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Did I Pass? How to Survive the Eye Test

By Sasha L Radford, OD


 

Do you get nervous about having your eyes checked?

I’ve noticed many patients are anxious about the eye exam. I used to think that visiting an optometrist was a breeze from a patient’s standpoint – you get to stay fully clothed, you don’t get shots or have blood drawn – nothing is really painful. Sure, there’s that puff of air everyone hates (pfft, I don’t use that anymore). No one enjoys having their pupils dilated but it doesn’t last very long and sometimes isn’t even necessary with the new imaging technologies.

I’ve learned over the years that eye examinations aren’t perceived to be as pleasant as I’ve always thought. Something about the eye exam fills patients with dread and foreboding, causing them to postpone their visit as long as possible – much the same way I procrastinate going to the dentist. It’s not the air puff; that’s over in a second. It’s not the dilation; that goes away after a few hours. The procedure we do that causes the most anxiety is the refraction – the part where we ask which lenses make the letters more clear – if you don’t answer correctly, will you get the wrong glasses?
Isn’t that a lot of pressure to put on someone? Of course you want your glasses to be made correctly but often the lenses we show you look very similar and you can’t make a decision. Sometimes we even coach you to read letters smaller than you can actually see, saying, “Guess if you need to! What does it look like? Keep blinking!” What’s worse is the fear of failing the test. Not only might you have an inadequate prescription in your new glasses, but you’ll be afraid that your vision is declining or that you might be blind someday.

How can we make this procedure less stressful?

The following tips will make you feel much better about your refraction. While you still may not take pleasure in the experience, at least now you’ll know how it works and why we do the frustrating things we do during your visit.

 
1.  The refraction is not a test. You cannot pass or fail! Refraction is formally called “subjective refraction,” which means whatever you say goes. Whatever looks the most clear to you is perfectly valid and there is no right or wrong answer.

2.  The refraction is a careful refinement of your glasses prescription, most of which we already know before we begin the test. If it seems like we’re splitting hairs here, we are! We have an instrument which gives us a very close estimate of what your prescription needs to be. Using that as a starting point and checking for your preferences, we discover the best lens combination for you.

3.  We do not try to trick you into being inconsistent or show you the same two lenses. We have many checks and balances during the refraction to make sure we’re on the right track, so if you do give an answer that seems a little unusual, we can double check it.

4.  You don’t have to choose between one and two. The choices often look incredibly similar and that is intentional. If they look the same, or if they’re both blurry in slightly different ways, just say so. During much of the refraction, we actually want you to say the choices look the same. It indicates we are at the endpoint of that step and can move on.

5.  The reason we push you to read the smallest possible line is because that is how visual acuity is properly measured – whether it’s crystal clear or not, your visual acuity is based on the smallest discernible letters you can correctly identify.

6.  It’s common for the eyes to dry during the refraction because you’re staring at the screen, concentrating. Those with dry eye syndrome have a more difficult time with this. Remember to keep blinking.

You cannot pass or fail the refraction! I said that already, but it bears repeating. The refraction is a refinement your glasses prescription so your vision is the best it can be. Occasionally the resulting prescription doesn’t seem quite right to you. In most cases, your eyes adapt to the new lenses in a few days. However, if you’re still having difficulty after several days, please let your eye care provider know. We are happy to recheck your prescription and solve the problem.

Remember, the refraction is not supposed to cause you stress; it is designed to help you see your best. So sit back, relax, and tell me: One? Or two?