Do Adults Need Dilated Eye Exams? Common Vision Concerns Explained

Q: Do Adults Need Dilated Eye Exams? Common Vision Concerns Explained

Hello： 1. <br>In general, adults do not require the use of mydriatic agents during an eye examination. <br>However, if there are specific needs, the physician will evaluate whether mydriatics are necessary based on your symptoms and condition. <br>2. <br>It is generally normal fo

Do adults need to undergo dilation for an eye exam?

Hello, doctor.
I have quite a few questions, and I appreciate your help.

1.
For an adult (28 years old), is it necessary to use a dilating agent during an eye exam? My concern is that even if there is pseudomyopia, we don't typically use dilating drops regularly, so shouldn't the prescription be based on the measurements taken without dilation?
2.
I have a disparity in my vision and have developed a habit of closing one eye when looking at things up close for too long.
Could this be due to an improper glasses prescription? Previously, the doctor said both eyes should have the same prescription, but one of my eyes doesn't see clearly.
Later, I got a second pair of glasses with a stronger prescription for one eye, but I couldn't get used to them.
After my prescription increased again, I found them more comfortable, but I still tend to close the stronger eye after prolonged use.
Would you recommend prescribing full correction for both eyes?
3.
If the eye exam only uses a phoropter and does not include a cross-cylinder test, does this mean the astigmatism measurements may be less accurate?
4.
Is red-green balance a necessary step in the eye examination process? Thank you, doctor.

Xī bān yá hǎi xiān dùn fàn, 20~29 year old female. Ask Date: 2023/08/07

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
In general, adults do not require the use of mydriatic agents during an eye examination.
However, if there are specific needs, the physician will evaluate whether mydriatics are necessary based on your symptoms and condition.
2.
It is generally normal for the refractive error in each eye to differ, as there are slight variations in everyone's eyes.
However, if there is a significant difference in the refractive error between the two eyes, or if you feel that one eye is not seeing clearly, it may indicate that you need different prescription lenses to correct your vision.
Habitually closing the eye with the higher prescription may suggest poor accommodative ability, and you might consider getting a pair of reading glasses for near tasks.
3.
Nowadays, a standard autorefractor is usually sufficient, and the use of cross-cylinder lenses is rare.
4.
The red-green balance test is used to check if the prescription is too weak or too strong.
When the two colors are balanced, it indicates the prescription is just right.

Reply Date: 2023/08/07

More Info

When it comes to eye health and vision care, regular eye exams are crucial for adults, especially as they age. Here’s a detailed response to your questions regarding dilated eye exams and common vision concerns.

1. Do Adults Need Dilated Eye Exams?
Yes, adults should consider having dilated eye exams, especially if they have risk factors for eye diseases or if they experience vision problems. Dilated exams allow eye care professionals to get a better view of the retina and optic nerve, which can help in detecting conditions such as glaucoma, diabetic retinopathy, and macular degeneration. Even if you have pseudo-myopia (a temporary condition where the eye appears to be nearsighted), dilating drops can help provide a more accurate assessment of your refractive error and overall eye health.

2. Understanding Pseudomyopia and Prescription Needs:
While it’s true that you may not need to use dilating drops regularly, they can provide a clearer picture of your eye health during an exam. If you have a history of pseudo-myopia, your eye care provider may recommend dilating drops to ensure that any underlying issues are not overlooked. Regarding your prescription, if you have significant differences in vision between your eyes, it may be necessary to have different prescriptions for each eye. This is particularly important if one eye is significantly weaker or has a different refractive error.

3. Vision Discomfort and Eye Strain:
If you find yourself closing one eye when focusing on near objects, this could indicate an imbalance in your prescription or an issue with binocular vision. It’s essential to have a comprehensive eye exam where both eyes are evaluated for their specific needs. If your prescription is not accurately addressing the differences in your eyes, it can lead to discomfort and strain. In some cases, a specialized lens or prism may be necessary to help alleviate these symptoms.

4. Importance of Using Proper Equipment During Exams:
You are correct that using only a standard autorefractor without a cross-cylinder lens may not provide the most accurate assessment of astigmatism. The cross-cylinder test helps to refine the prescription for astigmatism by determining the exact axis and degree of the refractive error. If you feel that your vision is not being accurately assessed, it’s worth discussing this with your eye care provider to ensure that all necessary tests are performed.

5. Red-Green Balance Testing:
The red-green balance test is not always a mandatory part of every eye exam, but it can be useful in assessing color vision and ensuring that both eyes are working together effectively. This test can help identify any discrepancies in how each eye perceives color, which can be important for overall visual function.

In summary, regular dilated eye exams are essential for adults, especially those experiencing vision issues or with risk factors for eye diseases. If you have concerns about your vision or the accuracy of your prescriptions, it’s crucial to communicate these with your eye care provider. They can provide tailored recommendations based on your specific needs, ensuring that you maintain optimal eye health and comfort. Additionally, if you experience discomfort or strain, consider discussing the possibility of different prescriptions for each eye to better accommodate your vision needs.

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