ROUTINE & PRIMARY EYE CARE

Don't miss your next eye examination test...

Your vision should be checked every two years as part of a routine eye exam. A professional eye checkup can detect refractive errors, eye disease, and other conditions that can affect your eyes. A complete clinical examination of the eye takes approximately 60 minutes.

Your clinical examination of the eye should include:

A complete history of your current eye symptoms, as well as your general health

A measurement of your vision, and determination of the power for your current glasses

An eye pressure test for glaucoma

A comprehensive medical exam of the back of your eye (retina) using dilation or Optomap Retinal Imaging

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Why are routine eye exams so important?

During a routine eye exam, each eye is examined for signs of serious eye issues. These can include:

Receiving regular eye exams regardless of visual acuity can help detect serious eye problems at the earliest stage, when they are most treatable.

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As a reminder: There is a $75 charge for determining your glasses prescription (refraction). Additional charges may apply for determining your contact lens prescription.

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Improve the experience of your routine eye exam with

- Optomap Imaging -

NOTE: Depending on the nature of your exam (routine or medical) and your insurance coverage,

there may be a $39 fee associated with your optomap image.

For many years, the only way to get a good view of the retina was to dilate the eyes. This process involves the doctor placing special eye drops into your eyes to open the iris (the color part of the eye). When the iris is open, the doctor uses bright light and lenses to examine the nerves and blood vessels of the retina for signs of damage or disease. Unfortunately, despite its benefits, dilation is not always a pleasant experience for most patients.

Thankfully, for routine eye or vision exams, Clarus Eye Centre now offers an alternative to dilation called optomap imaging. This high-tech camera takes a wide-field, high-resolution, digital picture of the retina – without eye drops! (NOTE: This service is available for eligible patients only. Patients who require a higher level of retina care will still require dilation).

For eligible patients, OPTOMAP IMAGING IS FAST AND DOES NOT REQUIRE DILATION.

In addition to being faster and more convenient than dilation, optomap allows your doctor to show you what the back of your eye looks like, gives you a snapshot of your overall eye health, and provides an opportunity for you to discuss any questions or concerns that arise from any abnormal findings.

While the optomap has been a great addition to our practice, it is not a replacement for dilation. There are several instances in which dilation may be more appropriate than the optomap. These can include but are not limited to patients with extremely small pupils, droopy eyelids, dementia, certain physical disabilities, and emergency eye conditions.

At Clarus Eye Centre, we believe that optomap imaging and dilation are both important tools for evaluating the health of the retina, but one or the other may be a better option for you depending on your circumstances.

Your doctor will recommend which option is best for you.

Optomap imaging is now preferred by many patients who do not require dilation. Schedule your next eye exam today and ask your doctor if optomap retinal imaging is right for you!

NOTE: Depending on the nature of your exam (routine or medical) and your insurance coverage,

there may be a $39 fee associated with your optomap image.

Ready to schedule your next eye exam?

CALL NOW

Why optomap retinal imaging?

Your retina (located in the back of your eye) is the only place in the body where blood vessels can be seen directly. This means that in addition to eye conditions, signs of other diseases (for example, stroke, heart disease, hypertension, and diabetes) can also be seen in the retina. Early signs of these conditions can show on your retina long before you notice any changes to your vision or feel pain. While eye exams generally include a look at the front of the eye to evaluate health and prescription changes, a thorough screening of the retina is critical to verify that your eye is healthy.

What is an optomap retinal image?

Getting an optomap image is FAST AND DOES NOT REQUIRE DILATION. Nothing touches your eye at any time. It is suitable for the whole family. To have the exam, you simply look into the device one eye at a time (like looking through a keyhole) and you will see a flash of light to let you know the image of your retina has been taken.

Under normal circumstances, dilation drops might not be necessary, but your eye care practitioner will decide if your pupils need to be dilated depending on the health of your eyes. The image capture takes less than a half-second and is available immediately for you and your practitioner to view immediately.

Early signs of disease can be present in the periphery of your retina and remain undetected for a long time when using traditional methods. The optomap ultra-widefield retinal image is a unique technology that captures more than 80% of your retina in a single image while traditional imaging methods typically only show 15% of your retina at one time.

Benefits of optomap retinal imaging

FAST & DOES NOT REQUIRE DILATION
Optomap provides a permanent digital retinal imaging that is saved and is used as a record in the patient’s history for future reference. Changes in the patient’s eyes that occur over a period are picked up faster and more efficiently as a visual record is available for comparison.
Earlier diagnosis and treatment prevent and slow the deterioration of vision (not to mention the medical expense savings long term).
A digital image is immediately available for review by the doctor.
Convenience: Optomap eliminates the uncomfortable and time-consuming process of dilation for asymptomatic patients undergoing routine eye examination and is performed within minutes.

