centralfloridahealthnews.com
CFHN | 21 
T 
he human eye is roughly the size of a 
quarter, yet it is incredibly complex. For 
you to have clear, functional vision, several 
different structures must be healthy and 
working in harmony. Think of an eye exam as 
a “bumper-to-bumper” safety check for your 
sight. Here are the primary tests we use to 
ensure your eyes are performing at their best. 
VISUAL ACUITY 
The visual acuity test is the cornerstone of the 
eye exam. This is the familiar process of read-
ing increasingly small letters on a wall chart 
to measure the sharpness of your vision. The 
ideal score is 20/20, but what does that actu-
ally mean? The top number indicates the dis-
tance you are from the chart (usually 20 feet). 
The bottom number indicates the size of the 
letter you can identify. If you have 20/40 vi-
sion, it means you have to be as close as 20 
feet to see what a person with “normal” vision 
can see from 40 feet away. The smaller that 
bottom number is, the sharper your vision. 
EYE PRESSURE
This is most commonly tested by the “air puff” 
machine (medically known as Tonometry). 
While some might find the puff a bit startling, 
it serves a vital purpose. The pressure inside 
your eye can tip us off to various conditions. 
A typical score for most people is between 
10 and 20. Readings outside of this range can 
indicate issues like glaucoma, inflammation, 
or infections. However, “ideal” pressure varies 
from person to person, so it is your eye doc-
tor’s job to determine what is a safe level for 
your specific eyes. 
EYE ALIGNMENT
Each eye is moved by six small muscles at-
tached to the outside of the eyeball. These 
muscles ensure that both eyes are focused on 
the exact same spot at the exact same time. 
When these muscles are out of balance, your 
eyes stop working as a team. This can cause 
you to see double because each eye is send-
ing a slightly different “picture” to the brain. By 
conducting this test, we can identify which 
muscle is struggling and determine what 
might be causing the lack of coordination. 
PUPIL CHECK
The pupil is the dark opening in the center of 
your eye that acts like a window, changing 
size to control how much light enters. These 
changes are controlled automatically by sig-
nals sent between your brain and your eyes. 
We test this reaction by shining a light directly 
at the eye and observing how the pupil re-
sponds. If the pupil doesn’t “zip up” or react 
as expected, it can indicate a problem within 
the eye itself, the brain, or the pathways in be-
tween. 
REFRACTION
This is the part of the exam where the doctor 
asks, “Which is better: one or two?” This test 
allows us to determine if you are nearsight-
ed (struggling to see far away) or farsighted 
(struggling to see up close). By fine-tuning 
these options, we can find the exact prescrip-
tion needed for your eyeglasses or contact 
lenses to bring the world back into focus. 
THE PHYSICAL HEALTH CHECK
Using a specialized microscope called a Slit 
Lamp and powerful hand-held lenses, we 
examine the actual structures of the eye. We 
look at everything from the clear “windshield” 
(cornea) in the front to the “wallpaper” (retina) 
in the back. This part of the exam allows us to 
assess for eye-specific conditions like macular 
degeneration (wear and tear on your center 
vision) or infections. Remarkably, we can also 
see early signs of “whole-body” health issues 
— such as high blood pressure, high cholester-
ol, or diabetes, sometimes even before your 
primary care doctor detects them. 
Eye exams are not “one size fits all.” We may 
add or remove certain tests depending on 
why you are visiting. However, these basic el-
ements provide a vital foundation for the rou-
tine eye care we recommend at least once a 
year. Our team of doctors at Eye Specialists of 
Mid-Florida will gladly assist you with any of 
your vision needs. We have several locations 
to serve you better; contact us at 800-282-
3937 or EYESFL.COM. HN
RYAN PEARDON, O.D.
HEALTHY 
AGING
ADVERTORIAL
HEALTHY 
AGING
Beyond the Chart:  
What Is Really Happening 
During an Eye Exam  
by RYAN PEARDON, O.D.
This column is sponsored by Eye Specialists of Mid-Florida, and the opinions expressed herein may not reflect those of CFHN or of its advertisers. 
About the author: Dr. Ryan Peardon is a board-certified optometrist who sees patients at the Lake Wales and Winter Haven locations for Eye Specialists of Mid-Florida. He specializes in primary care optometry and contact lenses and 
is currently accepting new patients. 

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