The staff of Bell Family Eye Care welcomes you to our practice.
Comprehensive Eye Exams
Annual exams are very important not only to determine if you need correction to see well but also to maintain the health of your eye. We recommend an annual eye health and vision exam by Dr. Bell. They typically only take 30 minutes and are crucial to protecting and preserving your precious vision for a lifetime. A complete eye exam involves a series of tests designed to evaluate your vision and check for eye diseases. Each test is necessary and allows your doctor to evaluate a different aspect of your vision. Common tests that you might have include:
External Eye Exam
- Your pupils to see if they respond normally
- Position and movement of your eyes, eyelids, and lashes
- Your cornea and iris for clarity and shininess
Eye Muscle Test
This test examines your eye muscles to ensure they’re functioning properly. Your eye doctor looks at your eyes as they move in six specific directions. Your doctor will ask you to sit still and look forward, using your eyes to follow an object, such as a pen. The eye muscle test is designed to detect any weaknesses or uncontrolled movements in the muscles that move your eyes up and down and side to side.
Visual Acuity Test
This test measures how sharply or clearly you can see something at a distance. Your doctor will ask you to identify different letters of the alphabet off a chart positioned usually 20 feet away. The lines of type get smaller as you move down the chart. You cover one eye and read aloud, then cover the other eye and read aloud. Your doctor monitors how well you can identify the letters. Your visual acuity is expressed in a fraction – such as 20/20 vision. The top number refers to your distance from the eye chart, usually 20 feet. The bottom number indicates the distance at which a person with normal eyesight could correctly read the line you read. For example, 20/20 vision means that you can see objects clearly from 20 feet away that a person with normal vision could see clearly from 20 feet away. However, if your visual acuity is 20/50, the line you read correctly at 20 feet could be read by a person with normal vision at 50 feet.
Refraction refers to how light waves are bent as they pass through your cornea and lens. A refraction assessment helps your doctor determine a corrective lens prescription that will give you the sharpest vision. We may use a computerized refractor to measure your eyes and estimate the prescription you need to correct a refractive error. We then fine-tune this refraction assessment by asking you to look through a phoropter, a mask-like device that contains wheels of different lenses, and judge which combination gives you the sharpest vision. By repeating this step several times, we will find the lenses that give you the greatest possible acuity.
Visual Field Test (Perimetry)
Your visual field is the area in front of you that you can see without moving your eyes. Your eye doctor uses this test to determine whether you have difficulty seeing in any areas of your peripheral vision – the areas on the side of your visual field.
A slit-lamp allows us to see the structures at the front of your eye using a microscope – called a slit lamp because it uses an intense line of light to illuminate your eye. We use this light to examine the cornea, iris, lens, and anterior chamber of your eye. When examining your cornea, we may use fluorescein dye. The orange dye spreads across your eyes to help your eye doctor detect tiny cuts, scrapes, tears, foreign objects, or infections on your cornea. Your eyes’ tears will wash the dye away.
A retinal examination – sometimes called ophthalmoscopy or fundoscopy – examines the back of your eye, including your retina, optic disc, choroid, and blood vessels. We may use special eye drops to dilate your pupils, opening them wider so we can see the back part of your eye. We also have the retinal camera which can be used as an alternative to dilation in many people. It allows us to take a digital picture of the retina through undilated pupils. Our staff will talk to you more about this when you get to the clinic. Your eye doctor may use one or more of these techniques to view the back of your eye: The retinal examination takes five to 10 minutes, but if you’re given eye drops, the effects won’t wear off for several hours. Your vision will be blurry, and you’ll have trouble focusing your eyes. Depending on your job, you might not be able to return to work immediately after your exam. You will also be very sensitive to the light so we recommend using sunglasses. We are happy to provide disposable sunglasses to you if you prefer.
Tonometry measures your intraocular pressure – the pressure inside your eyes. This test in conjunction with other more specific tests such as an OCT, a visual field, and a detailed retinal exam will help us determine your risk for the development or progression of glaucoma. Glaucoma can be treated if it’s caught early.ns.
A fitting for contact lenses is a process. You will be seen for several visits to complete the process. These include the initial fitting, and lens dispensing with insertion and removal training. Once you have been fitted with your new contact lenses, you will need to return for follow-up care on a regular basis as prescribed by the doctor. In general, annual follow-ups are required to renew contact lens prescriptions.
What are the advantages and disadvantages of contact lenses?
In general, contact lenses provide the following advantages Good peripheral (side) vision. Excellent for active lifestyles. Do not steam or fog up. Changes one’s appearance. Some disadvantages may include more daily care than eyeglasses. Some types require a short adaptation period. Potential for eye infections if not worn or cleaned properly.
What if I find that contact lenses are not right for me?
Our caring staff will do all it can to help you wear contact lenses successfully. We will teach you how to care for your lenses and how to insert and remove them properly. Fitting fees are non-refundable.
