Dilated Eye Exam: Why, When and How Your Doctor Does It

dilated eye exam

What to Expect at Your Eye Exam Center in Palm Beach County

Pupil dilation during an eye examination is essential in preventing, diagnosing and treating eye conditions that may impact your vision. The board-certified optometrists at our eye exam center in Palm Beach Country, FL briefly explain the importance of having your eyes dilated during your next examination.

Why Does Your Eye Doctor Dilate Your Pupils

The iris is the part of the eye that has given rise to many famous songs over the years. Brown eyes, blue eyes, green eyes; all have made their way into the lyrics of songs. The iris is the pigmented part of the eye that determines eye color. But the iris has a much greater role in the eye than wielding eye color and inspiring songs – it’s greatest job is controlling the amount of light that makes its way to the inside of the eye, having a profound impact on vision and the preservation of eye health. The iris is composed of muscle fibers, which constrict or reduce the size of the pupils when exposed to bright light and dilate or enlarge the size of the pupils when in poor lighting. Given a bright light is needed to evaluate the health of the inside of the eye, the microscope used by your eye doctor illuminates the eye and constricts the pupils in so doing. Dilated pupils allow more light giving your optometrist a better view of the inside of your eyes. This assists in the diagnosis of many eye conditions and ailments such as:

  • Macular degeneration
  • Retinal detachment
  • Glaucoma
  • Eye tumors
  • Diabetes
  • High blood pressure
  • Infectious diseases
  • Vasculitis from autoimmune conditions

What Happens at Your Dilated Eye Exam

During your eye examination, your eye doctor will instill dilating eye drops into each eye. Given that some people are uncomfortable with the idea of anything in or around their eyes, our doctor and staff are happy to place these drops at the corner of closed eyelids to put our patients at ease.  Typically, it takes 15 to 30 minutes for pupils to dilate and 4 to 24 hours for the effect to completely wear off. Once dilated, each eye is examined using a special magnifying lens that provides a clear view of the inside of the eye, including the retina, the macula, the blood vessels and the optic nerve.

The National Eye Institute reports that a comprehensive dilated exam is the only way to make sure your eyes are healthy. Key elements of the examination include dilation, tonometry (a test that measures eye pressure and can provide a risk assessment for glaucoma), an assessment of peripheral vision, and a visual acuity test (reading an eye chart to gauge your eye sight at various distances).  

The measurement of eye pressure has in the past generated some angst of its own, as many do not quickly forget “the air puff test,” whereby air is briefly blown at the eye (at hurricane force wind speeds as recalled by many-we jest) to determine the amount of pressure inside of the eye.  Rest assured that “the air puff test” has been banished from SeaView Eyecare and has been replaced with a much gentler test that all of our patients agree is much improved.

Although minimal, there are some side effects to dilation. Dilation makes your vision blurry, particularly at near and increases your sensitivity to light, which can affect your ability to drive or work. Pupil dilation tends to last longer in individuals with lighter colored eyes (such as hazel, blue or green), and occasionally, with children. Because of these effects, we recommend scheduling your eye examination at time when you do not plan on returning to work or school immediately afterward. Of note, patients are permitted to wear their contact lenses and/or glasses after their dilated examination, but are most certainly recommended to wear sunglasses for the drive home.

When to Have a Dilated Eye Exam

How frequently you should have your eyes dilated depends on many factors, including the reason for your exam, your age, your overall health, and your risk of eye diseases.

With glaucoma being a major cause of vision loss in the United States, the National Eye Institute recommends that those at higher risk for glaucoma do so annually or every two years. While anyone can develop glaucoma, people with a higher risk include individuals above the age of 60, African Americans aged 40 years and over, and those with a family history of the disease.  

Also, the American Academy of Ophthalmology has specific recommendations for diabetic patients.

  • Type 1 diabetics should have their first eye exam within 5 years of diagnosis and every year thereafter.
  • Type 2 diabetics, should have their eye exam at the time of diagnosis and every year therafter.
  • Diabetic patients who become pregnant should have an exam early in the first trimester.

Children and Dilation

Many parents have expressed concern over the need for dilation for their young children. We can assure you it’s very safe; so much so that it’s possible you were dilated as a baby prior to leaving the hospital, as is the case for all neonates in the Neonatal Intensive Care Unit.  It’s important to note also that dilation does not only serve the purpose of permitting a more comprehensive view of the inside of the eye. Dilation drops not only relax the pupillary muscles, they relax the ciliary muscles. The ciliary muscles are responsible for accommodation, or near focus. While this can be important in adults, it’s most critical in children, as they have very strong ciliary muscles, which can compensate for and obscure far-sightedness and affect the accuracy of the prescription determined by the doctor.  In short, dilation can be instrumental in arriving at the most accurate prescription for our youngest patients. It is in fact the absence of dilation at the vision screenings performed in schools and in the pediatrician’s office that often leads to the delayed diagnosis of far-sightedness in young children. Far-sighted children are able to focus and read the eye chart for short periods of time, thus obscuring the presence of often-significant vision problems. Uncorrected far-sightedness can often lead to delays in learning and reading skills.

Finally, it is important to make clear that absolutely nothing can replace dilation. There are some wonderful instruments now available to us in this age of great technological progress. Our office is proud to provide one such instrument, which captures an image of the inside of the eye to better screen for disease and to monitor for the progression of disease. However, there exists no such instrument that can provide imaging to the extent possible with a dilated examination with its 3-dimensional views. While we hold these new instruments in high regard, please do not make the mistake of forgoing a dilated examination by your eye doctor.

Our state-of-the-art SeaView optometric eye care center in Lake Worth provides comprehensive services for your whole family. We have invested in the latest diagnostic tools to provide you with prescriptions for the clearest vision as well as detect any eye problems. An extensive range of eye wear and sunglasses helps cater to diverse tastes. If we do not have the frames you desire, we  will be happy to order them for you! As contracted providers for most insurance plans we can help you make optimal use of your benefits to maintain healthy eyes.

Call SeaView Eyecare at 561-790-7290 or contact us online to schedule an appointment at our eye exam center in Palm Beach County, FL.

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