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Eye Test at home

Introduction

A lot of people ask if they can get an eye test at home.  Some even wonder if they can do an eye check at home by themselves.  These inquires are more considering the Covid-19 risk situation.  

Here are what we are going to talk about

1) What we do at an eye exam in the clinic

2) What we do when do come to your home to do an routine eye examination

3) What you can do to perform an eye test at home

What is done in a comprehensive eye exam in an eye hospital

When we perform an regular eye exam at an eye clinic we do the following

  1. Visual acuity testing - this is nothing but checking your vision.  We make you read a chart and check how much of the chart you can read.  Snellen's visual acuity chart and the Logmar chart are two of the commonly used vision charts to check visual acuity.
  2. We do a refraction - A refraction is checking your eye number.  We can do this with a machine or manually.  The machine is called an autorefractormeter and the manual procedure is called retinoscopy.  We have to check both the distance number and the near number.  Individuals under the age of 40-42 usually have only glasses for distance vision. These are single vision lenses.  After that age they may need reading glasses also.  If someone needs reading glasses it is known as presbyopia.  Refractive error could be of three types.  Myopia, Hyperopia and Astigmatism.
  3. Anterior segment examination - Here we examine the front part of the eye.  The eyelids, the conjunctiva, the cornea, sclera, anterior chamber, iris, pupil and lens.
  4. IOP - Intraocular pressure.  Here we measure the intraocular pressure by applanation tonometry.  If the pressure in the eye is increased we get a disease known as glaucoma.
  5. We then dilate your pupils and once dilated examine the retina by performing direct and indirect fundoscopy.
  6. Finally we prescribe glasses or eye medicines if needed.

What we can do at an eye test at home

If you have read the previous paragraph you would realize that we use a lot of equipment to do a detailed eye examination.    We cannot transport this equipment to your house to perform the eye exam.

However, we can do the the first two things which is visual acuity testing and refraction at home.  Once that is done our optician can help you with selecting frames and lenses.   

Process of selecting frames and lenses

Frames can be selected in two ways.  

  1. Selecting from frames which are physically shown to you
  2. Selecting from frames which are sent to you via pictures

Selecting frames physically

Our optician carries the frames to your home.  The type of frames that he carries depends on the guidelines that you have explained to him.  For eg the size, shape, colours, styles and price range.

Selecting frames by looking at pictures

Our optician will send you multiple images of frames depending on your requirements.  You can narrow down your selection and he can show you similar frames for you to choose from.

Once the frames are selected our optician will fit the correct lenses based on your glasses prescription.  Your pair of glasses would then be delivered to you.  The lenses could be single vision, bifocals or progressive lenses.

The cost of these glasses will depend on the frame but more importantly on the lenses that you choose.  You should know that progressive lenses are much more expensive than all the other lens types.

What we cannot do at an eye check up at home

As mentioned earlier we can carry out the vision tests at home.  These tests at home are done by a licensed optometrist.  However, we cannot perform the following

  1. Examination of the front part of the eye with the accuracy that we can do at the hospital. 
  2. We cannot check the eye pressure
  3. We cannot dilate your pupils and examine the retina and optic nerve.

Thus even though we can perform an eye exam at home its not as complete and as accurate as performing an eye exam at an eye clinic.

Do it yourself eye check up at home

This is a question we get asked often.  More so in these Covid times.  People dont want to visit an eye doctor but want to be sure they dont really have an eye issue because of the risk of getting infected.  

As you may have guessed by now, ophthalmology is dependant on significant amount of equipment which help us examine the eyes.  These pieces of equipment are for obvious reasons not available at home.  Thus an eye exam at home by yourself without a vision care professional having a look at you may not be a great idea.

Some patients who have certain eye conditions and need repeated eye check ups actually purchase the eye charts to check vision at home.  Usuallly parents whose children may have an amblyopia may consider buying an eye chart.  

Here is what you can do for an eye check up at home

  1. Cover one eye at a time and see if you can see the subtitles of a movie playing on your TV.  Or if you can see the ticker at the bottom of your televsion screen.  Defective vision or blurry vision may mean you have a small number for far or you may even have an early cataract.  On the other hand comfortable vision may mean that your eye health is grossly ok.
  2. You will have to notice if you are holding the phone or book a little further away from you while reading.  Holding the book further may mean you have a small reading number.
  3. You should not have any redness, watering and discharge from your eyes.  These symptoms are usually associated with dryness, allergies or infective conjunctivitis.
  4. You can also pay attention to if you need more light to see things clearly in the evenings.   Or is there a situation at home where someone keeps switching off the lights and you keep turning them on.  This may mean that you have an early cataract.  Cataracts can also lead to you seeing halos around the oncoming headlights when driving in the evening or night.  Quite a few times patients with cataract will also see faded colours.  
  5. You should also notice if you are seeing things a little wavy or bent.  This should be done with one eye covered.  Like the edge of a TV may not be straight.  Or letters that you are reading from a book may not appear normal.  Usually these types of complaints are associated with ARMD.
  6. We eye care professionals also worry about a disease called glaucoma.  This part of the eye exam cannot be done at home and if you have a family history of glaucoma then it is important to get a yearly eye exam.
  7. You also have to get a yearly complete eye exam if you have diabetes to rule out diabetic eye disease.
  8. Double vision or diplopia is not a very common complaint and if someone has double vision its imperative that they visit an eye clinic.

Online Eye Testing

Covid has created a renewed interest in online eye testing.  The problem with testing your vision on a computer is the unavailability of a correct testing chart.  There are however tools available to do the same.  

Ordering contact lenses from home

Previous contact lens users can order contact lenses from their homes.  These contact lenses would be delivered to their homes and you can read about the different contact lenses or the contact lens charges.

Eye Check up at home