Specialised eye examination
FAQ
We definitely do not recommend this at our clinic. As part of the specialised eye examination we also carry out the examination of the rear segment (vitreous humour, retina, optic nerve). To do so, we use eye drops that dilate the eye and thus the reactive dynamics of the pupil and its adaptability is distorted. This may complicate the registration of points on the iris which is essential for all types of tailor-made procedures. In addition, all eyedrops and any manipulation with the eye may disrupt the tear film of the eye. Ideally, we aim to carry out laser eye surgery once in a lifetime and so why take the extra unnecessary risk.
There exists a plethora of beliefs and discussions on this matter. The fact remains that a thorough examination of the periphery of the retina is next to impossible without dilation. Another irreplaceable examination is the examination of the refraction in the so-called cycloplegia (once the adaptability of the intraocular lens has been eliminated). Often, the readings between the manifest (measuring of the eye without prior preparations, whereby it is impossible to eliminate adaptation efforts – focusing) and the cycloplegic refraction (measurements once the eye has been dilated, where the result is without the effect of the adaptation of the pupil) are widely different.
The very first eye examination in children is carried out before leaving the maternity hospital. It serves as a tool to eliminate hereditary pathological phenomena (cataracts, tumours). An indicative eye test is carried on your child at your paediatrician before starting school. Until this time, a child comes to a specialised ophthalmological centre only in case of issues with vision (increased tearing, repeat conjunctivitis, inflammation, lazy eyes, trauma and cases where the child overlooks objects or bumps into obstacles). The paediatric ophthalmologist decided the course of action.
At our clinic, we carry out examinations in slightly older children who are of an age to be able to co-operate with the person examining them. Usually, we examine children in cases where there is potential of a higher degree of a refractive error or where suspicions prevail of a corneal disease, for example keratoconus. The co-operation of the child during such an examination is absolutely necessary. Older children are also taught to apply the contact lenses.
If we leave out our minor patients here, the frequency of examinations depends on age and diagnosis. Generally speaking, for prevention purposes, it is applicable that every person aged 40+ should undergo an eye examination once a year. This is the age of the onset of both, cataract and glaucoma as well as ailments of the retina. The sooner the disease is discovered, the easier it is to cure it. In addition, this is also the time when the so-called presbyopia (the natural ageing of the eyes) may start causing issues. Prescribed correction (reading glasses) often ends up solving issues unexplained until this point (headaches, dizziness).
The frequency of your visits to your ophthalmologist in case of a refractive error depends on its development. When the progression is fast, it could be as often as every 3‒4 months. The same rules apply for patients with keratoconus – this is the only way that action may be taken in good time.
This applies in many cases. In case of trauma, the patient must seek out his doctor immediately. A patient must waste no time in getting professional help also when experiencing loss of vision, sudden appearance of flashes of light or a grey curtain-like phenomenon moving across the field of vision. In such cases we recommend that you visit a larger clinic where they are likely to also have an emergency department.
The situation is somewhat different where there are eye infections in question. Here, the 24-hour rule applies. It is possible to commence treatment using eye drops recommended by a pharmacist. Should the treatment not help within 24 hours, then it is advisable to visit an eye specialist and increase hygiene care at home (thorough washing of the hands, separate towels) so as to curb the spread of potential infection to the other members of the household.
Dioptres in glasses and in contact lenses do not correspond. It is an example of using physical (optical) principles in practice. The contact lens is placed directly on the cornea, but the rear surface of the glass in your glasses is some 12 millimetres from the apex of the cornea. What more, different types and different manufacturers of contact lenses differ (for example for a glass used in glasses with −3 dioptres the corresponding contact lenses would be some 0.25 to 0.5 dioptres weaker.
The main problem comes in where hard contact lenses are worn however, even soft contact lenses may enforce their shape onto the cornea. Lenses function in a similar manner as corrective teeth braces. When we carry out your examination, we need to know the real curvature of your cornea and this is why it is absolutely necessary to refrain from using contact lenses prior to the examination where your surgery is planned.
Yet another negative influence is that the lens in your eye may also influence the thickness of your cornea and the condition of the upper most layer – the epithelium.
When using contact lenses, it is important to take into consideration a certain degree of risk of damaging your cornea. Such damage may arise through wrong manipulation, when using mechanically damaged contact lens, when a foreign body accidentally finds its way under your contact lens or into the conjunctival sac. Subsequently, there is also the risk of contracting infection which may lead to permanent damage. Similar risk is linked to “transferring” your contact lenses or where hygiene is insufficient (hands, lens, container, solutions). As such, a person that wears contact lenses should be an individual who is agile enough and mentally mature enough to understand and be able to forego such risks. Judging such capabilities in children may be tricky, therefore, a high-quality co-operation between the child, the parent as well as the contactologist is essential.
Yes, for hygienic as well as medical reasons. During a specialised eye examination, your eyelids are very likely to be manipulated with and as such, particles of your make-up may reach places within your eye where it is not advisable for such particles to reach (for example the conjunctival sac). There exists a high risk of irritating the eye or contracting infection. In addition, the greasy components of cosmetic products significantly affect the tear film of the eye and as such may distort the results of some of the specialised examinations. This in turn may negatively influence the actual outcome of the surgery. The same applies to the surgical procedure as well as the post-surgery period. During the post-surgery period, the pressure exerted on the eye when removing make-up would also be a problem.
For us to be able to compare the quality of eye sight in different patients and among different doctors as well as to facilitate and speed up this process, a quality of vision scale is used. Most commonly it states the result as a fraction or a real number.
Vision graded with the values of 6/6, 20/20 or 1.0 always stands for perfect, 100% vision. It basically means that at a distance of 6 metres a patient actually sees what he should be seeing at a distance of 6 metres (6 metres are equivalent to 20 feet and this is where the value 20/20 comes from). A 50% vision is therefore graded as 6/20, 20/40 or 0.5. Thanks to modern laser methods (individualised procedures of the iDesign type) it is feasible, in many patients, to reach vision beyond the 20/20 boundary. This means more than 100%!
Experienced doctors
At our clinic you will only meet experienced specialists who love what they do and will find pleasure in helping you find the best solution for your eyes.
We care about our patients
The team at the Refractive Center Prague is primarily concerned with helping patients rediscover the pleasure of good eyesight. Rest assured knowing that you will be given the best possible care.
Pleasant surroundings
Our patients appreciate that examinations take place in pleasant, modern settings that are a far cry from what one might expect from a health facility. The friendly staff is there for you – should you want a cup of tea or a reassuring chat.