Home Patients & Public What to expect at an eye exam
What to expect at an eye exam
Dilation, OCT, OCT angiography, and retinal photos, step by step
Same-day care
Sudden vision loss in one eye needs same-day care.
Call an eye doctor or go to the emergency department.
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A comprehensive eye exam checks how well you see and the health of every part of your eye, including the optic nerve.¹ Here is what usually happens at our offices. Every visit is tailored to you, so your exam may include more or fewer steps.
Before your visit
- Bring a list of all your medicines, including GLP-1 medicines (and the date you started), blood pressure medicines, and the time of day you take them.
- Bring your glasses or contact lenses.
- Bring sunglasses, and consider bringing a driver if your eyes will be dilated.
- Write down any symptoms, even small ones.
Step by step
1. Health history and vision check
We’ll ask about your eyes, your general health, your medicines, and your family history. You’ll read letters on a chart, and we may check your glasses prescription.
2. Pupils, eye movements, and side vision
We check how your pupils respond to light, a quick and useful test of the optic nerve. We may also check color vision and side (peripheral) vision. Some people need a visual field test, where you press a button each time you see a small light.
3. Eye pressure
Eye pressure is measured with a quick puff of air or a gentle probe after numbing drops. It helps screen for glaucoma.
4. Dilation
Drops widen (dilate) your pupils so the doctor can see the retina and optic nerve clearly. They take a short while to work. Afterward, your vision may be blurry, especially up close, and sensitive to light for several hours.¹ ²
5. OCT (optical coherence tomography)
You rest your chin on a support and look at a target. The machine uses light waves to take cross-section pictures of the retina and optic nerve. Nothing touches your eye, and it takes a few minutes.² OCT measures the nerve fiber layer so changes can be tracked over time.
6. OCT angiography (OCTA)
OCTA uses the same kind of machine to map the tiny blood vessels in the retina and around the optic nerve. Unlike older tests, it does not need a dye injection.²
7. Retinal photographs and autofluorescence
Fundus photos are color pictures of the back of the eye, including the optic nerve, for your record. Fundus autofluorescence uses a special light and filter to show natural glow from the retina and, sometimes, from deposits in the optic nerve called drusen.³ You’ll see a bright flash. No dye or injection is used.
8. Talking it over
Your doctor will explain the findings, answer questions, and recommend when to return. If you take a GLP-1 medicine, we can send a summary to the doctor who prescribes it, with your permission.
Why baseline images help
See Eye imaging explained for diagrams of OCT, OCTA, and retinal photography, and why follow-up scans matter.
Images taken when your eyes are healthy give your doctors something to compare against later. They do not predict or prevent NAION or other sudden problems. If you ever have sudden vision loss, get same-day care.
Choosing an eye doctor (Dr. Deom’s opinion): In Dr. Deom’s opinion, the eye doctor and office you choose should have the technology to assess you and follow you over time, including OCT, OCT angiography (OCTA), and retinal photography with autofluorescence.
Dr. Deom’s recommendation (clinical opinion / practice recommendation)
Dr. James Deom recommends that everyone starting or taking a GLP-1 medication have a comprehensive dilated eye exam with OCT, OCT angiography (OCTA), and retinal photography (fundus photos with autofluorescence) as a baseline and for follow-up, and seek same-day care for sudden vision loss.
This is his clinical opinion, not a formal rule from every professional group. AAO and NANOS do not recommend an eye exam only to predict NAION, and no test can reliably predict or prevent it. Dr. Deom recommends the baseline so there is a record to compare against if anything changes, and so other eye problems can be found early.
Dr. James Deom’s personal clinical thought
This is his opinion, not established evidence. It is not a finding from the studies or a position of the FDA, EMA, AAO, NANOS, or AOA.
As people lose weight and get healthier on GLP-1 medicines, their blood pressure and cholesterol medicines are often not reviewed or adjusted. Blood pressure treatment that is no longer matched to a person’s needs may lead to low blood pressure (hypotension). Low blood pressure can be more pronounced at night and could reduce blood flow to the optic nerve during sleep. That possibility would fit the typical way NAION presents: vision loss noticed on waking.
Dr. Deom recommends that people taking a GLP-1 medicine also work on exercise and diet, and keep regular visits with their usual doctors — even if that doctor did not prescribe the GLP-1 — so the rest of their care, including blood pressure, is maintained. Do not start, stop, or change a blood pressure or cholesterol medicine on your own; talk with the clinician who prescribes it.
How to reach us
Hazleton Eye Specialists: phone 570-453-2020, fax 570-453-1020. Addresses for all five offices (Hazleton, Stroudsburg, Nanticoke, Pottsville, and Bangor) are on Find an Eye Doctor.
Sudden vision loss needs same-day care. Call an eye doctor right away. If you also have a new headache, jaw pain when chewing, scalp tenderness, fever, or you are over 50 and feel unwell, go to the emergency department.
All five offices (Hazleton, Stroudsburg, Nanticoke, Pottsville, and Bangor) have OCT, OCT angiography, and fundus photography with autofluorescence.
Sources
- American Optometric Association. Comprehensive eye exams. https://www.aoa.org/healthy-eyes/caring-for-your-eyes/eye-exams
- American Academy of Ophthalmology. What Is Optical Coherence Tomography? (covers OCT and OCTA). https://www.aao.org/eye-health/treatments/what-is-optical-coherence-tomography · Dilating eye drops. https://www.aao.org/eye-health/drugs/dilating-eye-drops
- Malmqvist L, et al. The Optic Disc Drusen Studies Consortium Recommendations for Diagnosis of Optic Disc Drusen Using Optical Coherence Tomography. J Neuroophthalmol. 2018;38(3):299-307.
Medical disclaimer. This page is for general education only. It is not medical advice and does not replace an examination or a conversation with your own doctors. Do not start, stop, or change any medicine without talking to the clinician who prescribes it. If you have sudden vision loss, seek same-day care from an eye doctor or an emergency department. Information is current as of the “last reviewed” date and may change as new research is published.