Initial Eye Test for Laser Eye Surgery


At the initial appointment, the eye surgeon/ophthalmic surgeon/ophthalmologist will assess your eyes and your suitability for laser eye surgery.  An in-depth eye examination using advanced equipment will be completed.  The assessment will include an eyesight test and a series of diagnostic tests for example, measurement of the thickness of the cornea and assessment of the cornea in different light conditions, followed by computerised imaging of the eye surface.  The tests and assessment procedures vary between clinics depending on how advanced their technology is, the type of laser eye surgery they conduct and variations between individual eye surgeons.

Contact Lens Users

If you wear contact lenses, you may be required to stop wearing these prior to this appointment and asked to start wearing prescription glasses.  This is because contact lenses change the shape of the cornea over a period of time and therefore will not enable a true analysis of the corneal topography (cornea shape).  An inaccurate assessment of the natural shape of the cornea can lead to negative consequences of surgery such as poor vision.  It is important to seek advice on when wearing contact lenses should be stopped, prior to the initial assessment.

Eye Test Procedures

Many of the tests mentioned below may be repeated closer to the actual laser eye surgery procedure.  This is to obtain the utmost accuracy.  The surgeon should be made aware of past and present medical and eye conditions, medications taken and allergies.  The results of tests and assessments listed below, will determine or reveal:

  • The degree of optical error
  • The thickness of the cornea
  • Wavefront results
  • Eye disease
  • The size of the pupil
  • Mapping data

Focimetry

This is the determination of focal length and will determine prescription strength by measuring spectacle power

Autorefraction

Light is changed as it enters the eye and autorefraction measures this light to reveal refractive error and a person’s prescription.

Wavefront/WavePrint

Everyone’s vision is unique and wavefront technology provides the eye surgeon with a wavefront map, which is a more detailed visual analysis that can help provide personalised laser vision correction treatment.

Tonometry

This is used to detect glaucoma by determining the pressure in the eye by measuring the tone or firmness of its surface.  It is able to determine the intra-ocular pressure both preoperatively and postoperatively.

Pentacam

This gives detailed information about the cornea including its surface shape and thickness.

Computerized Topographical Analysis

This enables a detailed analysis of the shape of the cornea so that it can be analysed in detail by the surgeon and can also help him/her predict the effects of laser eye surgery.

Visual Acuity Testing

This is a common test in most regular eye examinations.  It involves your ability to see black letters that become increasingly smaller on a white background.  A numerical value is calculated from the results.

Pupillometry

This is the measurement of the diameter or width of the pupil of the eye in the dark, when it is at its largest. 

Pachymetry

An ultrasonic probe may be used to measure the thickness of your cornea.

Slit Lamp Exam

This test looks at structures that are at the front of the eye including the eyelids, the sclera, conjunctiva, iris, lens and cornea.  It can also detect diseases of the eye including, Retinal Vessel Occlusion, Retinitis Pigmentosa, Cataract, Corneal injury, Dry eye, Macular Degeneration, Retinal Detachment and Uveitis.

Keratometry

Both automatic and manual keratometry may be completed to measure the curvature of the central three millimetres of the cornea.

Retinal Examination (ophthalmoscopy/fundoscopy)

This examines the back of the eye, including the retina, optic disk and the underlying layer of blood vessels.

Endothelial Cell Count (ECC)

This is used to determine the number of endothelial cells present on the back of the cornea, as well as the health of the endothelial cells.  These cells are responsible for corneal clarity and hydration of the cornea.

Contrast Sensitivity Analysis

This is a measure of how well you can see images in different lights.  For example, you may only be able to see small objects when contrast is very high and large objects when contrast is low.

A-Scan

This uses ultrasound to measure the axial length of the eye, which is the length from the cornea to the retina.

If all the basic conditions have been met and the surgeon is happy with the results of the various tests and assessments and laser eye surgery is suitable, you can prepare for the procedure.

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