Certain conditions make it important for your care provider to get an inside look.
A comprehensive eye exam, like any regular healthcare visit, is often a fairly routine experience. Your provider will complete roughly the same set of tests every time. One step that can vary, though, is whether your care provider needs to dilate your eyes.
Pupil dilation lets your provider get a good look at certain structures inside your eye. For that reason, it’s not always necessary, especially if you don’t have many risk factors for certain eye conditions. Even so, it’s important for your provider to check your retina periodically, and it will get more important as you age—so it can help to know what to expect from a dilated-eye exam.
What is eye dilation, and what are the effects?
The pupil is the black opening in the center of your eye which lets in light so you can see. It’s surrounded by a ring of muscle, called the iris—the same part of your eye that is brown or blue or green. The iris contracts and relaxes in response to light, making the pupil bigger or smaller and controlling how much light enters your eye.
To dilate your eyes, your care provider will put a few drops of medication in them. This medication relaxes the muscles that keep your pupils small, letting them widen and keeping them wide even when your provider shines a light into your eyes.
If your eyes are dilated for an exam, you can expect:
- Blurry vision
- Sensitivity to light
- Trouble focusing on objects up close
The effects of dilation drops can last around 4-6 hours, so it’s important to come prepared to a dilated-eye exam. Be sure to have:
- Sunglasses to protect your eyes afterward. (Some providers give you a disposable pair to take!)
- Someone to drive you home
Who needs a dilated-eye exam?
For most people, it’s a good idea to get a comprehensive eye exam once a year (though you and your provider can determine what’s best for you). Depending on your age, risk factors, and health, you may not need your eyes dilated for every exam.
Dilation lets your care provider get a better look at the back of your eye, specifically at the retina: the light-sensitive membrane that sends visual information through the optic nerve to your brain. Many small blood vessels run through the retina, and early symptoms of a lot of diseases—both eye-specific and whole-body diseases—can appear there.
Examining the retina can help your provider diagnose:
- Glaucoma
- Macular degeneration
- High blood pressure
- Diabetes
- Multiple sclerosis
…as well as a wide range of other conditions. For this reason, a regular dilated-eye exam is especially important if you have extra risk factors for these and other related conditions.
These risk factors may mean you need a dilated eye exam more often:
- Age. The risk of many conditions, such as macular degeneration, increases with age.
- Race and ethnicity. Certain communities have an elevated risk of specific conditions. Black and Latino patients, for example, face an increased risk of diabetes and high blood pressure, which can affect the retina. White patients, especially those with blue eyes, are at a higher risk of macular degeneration.
- Family history. Some eye conditions, like glaucoma, tend to run in families. If a relative has had glaucoma, you are probably at an increased risk of getting it yourself.
- Overall health. A retinal exam can help to diagnose diabetes or high blood pressure—which means that if you already know you have these diseases, it’s important to have your eyes checked regularly. Diabetes, high blood pressure, and other whole-body conditions can cause damage to your retinas and affect your vision.
- Smoking. Smoking can increase your risk of developing certain health conditions, like high blood pressure, that can affect your retinas. It can also worsen the effects of health conditions you already have, such as diabetes, and contribute to eye-specific conditions like cataracts.
- Eye health. If you’re already being treated or have been treated in the past for eye conditions like glaucoma, or eye injuries like a detached retina, regular dilated-eye exams are necessary to keep track of changes.
What to expect at a dilated-eye exam
If you’ve had a comprehensive eye exam without dilation, many of the steps in a dilated-eye exam will be the same. Your provider will examine the front parts of your eye, check the sharpness of your vision and its range out to the sides. They will ask you to follow an object or their finger with your eyes, to see how well your eye muscles work together, and check the pressure in your eyes with a (painless!) puff of air. And, before they dilate your pupils, they’ll check to make sure that your pupils respond normally to light by widening and shrinking.
All these parts of the exam work best when your pupils are still reacting normally, so they’ll happen first. If your provider needs to dilate your pupils, they’ll most likely do it towards the end of the exam. They’ll begin the dilation by putting a drop of medication in each eye, after which it will take 20-30 minutes for your eyes to fully dilate.
Once your pupils are dilated, your provider can use specialized lights to examine the structures at the back of your eye, particularly the retina and the optic nerve. They may take images of your retina, to examine them in more detail, and also as a reference to help them identify changes in the future.
Your vision will be blurry for several hours after the exam, so again—be sure to bring your sunglasses, and have someone else who can drive you home!
Connect with comprehensive eye care through Heritage.
Our vision changes throughout our lives—often slowly, sometimes suddenly. High-quality vision care happens over the long term, with trusted providers who can monitor your eye health, spot changes early, and help you get the most out of your vision at every stage.
Heritage Vision Plans connect you with a handpicked network of care providers who can support you in this chapter and the next. Join the Heritage family with an individual or family plan, and take advantage of your annual exams to build an eye-healthy habit for the long haul. Find a local provider with our search tool and schedule an appointment today.