YOU NEED TO DILATE MY PUPILS?

During a full test of your eyes, we need to check the health of the inside of the back of your eyes (including your optic nerves and maculae) by looking through your pupils.

If your pupils are very small it is like trying to look at a room through a keyhole, we don’t get a very good view.

However, if we dilate your pupils it is like opening the door to the room and we get a much better view of the inside of the back of your eyes and can be much more certain how healthy they are.

CHILDREN’S EYE TESTS

WHY SHOULD I GET MY CHILD’S EYES TESTED?

Children often don’t know that there is anything wrong with their vision as they assume everyone sees the same way they do.

They also find it easier to compensate for any difficulties they may be having, however this can lead to headaches and eyestrain.

WHAT SIGNS SHOULD I LOOK FOR IN MY CHILD’S EYES?

There are many signs to look for with children’s vision, including;

– eyes that turn in or out
– holding print in or out to try and focus
– difficulty learning to read
– headaches
– blurred or double vision

If you have any of these concerns or others, the easiest thing to do is to book your child in for a comprehensive eye examination to be sure that all is well.

HOW OLD DOES MY CHILD NEED TO BE IN ORDER TO HAVE AN EYE TEST?

If you have any concerns about your child’s vision they are not too young to have an eye test.

It is recommended that all children have an eye test before they start school to ensure they are not disadvantaged, and continue to have regular eye checks every 2 years or so.

A PARENT'S GUIDE TO GOOD VISION.

To view our parent’s guide click here.

CONTACT LENSES

CAN I WEAR CONTACT LENSES?

There are now contact lenses to suit most spectacle prescriptions, even for those who just wear glasses for reading.

There are other factors that determine your suitablilty for contact lenses, such as the shape of your eye and the stability of your tear film.

The best option is to come and have a consultation with an optometrist who will look at the health of your eyes as well as your prescription and lifestyle and then be able to let you know what sort of contact  lenses, if appropriate, will suit you best.

WHAT IS ORTHOK (ORTHO-KERATOLOGY)?

OrthoK is a relatively new type of hard contact lens that is worn to bed and removed first thing in the morning.

Once the lens is removed, the person has clear vision for 1-2 days before needing to wear the lens again overnight.

This unique type of lens reshapes the cornea, to allow for clear vision.

Recent research has also shown that these help slow or stop the progression of myopia/short sightedness in children.

If properly maintained, the lenses can last for 5-10 years, meaning that it can be a very economical option as well.

SPECTACLES

WHY DO YOUR GLASSES COST SO MUCH MORE THAN READY-MADE ONES?

In a word, quality.

Our lenses are made of different optical materials depending on your needs; they are also specially ground for your individual prescription individually in each eye.

The frames we stock are all made of materials that we are happy to offer a two year manufacturers warranty for.

HOW LONG DOES IT TAKE TO HAVE A PAIR OF GLASSES MADE?

This depends on the type of lens you have chosen and if you want coatings added. Lenses in stock may only take a couple of days to come back, but generally most glasses will be made within two weeks.

The exception to this is the MASS scheme, which usually takes 6-8 weeks.

DO MY GLASSES COME WITH A WARRANTY?

Yes!

All optical frames (prescription sunglass frames included) carry a 2 year warranty against defects.

Plano sunglasses attract a 1 year warranty.

MY NEW GLASSES FEEL ‘STRANGE’. WHAT SHOULD I DO?

If there has been a change in your prescription it will often take a little while for your brain to adapt to the new prescription. The bigger the change, the longer it will take.

If you still can’t see clearly, try having the glasses adjusted by one of our dispensers to make sure they’re sitting correctly. If they are, persevere for 2 weeks or so, trying only to wear your new glasses rather than any old pairs.

If you still cannot adapt or cannot or cannot see at all clearly, please come in and have one of our optometrists re-check your prescription.

HOW MUCH WILL MY HEALTH FUND GIVE ME BACK?

The rebate amount you will receive depends on your level of cover.