Common Eye Tests and Procedures

Dilated Eye Exams

Your eye examination test at Clarus Eye Centre begins with a thorough investigation of your lids, lashes, conjunctiva, sclera and cornea – the external surfaces of your eye.

For the next stage of your eye examination test, your doctor will use a microscope and a bright light to gain a closer look at the anterior chamber, iris, and crystalline lens of your eye.

The iris is very similar to the shutter of a camera—when you take a picture on a bright sunny day, the shutter becomes smaller, allowing less light to enter. Likewise, your pupil becomes smaller when we shine a bright light at your eye, making it very difficult to peer inside.

Dilating drops work on one of two principles: they either stimulate the iris muscle that opens the pupil (the dilator) or prevent action of the iris muscle that closes the pupil (the sphincter). After the drops take effect, your doctor can get a much better view of your retina, optic nerve, and vessels in the back of the eye.

It is important that we check these areas of the eye as part of your eye exam. Why? Assessing the health of your retina, optic nerve and vessels is a key piece of preventative eye care. We may also need to view these areas of the eye in preparation for some eye surgeries.

Dilation has historically offered the most thorough and detailed assessment of the eyes, especially for those patients who meet the ‘at-risk’ category for common eye problems, are older, or have a pre-existing retinal condition.

However, it can take 30 to 40 minutes for the eye drops to take effect and dilate the pupils well; your vision can remain blurred for 4 to 6 hours, and you may be unable to resume normal activities till then.

These are some of the reasons why many people prefer optomap retinal imaging (see more above) over dilated eye exams.

If your doctor recommends a dilated eye examination, there are a few things you can do to make it a bit more comfortable:

Don’t plan any activity after your appointment that requires crisp vision.

Bring along a pair of dark sunglasses for the ride home. Don’t worry if you forget, we’ll provide you with a disposable pair as you check out.

If you know you’ll have trouble seeing to drive home (even with the sunglasses), please bring a friend.

OPTOMAP RETINAL IMAGING

Refraction

A refraction test is usually given as part of a routine eye examination to determine your glasses or contact lens prescription. It may also be called a vision test.

Normally, a value of 20/20 is considered to be an optimum, or perfect vision. Individuals who have 20/20 vision are able to read letters that are 3/8 of an inch tall from 20 feet away.

If you don’t have 20/20 vision, you have what is called a refractive error. A refractive error means that the light is not bending properly when it passes through the lens of your eye. The refraction test will tell your doctor what prescription lens you should use in order to have 20/20 vision.

Why is this test used?

This test tells your doctor if you need prescription lenses, as well as what prescription lens you need to see properly.

The results of the test are used to diagnose the following conditions:

astigmatism: a refractive problem with the eye related to the shape of the lens, which causes blurry vision
hyperopia: which is also known as farsightedness
myopia: which is also known as nearsightedness
presbyopia: a condition related to aging that causes the lens of the eye to have trouble focusing

Who should be tested?

Healthy adults under age 60 who aren’t experiencing vision problems should have a refraction test every two years. Children should have a refraction test every one to two years, starting at no later than 3 years of age.

If you currently wear prescription glasses or contact lenses, you should have a refraction test every one to two years. This will allow your doctor to figure out what prescription is necessary as your eyes change. If you’re having problems with your vision between exams, you should see your eye doctor for another refraction test.

What happens during the test?

Your doctor will first assess how light bends as it moves through your cornea and the lens of your eyes. This test will help your eye doctor determine whether you need corrective lenses and, if so, what type of prescription you need. Your doctor may use a computerized refractor for this part of the test, or they may simply shine a light into your eyes.

In the computerized test, you look through a machine that measures the amount of light reflected by your retina.

Your doctor may also do this test without the help of a machine. In this case, they will shine a light into each of your eyes and look at the amount of light that is bouncing off your retina to measure your refractive score.

Afterward, your doctor will determine exactly what prescription you need. For this part of the test, you’ll be seated in front of a piece of equipment called a Phoroptor. This looks like a large mask with holes for your eyes to look through. On a wall in front of you will be a chart of letters. For children who cannot yet identify letters, your doctor will use a chart with small pictures of common items.