Soft Lenses vs. Rigid Gas Permeable
Soft contact lenses are also known as hydrogel or hydrophilic lenses. These lenses are very flexible and are often the most comfortable lens to be worn initially. While very safe to use, these lenses are often disposable to decrease risks of complications, such as infection. Rigid gas permeable contacts are stiffer lenses and require an adaptation period for the best comfort. For some prescriptions, these lenses offer crisper vision and excellent oxygen permeability.
Daily Wear vs. Extended Wear
Daily wear contact lenses are worn during the day and are removed at night for cleaning and disinfection. This is typically the healthiest mode of contact lens wear. Extended wear contact lenses can be worn for prolonged periods of time or while sleeping. Typically, prolonged wear of contacts or sleeping in contacts reduces the amount of oxygen and tears that reach the cornea. This can result in eye infections, swelling, and abnormal vessel growth.
How am I fitted for contact lenses?
You will start with a comprehensive eye examination. The doctor will examine your eyes to determine if you are a candidate for contact lenses and then discuss your options. The fitting then commences with additional tests to design an initial trial pair of contact lenses. Successful contact lens wear depends on healthy eyes, a proper fit, and a patient’s compliance with the prescribed wearing schedule and care system. Fitting fees are non-refundable.
How much do contact lenses cost?
The cost of contact lenses depends on the type of contact lens and how frequently you replace them. There are two fees associated with contact lenses: A fitting fee and a material fee. The fitting fee is for services provided and includes training and all follow-up visits up to 3 months after the prescription is finalized. The material fee is for the supply of contact lenses. A written contact lens prescription can be given only after the fitting process is complete. We purchase contact lenses directly from the manufacturers and pass the savings along to you. For your convenience, contact lenses can be delivered directly to your home or office.
Specialty Contact Lenses
Research in contact lens use for specific eye conditions has been extensive over the years. New technology has resulted in the development of advanced types of lenses, addressing many visual problems. Our doctors are able to assess and prescribe contact lenses from all the specialty areas listed below. a) Contact Lenses for Astigmatism b) Bifocal Contact Lenses c) Color Enhancing Contact Lenses d) Contact Lenses for Dry Eyes e) Post-Surgical and Post-Trauma Contact Lenses f) Specialty Lenses for Keratoconus and Corneal Irregularities
What Do I bring to my Appointment?
Current or Previous Contact Lens Users Bring to the Exam:
- Your contact lenses.
- Your glasses.
- Your most recent eyeglass prescription.
- Your most recent contact lens prescription (including brand name, base curve, diameter, power) or any vials/boxes that came with your lenses.
- A copy of your most recent eye examination (if available); a general eye examination needs to have been performed within the past 2 years.
- Please wear your contact lenses to the exam.
If You Have Never Worn Contact Lenses Bring to the Exam:
- Your glasses
- Your most recent eyeglass prescription
- A copy of your most recent eye examination (if available). A general eye examination needs to have been performed within the past 2 years.
Emergency Eye Care
An eye emergency is an event where eyesight is at risk. Events that risk eyesight requires prompt treatment to prevent vision loss. A complete evaluation by one of our doctors is essential after any type of eye injury. Anyone who sustains a serious injury to the eye, including blunt injuries, should be seen as soon as possible. If one of our doctors is not immediately available to assist or direct you, report to the nearest emergency room. We cannot offer specific medical advice through this website but we will make the general following recommendations:
What Are the Symptoms of an Eye Emergency?
- Chemical contact with eye or face
- Severe eye, head, or face injury
- Sudden loss of all or part of your vision
- Bulging eye
- Painful eye
- The onset of flashing lights, floaters, or a noticeable increase in the amount of flashes and floaters
- The appearance of a “veil” or curtain across the field of vision
- Sudden changes in pupil size
- Sensitivity to light
- Foreign body in the eye
- Double Vision
- Post-operative patients with pain in or around the eye, infectious discharge, increased redness, or decreased vision (in either eye)
Chemicals In The Eye
If you get an acidic or caustic chemical in your eye (e.g., chemical burn), please stop reading this and irrigate your eye with clean contact lens solution, if none is available, you may use clean tap water. Do this for 15 minutes, and then call Bell Family Eye Care or go directly to the nearest emergency room.
Mechanical Injury to the Eye
If you mechanically injure your eye or something gets in your eye, DO NOT push on your eye. DO cover your eye with a rigid shield, if one is available. However, do not put anything under the shield that would press on your eye. A rigid shield can be fashioned from the bottom of a paper cup. Alternatively, put your glasses or sunglasses on, which will also provide protection. Construction activities account for a large percentage of eye injuries seen at the Infirmary. Many of these injuries are preventable by the use of appropriate eye safety protection. Everyone engaged in construction activities, either at home or on the job, should wear eye protection at all times. Sports activities also account for a large number of eye injuries every year. Many people do not realize that sports activities such as basketball and golf can be associated with significant eye injuries. Many children also sustain eye injuries during sports. and therefore, protective eyewear during such activity is encouraged.