Just give your health fund a quick call to see what your rebate amount is and we can claim it in store according to your purchase.

EYE HEALTH

WHAT IS GLAUCOMA?

What is glaucoma?

Glaucoma is often called the ‘sneak thief of sight’ because it is a condition that gradually whittles away vision from the edges inwards. By the time anyone notices, a significant amount of vision loss has occurred.

In glaucoma, nerve cells that transmit information from the eye to the brain become damaged. Even though the eye may be capturing images, the nerve that sends the signal lo the brain is defective. This causes a disruption in visual processing, resulting in ‘blind spots’ that, if untreated, can lead to tunnel-vision and blindness.

What causes glaucoma?

Glaucoma is often associated with increased pressure inside the eye, which can cause physical damage to nerve cells. Several forms of glaucoma occur with normal or even low eye pressure. The chances of developing glaucoma are greatly increased by risk factors that include:

  • Age

Glaucoma becomes more prevalent as we age, with one in 12 people aged over 80 years having the disease.

  • Family history

Glaucoma can run in families. There is a higher risk of developing the disease if an immediate Family member has been diagnosed with glaucoma.

  • Myopia (shortsightedness)

Certain kinds of glaucoma are more prevalent in people who are shortsighted.

  • Diabetes

Diabetes may be associated with glaucoma, or may cause physical changes to the eye that result in glaucoma.

Can glaucoma be prevented?

Most cases of glaucoma cannot be prevented and vision loss from glaucoma is considered to be irreversible. Early detection and treatment are the best ways to control glaucoma.

What are the symptoms?

Symptoms of glaucoma can be very subtle so it usually goes undetected until the very late stages of the disease. Glaucoma typically causes no pain or discomfort, and does not affect central vision, so unlike other eye diseases, there is nothing to prompt someone to seek an eye exominotion.

As glaucoma progresses, sufferers may find that they tend to bump into things, or notice that they have poor peripheral vision, perhaps while driving. Some types of glaucoma can cause intense eye pain that requires emergency treatment but this is very rare.

How does an optometrist diagnose glaucoma?

Your optometrist will need to ask you questions about your health and ocular history and perform a series of tests to diagnose glaucoma. These tests may involve the optometrist looking at the nerve fibres at the bock of the eye, assessing the drainage network of the eyes, measuring the pressure inside the eyes with a special

instrument called a tonometer and measuring the thickness of the eye surface. Your optometrist may also toke a photograph of the retina at the bock of your eye or ask you to have a visual field test. All of these tests are simple and painless.

How is glaucoma treated?

Prescription eye-drops are usually the first line of treatment against glaucoma. Once diagnosed, glaucoma management becomes a life-long commitment. A shared-care arrongement between an optometrist and ophthalmologist makes it easier for people with glaucoma to be checked regularly and have their treatment altered if necessary. Sometimes, eye-drops alone are not sufficient to control glaucoma progression and special laser treatment or surgery may be required.

Glaucoma and regular eye examinations

In developed countries, modern examination techniques and treatment mean that glaucoma seldom causes absolute blindness. Even so, more than 300,000 Australians have glaucoma and only half of these people are aware that they have the disease. Regular eye examinations are your best protection against vision loss from glaucoma, especially if you are aged over 40 years.

Glaucoma Australia

Glaucoma Australia is a national, not-for-profit organisation dedicated to providing educational services to raise awareness about glaucoma, to support glaucoma sufferers and to raise funds for research.

For more information about glaucoma call Glaucoma Australia on 1800 500 880 or visit www.glaucoma.org.au

WHAT ARE CATARACTS?

What are cataracts?

Cataracts are a cloudiness that form in the lens of the eye. The lens normally is clear. Poor vision results because the cloudiness interferes with light entering the eye.

Are cataracts a kind of growth?

No. Cataracts are due to a change in the lens material.

What causes cataracts?

