Your Exam

During your visit, your eyes will be examined thoroughly. Before your pupils are dilated, your vision in both eyes will be measured; your pupils tested for reaction to light; eye movement evaluated; peripheral vision checked; and eye pressure measured to screen for glaucoma.

After allowing time for your pupils to dilate, the doctor will use specially designed medical instruments to examine your eyes, including the macula, retina and vitreous.

Depending on initial findings, other tests may be required, including:

ULTRASOUND. Ultrasound uses sound waves reflected from eye tissue to produce an image that enable the doctor to take specific measurements of the eye's anatomy.

OPTICAL COHERENCE TOMOGRAPHY (OCT) is a new, non-invasive technology used for imaging the retina, the multi-layered sensory tissue lining the back of the eye. OCT, the first instrument to allow doctors to see cross-sectional images of the retina, is revolutionizing the early detection and treatment of eye conditions such as macular holes, pre-retinal membranes, macular swelling and even optic nerve damage.

FUNDUS PHOTOGRAPHS. These involve the use of a sophisticated camera to study the retina.

FLUORESCEIN ANGIOGRAPHY is a common diagnostic test that uses a special camera to take pictures of the back of your eye. This enables your ophthalmologist to thoroughly diagnose and monitor certain retinal diseases and abnormalities, which may otherwise go undetected without the use of fluorescein angiography. This test may be performed the day of your visit, or scheduled for you to come back another day.

A water-soluble dye, called fluorescein, is injected into a vein of your arm or hand. As the dye circulates throughout your body, the retinal photographer will take multiple pictures of the blood vessels lining the back of your eye as the dye passes through them. After the fluorescein dye is injected, your skin may look faintly yellow for several hours. This does not mean jaundice or hepatitis. As the dye passes through your kidneys, your urine will turn dark orange or yellow over the next twenty-four hours.

A small percentage of individuals may experience nausea or vomiting after the injection of dye. However, this is transient, and usually passes within a minute or two. If some of the dye leaks out from the vein and into your arm under the skin, you may feel a localized burning sensation that lasts only a few minutes. Allergic reactions to fluorescein dye are rare. If they occur, they may cause a skin rash or itching. This is usually treated with oral or injectable antihistamines, depending on the severity of the symptoms. Even more rarely, severe allergic reactions can occur that are life threatening. Please inform your doctor if you are pregnant, had breast surgery or have had an adverse reaction in the past. Fluorescein is a relatively safe dye. Unlike the dye used for CT scans, heart angiograms and kidney studies, fluorescein dye contains no iodine. Therefore, the risk of allergic reactions or kidney problems from the injection is much lower. Patients who have allergies to iodine dyes can safely receive the fluorescein injection. After the test, vision may be blurry for several hours due to the multiple bright flashes of light.

These are photographs, not x-rays. There is no exposure to radiation from this test. Because angiograms are much more effective than regular eye exams in showing the presence or absence of abnormal blood vessels, patients may often undergo repeat angiograms on return visits to evaluate the response to treatment and the need for additional treatments.

Occasionally, patients undergo a different type of angiography called Indocyanine Green Angiography (ICG). This test is similar to a fluorescein angiogram except that it uses a different dye called indocyanine green. In some situations, ICG may allow identification of an area of leakage not visible on the fluorescein angiogram. After the photos are taken, your doctor will discuss with you what follow up is needed. A treatment plan will be formulated for you by your ophthalmologist after careful examination and interpretation of your angiogram.

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