Viral conjunctivitis is a very common infection of the outer layer of the eye, the conjunctiva, usually caused by the common cold virus. Treatment is largely supportive, consisting of cool compresses and artificial tears. Often we give an antibiotic ointment to soothe the eye and protect it from bacterial infection, but this does not treat the viral process, which resolves on its own. Patients with viral conjunctivitis are contagious for approximately seven days after the onset of symptoms. Patients should be very careful to avoid touching their eyes and frequent hand washing is advised. The symptoms of viral conjunctivitis can last up to three weeks and may fluctuate before finally resolving. Viral conjunctivitis is very common, especially in the winter months. Nonetheless, not all cases of a red eye are viral conjunctivitis and anyone who has a red eye that does not seem to be improving should be seen to rule out other causes.
PREVENTION OF EYE INJURIES
The good news is that most of these injuries can be prevented with protective eyewear. The best prevention of an eye injury is to use protective eye equipment as appropriate such as, when playing sports, or working with caustic chemicals. For other eye emergencies, the best prevention is an immediate response to the symptoms of an eye emergency. To reduce your risk of injury, wear certified protective eyewear whenever you play ball sports or hockey. Certified lenses display approval stickers from either the American Society for Testing and Materials (ASTM) or the Canadian Standards Association (CSA). Regular glasses, sunglasses, open-sided eye guards, and contact lenses do not provide adequate protection. Adequate eye protection is especially important for people with low vision or a blind eye, as they may be at greater risk of going completely blind after suffering an eye injury.
Minor Eye Injury
For minor or less urgent injuries, please calling our office is often the wisest choice. Flashing lights and floaters The sudden onset of many floating spots and flashing lights in association with the feeling that part of the vision is covered by a black curtain or a shade may represent a retinal tear or detachment. An examination is essential as soon as these symptoms appear. Anyone who has the onset of new floaters with or without flashing lights should be seen for a dilated fundus exam as soon as possible.
Pediatric Eye Care
Almost 15% of our children suffer from undiagnosed refractive problems such as excessive hyperopia, myopia, or significant astigmatism. Failure to identify these conditions at an early age can result in the development of amblyopia. Failure to detect these conditions can delay perceptual skills, reading abilities, create attention deficits and lead to the failure of the eyes to work together which, in turn, causes problems with depth perception. Fortunately, most of these conditions are easily treatable with glasses or contacts.
Eye Symptoms Checklist
Do they consistently turn their head to one side?
Do they consistently turn their head to one side when picking something up?
Do they seem startled if you approach from one side vs. the other?
Do they seem to consistently miss seeing something of interest?
Were there any complications during or immediately after birth?
Do their pupils look the same?
Do they have a family history of a lazy eye?
Do they sit close to the TV because they say they cannot see it?
Do they complain of headaches?
Do they tilt their head to one shoulder or to one side consistently when watching TV or reading?
Do they have a shorter attention span than usual when doing near tasks?
Were they slower than expected in hitting their milestones?
Do they have attention issues?
Do they say they have headaches?
Do they complain of double vision or blurred vision at distance or near?
Do they have trouble seeing the board?
Have their reading comprehension scores started to drop?
Do they lose their place on the page or use their fingers to keep track of where they are on the page (after 2nd grade)?
Strabismus, more commonly known as eye turn, affects about 3-4% of our children. It is an inability for the eyes to maintain alignment in the same direction simultaneously. When one or both eyes turn in or out, (esotropia and exotropia respectively,) symptoms such as headaches and blurred vision may occur. Hypertropia, also known as vertical misalignment, is much more difficult to pick up. It often manifests as blurred vision, headaches, and changes in reading speed and comprehension. Children will often start using their fingers or another object to help guide them (or prevent them) from losing their place in line as they read. In addition to the obvious social implications and cosmetic concerns these children can encounter with eyes looking in opposite directions, they also risk amblyopia and loss of fine depth perception as well as frustrations with reading and often poor performance in a traditional school setting. The treatment for strabismus depends on the type and severity of the condition but may include special prismatic glasses, surgery or vision therapy.
CHILDHOOD OCULAR DISEASE
Childhood ocular disease, though rare at about 0.5% of our children, has the most devastating effects. Childhood ocular diseases like retinopathy of prematurity, retinoblastoma (a 100% fatal cancer of the eye if not detected early in the disease), and toxoplasmosis (a fungal disease transferred from the mother to fetus through the placenta), can have effects much greater than just vision and ocular health. The treatments are variable depending on the condition, but early detection is the key.
Amblyopia, the term used to describe a preventable reduction in visual acuity in one or both eyes, affects 2-8% of the overall population. It may be caused by strabismus, developmental ocular diseases such as cataracts, or a significant difference in the prescription between the two eyes. It may lead to a permanent decrease in vision; if untreated, through pre-adolescence, and may have a significant impact by creating many occupational limitations. If caught early, the condition may be corrected through glasses, patching, or vision therapy.