Testing one eye at a time, your eye doctor will ask you to read the smallest row of letters that you can see. Your doctor will change out the lenses on the Phoroptor, asking you each time which lens is clearer. If you’re unsure, ask your doctor to repeat the choices. When your eye doctor is finished testing one eye, they will repeat the procedure for the other eye. Finally, they will come up with the combination that comes closest to giving you 20/20 vision.

Everyone needs a refraction test

Regular eye examinations are crucial for maintaining the health of your vision. They’re a routine part of an eye doctor visit and require no preparation on your part. They can help your doctor diagnose and treat conditions such as glaucoma and determine the need for corrective lenses, among other things. Healthy adults should have a refraction test every two years, while children need them every one or two years beginning at age 3.

Slit Lamp Exam

Diseases of the eye can be difficult to diagnose during a general physical examination. Your eye doctor is better able to examine and diagnose these conditions because the tools they have are specific to the eyes. When you have an eye checkup, you will likely undergo a slit lamp exam.

A slit lamp exam is also called biomicroscopy. It allows your doctor to microscopically examine your eyes for any abnormalities or problems.

What happens during a slit lamp exam?

You do not have to prepare in advance for a slit lamp exam.

Once you are in the examination chair, your doctor will place an instrument in front of you on which to rest your chin and forehead. This helps steady your head for the exam. Your eye doctor may put drops in your eyes to make any abnormalities on the surface of your cornea more visible. The drops contain a yellow dye called fluorescein, which will wash away your tears. Additional drops may also be put in your eyes to allow your pupils to dilate, or get bigger.

The doctor will use a low-powered microscope, along with a slit lamp, which is a high-intensity light. They will look closely at your eyes. The slit lamp has different filters to get different views of the eyes.

During the test, your doctor will examine all areas of your eye, including the:

Your doctor will first examine the front areas of your eye and then perform the exam again with a different lens to examine the back of your eye.

A slit lamp exam can help diagnose conditions related to glaucoma, retinal diseases, vascular conditions, and extraocular injuries.

Ask your doctor what they are looking for during the exam and which eye conditions you may be at risk for.

Visual Acuity Test

A visual acuity test is an eye exam that checks how well you see the details of a letter or symbol from a specific distance.

Visual acuity refers to your ability to discern the shapes and details of the things you see. It’s just one factor in your overall vision. Others include color vision, peripheral vision, and depth perception.

There are several different types of visual acuity tests, most of which are very simple.

No risks are associated with visual acuity tests, and you don’t need any special preparation.

Purpose of the test

You may need an eye exam if you feel you’re experiencing a vision problem or your vision has changed. A visual acuity test is one part of a comprehensive eye exam.

Children frequently take visual acuity tests. Early testing and detection of vision problems can prevent issues from getting worse.

Understanding your test results

Visual acuity is expressed as a fraction, such as 20/20. Having 20/20 vision means that your visual acuity at 20 feet away from an object is normal. If you have 20/40 vision, for example, that means you need to be 20 feet away to see an object that people can normally see from 40 feet away.

If your visual acuity is not 20/20, you may need corrective eyeglasses, contact lenses, or surgery. You might also have an eye condition, such as an eye infection or injury, that needs to be treated. You and your doctor will discuss your test results as well as any treatment or correction that might be necessary.

Visual Field Test

You may need a visual field test to help your doctor monitor or see signs of certain diseases like glaucoma. In the earlier stages of glaucoma, you may lose peripheral vision without realizing it, and a visual field test can help you manage your condition or start treating it.

The results of a visual field test can tell your doctor more about your eye health but also point to other issues. Your retina — a nerve cell layer that lines the back inside of your eye — is connected to your optic nerve, which is connected to your brain. So if you have an abnormal visual field, there may be problems in your optic nerves or your brain. ‌The visual field tests are designed so that your ophthalmologist can identify which vision problems are linked to which conditions. If you get tested regularly, your doctor can figure out which specific types of disease or injuries you may have.

What Do Visual Field Tests Diagnose?

Visual field tests help your doctor figure out whether you have blind spots, where they are, and what their shape is. This can tell you a lot about how an eye disease or brain disorder affects you.Visual field tests can also diagnose issues with your eyelids.

What Are the Types of Visual Field Tests?