Most cataracts are a result of ageing and long-term exposure to ultraviolet light. Some are caused by injury and certain diseases and in rare cases by exposure to toxic materials and radiation.
Occasionally cataracts are present at birth, due to the baby’s mother having had rubella during the pregnancy, or genetic defects.

Do cataracts get worse?

Yes. The clouded areas become larger and dense and cause the patient’s sight to become worse. The time taken for this to happen varies from a few months to many years.

Do cataracts affect both eyes?

Usually cataracts affect both eyes but often develop at different rates in each eye.

How common are cataracts?

People older than 65 years often have signs of cataracts and should have their eyes examined regularly.

Can cataracts cause blindness?

If untreated, cataracts can cause blindness. Blindness can be prevented by detecting the cataracts early and, if necessary, by having them removed surgically.

How well will I see if my lens is removed?

In most cases very well. Most patients have an intra-ocular lens (IOL) ) inserted at the time of surgery, with excellent results. This is a plastic lens which replaces your own cloudy lens. Patients may also need to wear spectacles or contact lenses.

What are the signs of cataracts?

Usually the development of cataracts is gradual with a painless worsening of sight. Other symptoms include blurred or hazy vision, spots before the eyes, double vision and a marked increase in sensitivity to glare.

How can I be sure I don’t have cataracts?

An examination by your optometrist will reveal any changes that have occurred in the lens of the eye. Optometrists have special equipment which enables them to see changes in the lens which may
lead to cataracts several years before any symptoms appear.

Can cataracts be prevented?

There is no proven method of preventing cataracts. Long-term exposure to ultraviolet light is thought to induce cataracts, so a brimmed hat and approved sunglasses should be worn in sunlight.

When should I have a cataract operation?

This varies with each patient. Usually cataract surgery is performed when the patient’s vision interferes with daily life. Your optometrist will assist you in making this decision.

Is cataract removal a major operation?

Cataract surgery is now a relatively minor procedure. Often it is performed under a local anaesthetic. Depending on the patient, the surgery may be performed on an out-patient basis. This means that the patient attends a hospital or clinic for the surgery and is able to go home the same day. The surgery is performed by an ophthalmologist, a medical doctor who specalises in eye surgery.

Your optometrist will refer you to an ophthalmologist if necessary.

WHAT IS MACULAR DEGENERATION?

What is age-related maculopathy?

Age-related maculopathy (ARM), also known as senile macular degeneration, is damage or breakdown of the macula. The macula is a very small part of the retina, the light-sensitive tissue of the eye, which is responsible for central vision. This is the part of the retina which produces the finest detailed vision.

How does ARM affect vision?

As ARM damages the part of the retina responsible for central vision and for seeing fine detail, it becomes difficult to see small details of objects. Vision to the sides is not affected. If both eyes are affected, reading and other tasks requiring fine vision may become very difficult. ARM does not cause blindness. Because some side vision remains, usually people can still take care of themselves.

What causes ARM?

ARM is the result of ageing processes in the eye. Some of the layers of the retina thicken and waste material which is usually removed from the retina forms deposits, distorting the retina. This distortion can cause damage to the other layers of the retina. In about 10 per cent of cases, new blood vessels grow into the macula from beneath.
These newly formed vessels are fragile and often leak blood into the retina where it causes scar tissue to form. The scarring blocks out central vision to a severe degree. There are also some other forms of macular degeneration which are inherited and not associated with ageing.

How common is ARM?

ARM mainly affects older people: about four per cent of those more than 40 years old, nine per cent of those over 50 years, 23 per cent of those over 65 years and 31 per cent of those aged 80 years or more. Men and women are equally affected. ARM accounts for up to 45 per cent of legal blindness and up to 70 per cent of seriously impaired vision in people over the age of 70 years.

How is ARM detected and diagnosed?

People with ARM may notice that their vision has deteriorated. Many patients do not realise that they have a problem until their vision becomes blurred. Optometrists perform a number of tests in an examination which enables them to detect the presence of ARM in the early stages.

