What Does A Comprehensive Eye Exam Check? – Interview With Jayden

Another excerpt from Ezekiel Eyes Optometrist Jayden’s interview for our YouTube channel, this time on what actually happens during a comprehensive eye exam — and why it’s a lot more than just reading letters off a chart.

Jayden walks through the process from the initial conversation through to the technology that lets us pick up on early signs of serious eye conditions and touches on something a lot of patients don’t expect: how much a simple look at the back of the eye can reveal about overall health.

Key Takeaways

• A comprehensive eye exam starts with a conversation about the patient’s concerns, visual needs and medical history before any testing begins.
• An eye health check — examining the structures at the front and back of the eye — is arguably the most important part of the exam.
• Equipment like OCT scans, retinal photography and visual field testing can pick up on issues invisible to a standard vision chart exercise.
• The back of the eye can reveal early signs of conditions like high blood pressure, diabetes and high cholesterol.
• Conditions like glaucoma often have no early symptoms, since the brain compensates and the unaffected eye covers for vision loss in the other.

It Starts With A Conversation

“The first step is to just have a chat with the patient about their concerns, not only their concerns but also their visual needs.” — Jayden Simpson, Optometrist

One of the things that drew Jayden to Ezekiel Eyes in the first place was the amount of time given to each patient — enough to actually get to know them, not just run through a checklist. A comprehensive eye exam reflects that. Before any testing begins, a consultation starts with talking through what the patient is actually concerned about, what they’re hoping to get out of the appointment, and what’s going on in their day-to-day life that might be relevant.

From there, a proper history is taken — medications, systemic health conditions, family history — which shapes how the rest of the eye exam is structured. At Ezekiel Eyes it is not a formality. That history genuinely determines what to pay closer attention to once the clinical testing starts.

The Vision Chart Is Just The Beginning Of An Eye Exam

“An eye test is so much more than a vision chart.” — Jayden Simpson, Optometrist

After the history, the exam moves into the parts most people are familiar with — the vision chart, checking whether a prescription is needed, and looking at how well the eyes focus and coordinate together. But the health check that follows is where the real depth of a comprehensive exam begins.

This involves a thorough look at the structures making up both the front and back of the eye. If anything looks out of the ordinary during that examination, that’s when additional testing comes in — and this is where Ezekiel Eyes has the right equipment on hand to make a genuine difference. Between OCT scanning, retinal photography and visual field testing, there’s a lot more available than what a basic vision check alone would ever pick up on.

What The Back Of The Eye Can Reveal About General Health

“The eye is one of the only places where you can view naked blood vessels.” — Jayden Simpson, Optometrist

It’s a bit of a cliché to call the eyes a window into general health, but there’s genuine truth behind it. The eye is one of the few places in the body where blood vessels can be viewed directly and without any invasive procedure, and because blood vessels run throughout the entire body, changes at the back of the eye can point to what’s happening elsewhere.

High blood pressure is one example. Diabetes is another — uncontrolled blood sugar can show up as small bleeds at the back of the eye, which can be a useful prompt for a patient to get their levels under tighter control. Cholesterol issues can present with changes there too. It’s a large part of why GPs and optometrists work closely together — a look at the back of the eye can reveal information that is relevant well beyond eye health alone.

Catching Eye Conditions Before They Become Noticeable

“A lot of the time glaucoma is asymptomatic, and you don’t get any symptoms early on.” — Jayden Simpson, Optometrist

Some conditions are particularly good at staying hidden, and glaucoma is a perfect example. It typically affects peripheral vision first while central vision stays intact, and because we don’t walk around with one eye covered, the unaffected eye compensates without us ever noticing anything’s changed. By the time it becomes obvious without testing, meaningful vision loss has often already occurred.

This is where diagnostic equipment matters. Visual field testing isolates each eye individually — the patient covers one eye at a time and responds to lights appearing in their field of vision, which removes any compensation from the other eye and gives a genuinely accurate picture of what’s happening. OCT scanning adds another layer, building a detailed cross-section of the interior of the eye, layer by layer, making it far easier to pick up anything out of the ordinary than examination alone ever could.

These objective tests are timestamped measurements, that allow our Ezekiel Eyes optometrists to compare directly against future scans — which means changes over time become measurable rather than something a patient has to notice and report themselves.

Final Thoughts

The pattern across all of this is the same: a lot of what matters in an eye exam simply isn’t something you’d notice yourself, whether that’s a slowly bulging cornea, blocked oil glands, or the earliest signs of glaucoma or diabetic retinopathy. A comprehensive exam at Ezekiel Eyes exists precisely because symptoms are often the last thing to show up, not the first.

If it’s been a while since your last full eye exam, or you’ve never had one that went beyond a basic vision chart, it’s worth booking a consultation with us at Ezekiel Eyes, today.

Scheduling an appointment with us is straightforward and hassle-free. Simply give us a call at (08) 9386 3620, and our friendly staff will be happy to assist you in booking a convenient time for your consultation. Alternatively, you can click the “Request an Appointment” button to arrange a call-back.

YOUTUBE TRANSCRIPT

0:00

So one, again, to go back to why I joined Ezekiel Eyes, one of the things that attracted me so much to the practice was that every patient is treated as an individual, and you, you get the time to get to know them.

0:21

You, you can ask about their day, what they’re doing, and I think part of the reason where we’re fortunate enough to do that is because we do have a little bit longer that we can spend with the patients.

