The comprehensive evaluation begins with a dialogue to address the problems and concerns of each patient and their individual needs. After the patient's goals and visual demands have been determined, Dr. Battani will use his extensive knowledge and the available tools at his disposal to tailor the appropriate treatment plan for you. Dr. Battani is a good listener, so it is helpful for you to be prepared with your questions during this portion of the exam. The doctor believes that communication with his patients can be the most valuable diagnostic equipment in his arsenal and welcomes your input to design the best solution for your needs and concerns. The doctor has a wonderful sense of humor and an easy manner and may take it as a personal challenge to make you smile. If you are allergic to laughter, this is probably not the right office for you. So, be prepared for his disarming good nature and a steady dose witty sarcasm. You’ll find a comfortable environment where you know every attempt will be made to meet your needs by a competent capable medical professional with unmatched clinical skills. The comprehensive eye exam takes anywhere from 45 minutes to an hour or more, depending on the complexity of your individual needs. Be assured that he will take as long as is necessary to diagnose and address all of your concerns.
The comprehensive eye exam includes the following tests:
Before you see Dr. Battani, his optometric assistant will perform a series of manual and automated pre-tests. These tests are designed to collect data that will help the doctor individualize your exam and treatment plan. These tests include, color, depth perception, and your blood pressure measurement. Next are the auto-refractor and auto-keratometer. These instruments are used to measure the length and the shape of your eyes to give the doctor a ballpark measure of your refractive error. Your eyeglass prescription is a function of these measurements. Since there is no way to factor in human perceptual differences and preferences, this is by no means a final prescription. It just gives the doctor a place to start before you make your final choices in the exam room.
There is no single diagnostic test to determine whether or not you have glaucoma. The mysterious diagnosis of glaucoma has been compared to a ten piece puzzle. The more risk factors, or pieces of the puzzle you have, the easier it is to see the big picture and make an accurate diagnosis. During pre-testing, the assistant will use a handheld “puff-of-air” machine to measure the intra-ocular pressure (IOP) inside your eyes. This is a screening test to determine if the IOP is within the normal human limits. A high reading is by no means an indication that you have glaucoma, however, it is a risk factor, or as mentioned above, one of the pieces of the puzzle. Based on the result of this test, Dr. Battani may need to perform other testing such as corneal thickness measurement, threshold visual field testing, nerve fiber layer assessment, and fundus photography to rule out this disease in your case.
Dr. Battani will check to see how your eyes work together as a team. This simple hand held test involves covering and uncovering each eye alternately while you stare at an object on the wall or at a target held at your reading distance. The observation of how much each eye has to move when uncovered to pick up the fixation target, is recorded in your medical record. This helps to detect strabismus (or crossed eye) which can cause amblyopia (lazy eye), poor depth perception, and a host of other binocular vision problems.
In a dark room, Dr. Battani will have you stare at the big E on the wall after blurring the image with some lenses. He will then shine a bright light in your eyes while flipping lenses in a machine called the phoroptor, directly in front of you. What’s this test for? The doctor is using the reflective property of the mammalian retina to neutralize your refractive error. If you recall seeing the reflection from an animal’s eyes along the road at night, this is precisely what the doctor is using for this purpose. Based on the movement of the reflection, the doctor can determine very accurately (usually within a 0.25 to a 0.50 diopter) a good place to start before you make the final choices on your spectacle prescription. Retinoscopy is an objective test used to determine a patient’s prescription in the case where a patient is non-verbal or non-responsive. In skillful hands, the experienced clinician can confidently dispense an accurate prescription without the patient ever making a single choice. Of course, the doctor prefers your input, but the doctor could still get close without your help using this device.
Refraction is the subjective test to determine your final prescription. During the refraction, Dr. Battani will place the phoroptor in front of your eyes and give you a series of choices to narrow down your final preferences in each eye. Based on your answers, he’ll determine and record a final prescription. By law, eyeglasses and contact lens prescriptions expire one year after the date they are written.
The biomicroscope, also called the slit-lamp, is used to examine the health of the anterior and posterior segment of your eyes. It is basically an upright microscope designed for viewing living tissue. Dr. Battani will use this marvel of modern optics to magnify the image and the structure of the eyes in order to evaluate them for signs of infection or disease. Using this precision optical device, Dr. Battani can detect various ranges of eye conditions and diseases, such as conjunctivitis, corneal ulcers, cataracts, macular degeneration, and diabetic retinopathy.
Fundus And Anterior Segment Photography
Dr. Battani has a state of the art digital imaging system which allows for a 12.2 mega pixel digital photograph of the inside of your eyes to be catalogued and permanently attached to your electronic medical record. The high tech system allows the doctor to take retinal photographs through and un-dilated pupil in most cases. Before this technology came on the market routine dilation was necessary to view the ocular structures with this level of detail. Serial photography allows the doctor to view photographs from successive years and to superimpose the photos if necessary, to determine if any pathological changes have taken place. This new technology has become an invaluable diagnostic tool since it has been implemented into our practice.