The optometrist examines the macula carefully with an instrument called an ophthalmoscope which allows examination of the interior of the eye. Sometimes the optometrist may place a drop in the eye to dilate the pupil to get a better view of the internal structures. Through the ophthalmoscope the optometrist will look for changes in the structure of the macula such as accumulations of waste material or new blood vessels.

Another test which may be used is a grid pattern known as an Amsler chart. This is a regular grid which looks like a piece of graph paper. Patients with ARM often report that sections of the grid appear to be distorted or missing.

Optometrists will usually refer patients whom they suspect have ARM to an ophthalmologist (eye surgeon) for confirmation of the diagnosis. The ophthalmologist will perform a test called fluorescein angiography. In this test a fluorescent dye is injected into the patient’s bloodstream and the ophthalmologist observes the progress of the dye through the blood vessels in the retina. This reveals any leaking blood vessels.

Can ARM be treated?

When most body tissues such as muscle, skin or bone are damaged, the tissues’ cells have the capacity to regrow and repair the damage. Because nerve cells cannot regenerate, damage to nerve tissue, such as the retina, is usually permanent and irreversible. This is why the vision loss in ARM is so difficult to treat, compared with other vision disorders. For example, it is possible to remove and replace the eye’s lens in a person with cataract but it is not possible to replace or even repair the retina of a person with ARM

Where new blood vessels have appeared in the macula area, laser surgery may be used. In this treatment a focused, intense beam of laser light is used to seal off leaking blood vessels and to prevent new vessels growing. This treatment is most effective when it is applied in the very early stages of the disease, before extensive damage has been done.

While there is little which can be done to prevent or cure ARM, people with the disease can be helped to continue functioning normally. Many patients with ARM will eventually come under the classification of being a low vision patient. Special help in the form of low vision aids is available from optometrists and specialist low vision clinics. Low vision aids enable patients to make the most of their vision and include devices such as miniature telescopes, high-powered reading spectacles, hand-held and stand magnifiers, closed circuit televisions and other simpler aids such as large-print books.

What should you do about ARM?

For treatment of ARM to be effective, it must be diagnosed as early as possible. Regular eye examinations are the key to early detection of retinal changes and other signs of disease. If you notice any change in the quality of your vision, have your eyes examined immediately. Regular examinations are particularly important for people over the age of 50 years and people whose families have a history of eye problems.

Recent studies have shown that wearing good quality sunglasses and taking daily antioxidant supplements reduce the incidence and severity of ARM.

WHY IS IT HARDER TO READ AFTER 40?

Like a camera, your eye needs to focus differently to see objects up close as opposed to those far away.

The lens inside your eye is flexible so that you can pull it into shape to see things close up, and relax to look in the distance.

The lens is a living tissue, so as you get older it grows and puts on extra layers like an onion.

This makes it fatter and stiffer, so you can’t change focus to look as things close up like you used to be able to.

WHAT IS 20/20 VISION?

20/20 vision is a term used to express normal visual acuity (the clarity or sharpness of vision) measured at a distance of 20 feet. If you have 20/20 vision, you can see clearly at 20 feet what should normally be seen at that distance. If you have 20/100 vision, it means that you must be as close as 20 feet to see what a person with normal vision can see at 100 feet.

20/20 does not necessarily mean perfect vision. 20/20 vision only indicates the sharpness or clarity of vision at a distance. There are other important vision skills, including peripheral awareness or side vision, eye coordination, depth perception, focusing ability and color vision that contribute to your overall visual ability.

Some people can see well at a distance, but are unable to bring nearer objects into focus. This condition can be caused by hyperopia (farsightedness) or presbyopia (loss of focusing ability). Others can see items that are close, but cannot see those far away. This condition may be caused by myopia (nearsightedness).

A comprehensive eye examination by a doctor of optometry can diagnose those causes, if any, that are affecting your ability to see well. In most cases, your optometrist can prescribe glasses, contact lenses or a vision therapy program that will help improve your vision. If the reduced vision is due to an eye disease, the use of ocular medication or other treatment may be used.