This post reminded me of a question I have. I’ve worn glasses since I was 7. Until just a few years ago, every trip to the optometrist required dilation. I understand why - dilation forces your eyes to relax, not just the iris, but also the lens. That way the refraction exam can be performed without the patient interfering by inadvertently attempting to focus. However, in the last few years that practice seems to have stopped. Why don’t optometrists seem to need or want to dilate the patients eyes prior to an exam anymore and how can they possibly get an accurate prescription that way?
Dilation is done so the retina can be fully examined, not because it’s necessary to check refraction.
If the doc feels there’s no need for a complete retina exam, then a standard slit-lamp exam along with pressure check and refraction gives sufficient info to judge eye health and correction needed.
How common is an allergy to the eye dilation drops? I had them for years with no ill effects until one day I had severe flulike symptoms a short time after I got home from the exam. I’ve not had them since.
I had an eye exam about a month ago, and the ophthalmologist did dilate my eyes. Perhaps your optometrist had a reason for not dilating yours.
Yes…and no.
Since dilating drops cause cycloplegia too, one of the indications for dilation is not only the need for a full retinal exam, but also if various eye conditions related to the ciliary muscle are suspected – like latent hyperopia, pseudomyopia, or accommodative spasm. These things can and do interfere with the prescription gotten through a refraction.
Of course, dilation can actively interfere with refraction too. Giving a young hyperope a prescription for their full hyperopic prescription gotten through a dilated refraction will cause them to hate you and their new eyeglasses. But it can be useful to do both a pre and post dilation refraction on certain patients, so you know both their “wet and dry” prescription, as it’s sometimes called.
At any rate, I have no idea why you’re not being dilated now. Did you change eye docs? Some eye doctors seem more likely to dilate than others, and some seem more likely to do a full fundus exam for various reasons. For example, high myopes are at greater risk of retinal detachment, but plenty of eye doctors disagree about how myopic a patient needs to be before routine dilation at a yearly eye exam is necessary.
That’s what I get for speaking in absolutes, cromulent. I should have said dilation is mostly done so the retina can be fully examined.
Thanks for for the expert input.
Well, being in my second year of optometry school, I wouldn’t call myself an expert on anything. (Except keeping my eyes open without blinking – I’m good at that. It makes it easier on your ophthalmoscopy practice partner.)
But thanks!