0:31

So as far as what we do during a comprehensive eye exam and what it involves, I start by just asking the patient about their day, to be honest with you, before we go into the clinical side of things.

0:42

But obviously the first step is to just have a chat with the patient about their concerns, not only their concerns but also their visual needs.

0:49

So what are they actually wanting to get out of the exam? What solution can I offer them? What’s their problem?

0:55

We then take a good history, so any medications, anything like that, systemic history, family history, is that’ll also give me a pretty good idea of, of what’s important and how to structure the exam.

1:09

So the first thing is it just starts with the history.

1:11

Then what we do is, of course, we do the vision chart, which everyone is familiar with. We have a look at whether or not there’s any prescription there.

1:19

We then have a look at how the eyes are focusing, how’s the coordination of the eye muscles, anything like that. Then obviously we do the health.

1:27

So the health check’s the most important part of the eye exam, I would say. So we, we really, really thoroughly examine the front and back of the eye.

1:35

So we look at all of the structures that make up the front of the eye, we look at all the structures that make up the back of the eye, and then if there’s

1:43

any concerns or anything untoward coming from that testing, then we might do some extra tests. So we’re really, really lucky we have amazing technology at Ezekiel Eyes.

1:53

Which I’m not sure if you’ve heard of or not, Paul, but we have this what’s called an OCT machine. We have these retinal photos which take a photo of the back of the eye.

2:01

We have these visual field testing equipment.

2:04

So we have all of this testing equipment, whereas if something’s looking not quite right or we just want to make sure that everything’s okay,

2:11

then we have these— this equipment available, which is amazing, that we can then go on and perform with the patient. It just gives us so, so much rich information.

2:20

Again, I think the take-home message is an eye test is so much more than a vision chart. It’s again, it’s almost an art, Paul. I’ll keep coming back to that.

2:31

And I know it’s probably a bit of a cliché, but the window, the eyes really can be a window into somebody’s general health, can’t they?

2:40

I mean, your optometrist can maybe see the first signs of things like hypertension simply by you know, examining the, the back of the eye, can’t they?

2:51

Oh, it’s incredible. The, the eye is one of the only places where you can view naked blood vessels.

2:57

And because blood vessels obviously run throughout our whole body, if there’s issues with these blood vessels going on in the back of our eye, then there’s a pretty good chance, and we can infer from that, that these issues are also going on everywhere else in the body.

3:10

Which is why general practitioners love optometrists so much, is because we can view these, these blood vessels at the back of eye and just infer so much information about the patient’s general health.

3:22

So not only high blood pressure, but the other one that we see a lot is diabetes.

3:27

So sometimes in diabetes, when we image the back of the eye or we have a look with these lenses, we can see sometimes, if it’s uncontrolled, these small little bleeds.

3:36

And what we can infer is that if there’s these small little bleeds at the back of the eye going on, then there’s a pretty good chance it might

3:43

be occurring elsewhere in the body, and there’s a pretty good, um, motivator to try and get our blood sugar under tighter control.

3:52

So you can tell so much information just by looking at the back of the eye.

3:55

Cholesterol issues as well, that also presents with changes at the back of the eye.

4:00

There’s so many different conditions, and there’s so much we can infer just from looking at the back of someone’s eye. It’s, um, A lot more than people would think.

4:09

It’s really amazing. It’s really amazing. And because the human brain is so adaptable, sometimes

4:17

there are changes happening in your vision which the brain kind of compensates for.

4:23

And I’m thinking about things like maybe glaucoma, macular degeneration, even cataracts.

4:30

So are the kind of tests that you do one way of getting like an objective reading on those conditions before they get, you know, to a very serious extent.

4:43

Yeah, absolutely.

4:43

So like you said, they’re all very objective measurements, which is really good, and they all have a timestamp to them.

4:49

So we can then compare future scans to previous scans and we can see how things are changing over time. You’re exactly right, especially with glaucoma, for example.

4:59

A lot of the time glaucoma is asymptomatic and you don’t get any symptoms early on.

5:06

And a lot of the reason for that is because generally the pattern of glaucoma is you start to lose your peripheral vision but you preserve your central vision.

5:15

So what happens in a lot of patients is they might be getting this peripheral vision loss, but you don’t walk around covering one eye, so you never realize.

5:25

And the other thing is, you’re spot on, the other eye compensates for it.

5:29

So the way we overcome this compensation, of course we test one eye at a time, but to go back to the equipment is we have something called a visual field machine, for example, which is particularly helpful in glaucoma.

5:41

Anyone that’s done the test will remember it, but basically you cover one eye at a time and the patient looks, puts their head in a— almost looks like a fishbowl, and they click a button every time they see a light.

5:52

And because you’re isolating each eye, it gives really, really good idea of what the patient is actually seeing day to day without any compensation from the other eye.

6:03

So tests such as that are just so, so handy to get a good idea of, of what’s actually going on.

6:08

The other thing is, like I touched on briefly, these OCT scans, which basically uses light to produce a cross-section of your retina, which is the back of the eye.

6:19

And we can scan through with such precision and just see all of the different layers that make up the eye that if there is any

6:26

conditions or disease or anything out of the ordinary, it’s just so, so easy to pick up on these scans. It’s— they really have revolutionized eye care.

6:35

The patient outcomes are just so much better these days because, because of the precision of this equipment, it’s so much easier to diagnose.

6:43

So we’re, we’re so lucky, especially again out of Ezekiel Eyes. We have amazing equipment. I feel so fortunate to have access to everything that we have access to there.