Your consultation
What to expect when you come to see Miss Zakir.
Your relationship with your doctor should be built on trust and confidence, and Miss Zakir would like you to feel at ease when seeing her. She believes in giving you the care and information you want, in a way that helps you understand your treatment.
When you first see Rahila, she will ask about your eye problems, but also about your general medical health, current or recent medicines, allergies, and a little about yourself — your interests and activities — partly because eye and vision problems can affect your quality of life, but also because she would like to understand your visual needs. This helps her to help you make decisions about your care and treatment.
Vision test
If you use glasses or contact lenses, please bring them with you. Miss Zakir will start by checking your vision, and you will need your distance glasses or contact lenses for this — don't worry if you forget them, this part of the test can still be done. Depending on your symptoms, you may also need additional vision tests, such as colour vision testing or eye movements, before the eyes are examined.
Miss Zakir does not refract (prescribe glasses) routinely, but can refer you to excellent optometrists who are specially trained to give you the best outcomes for glasses and contact lenses.
Tests you may have at your first visit
Autorefraction
Gives an indication of any refractive error you may have, and helps decide if glasses might resolve some or all of your visual problems.
Visual fields
Maps your field of vision. You sit at a machine with a dome-shaped front and press a button as you see small lights flashing at the edges of your vision, with a trained technician monitoring you throughout.
Slit-lamp examination
You sit at a machine like a microscope, which lets Miss Zakir examine the front of the eye in great detail.
Intraocular pressure check
Usually checked at the first visit, using numbing drops and a yellow dye (fluorescein). Not uncomfortable. Rahila uses Goldmann applanation tonometry, the gold standard for eye pressure measurement.
Dilating drops and examining the retina
To examine the back of the eye, if Miss Zakir suspects this is necessary, she will put in dilating drops. These take about 20 minutes to take effect (longer in darker eyes), and the pupils remain dilated for a few hours, causing blurred vision, particularly up close. If you are short-sighted, a dilated retinal examination is advisable, as there is a slightly higher risk of conditions such as retinal holes and detachments, which can sometimes be detected before symptoms develop.
Your retinal examination starts at the slit lamp with special lenses to see the back of the eye. In some cases you will be examined in more detail lying down, using a technique called binocular indirect ophthalmoscopy with scleral indentation — this helps to see far out to the periphery of the retina, to be sure a retinal tear or hole isn't missed.
- Driving: you must not drive until your pupils return to normal, as you will not meet the DVLA standard for driving vision. Please arrange to get home safely after your consultation.
- Light sensitivity: while dilated, your eyes may feel light sensitive — you may wish to bring sunglasses and a hat with a brim.
Other tests that might be necessary
OCT scan
Optical Coherence Tomography shows the macula in 3D — particularly useful to see if there is any swelling or fluid at the back of the eye.
Autofluorescence
A photograph of the eye that shows up some of the deeper layers of the retina.
Retinal photography
A photograph of the retina, useful to establish a baseline for future comparison and to spot subtle changes over time.
Fundus fluorescein angiography
Photographs of the retinal blood vessels after a dye is injected into a vein in your arm. Most people cope well; you'll be monitored for up to 30 minutes afterwards as a precaution. Dilating drops and the driving precautions above will apply.
Anterior segment photography
Photographs of the front part of the eye. Doesn't usually need dilating drops, and vision is unaffected.
Central corneal thickness
A quick, simple, painless test using a fine probe on the front surface of the eye.