There are six main types of visual field tests. For each of them, you sit still while your doctor tests you. The types are:

Confrontation visual field test. You wear a blindfold while your doctor holds up different fingers in your peripheral vision and asks what you see.
Automated static perimetry test. This test is much more detailed. Your doctor uses it to make a complete image of your field of vision. They cover one eye with a patch as you look into a tool called a perimeter. You press a button when you see a light blink. This test can tell your doctor about which lights and what level of dimness you can or can’t see.
Kinetic visual test. This test is very similar to the previous one but uses moving lights instead of blinking lights.
Electroretinography. Electroretinography measures vision loss because of problems with your retina. It measures the electrical activity in your eye as it takes in light. The doctor uses drops to dilate your pupils and numb your eyes. They hold your eyelids open with a speculum and put an electrode on your cornea. You look into a circular machine that flashes different patterns of light.
Frequency doubling perimetry. In this test, your doctor shows you an optical illusion to check for damage in your visual field. It includes vertical bars — which are generally black and white — on something called a perimeter screen. These bars are set to flicker at various speeds. If you can’t see the vertical bars at certain time points of the test, you may have loss in certain parts of your field of vision.
Amsler grid. You can do this test at home. Generally, it looks for age-related issues with the visual field. You look at a dot in the middle of a grid and note what parts of the grid you can see and which parts look wavy.

When Should You Get Your Visual Field Tested?

It’s important to get your visual field tested if you have a condition that might put your vision at risk, such as:

Glaucoma
Multiple sclerosis
Thyroid eye disease
Pituitary gland disorders
Diabetes
High blood pressure
Any health concern related to the central nervous system
Stroke
Taking certain medications for long periods

Meet our optometrists

Tammy Burrell, O.D.

Dr. Tammy Burrell graduated from California State University, Dominguez Hills with a bachelor of science in biology. She earned her doctorate of optometry, cum laude, from Marshall B. Ketchum University’s Southern California College of Optometry, and was awarded recognition by the Beta Sigma Kappa Honor Society. Dr. Burrell began her career as a private practitioner in Torrance, California, establishing a start-up private practice with a patient base in two locations. From there, her passion for optometric care led her to practice in different areas across the Western United States, serving mainly seniors over the past 17 years. She provided and managed optometric services within an interdisciplinary health care setting at All Care Medical Group. Dr. Burrell continued delivering full-scope routine and medical eye care while working collaboratively with patients’ specialists and primary care physicians in Colorado, Arizona and on Whidbey Island, prior to moving to the South Puget Sound area.

Dr. Burrell finds the enhancement of vision and management of eye care services at all stages of life engaging. She focuses her practice primarily on the care of degenerative eye diseases, specifically glaucoma and dry eye. She also enjoys providing specialty contact lens services and co-managing surgical patients with our ophthalmologists.

In her spare time, Dr. Burrell enjoys being with family, watching old movies and baking. Additional pastimes include hiking, biking, and traveling abroad.

Kristen Clark, O.D.

Originally an Illinoisan, Dr. Kristen Clark attended Illinois College, earning her bachelor’s degree in biology. She moved to Chicago and graduated in 2011 from the Illinois College of Optometry, where she received accolades including the Dean’s list and membership to Golden Key International Honour Society and Beta Sigma Kappa International Optometric Honor Society. Dr. Clark’s professional pursuits focus upon delivering eye care within a fast-paced environment working alongside ophthalmologists to deliver quality care to both surgical and non-surgical patients. From Champaign, Illinois to Las Vegas, Nevada, she managed pre- and post-cataract surgery and laser vision correction patients, as well as provided primary care to patients of all ages, including routine eye care such as prescribing glasses and contact lenses.

Dr. Clark moved to the Olympia/Lacey, Washington area in 2019 to join the Clarus team. Her practice encompasses primary eye care, routine eye exams, treatment and management of ocular diseases such as dry eye, and co-management of post-surgical patients. Due to her experience and expertise, she also specializes in contact lenses, including specialty contact lenses.

When not in the office, Dr. Clark loves spending time with her two kids and husband, exploring, trying new restaurants, and staying fit and healthy.

Hannah Song, O.D.

Dr. Hannah Song, a Portlander, earned her undergraduate degree in human physiology from the University of Oregon. Following college, she went on to Pacific University College of Optometry, where she obtained her doctor of optometry. During her time in optometry school, Dr. Song actively participated in community outreach, conducting vision and eye screening to those with limited access to healthcare. Following graduation, she completed a residency in ocular disease at Mann-Grandstaff Veteran Affairs Medical Center in Spokane, Washington, furthering her training in diagnosis and management of various complex eye conditions, as well as co-management of surgical patients.

An active member of the American Academy of Optometry and Optometric Physicians of Washington, Dr. Song also maintains a position as an assistant professor at Pacific University College of Optometry. At Clarus, she practices comprehensive optometry, which includes contact lens fitting and medical optometry. Dr. Song is a native English speaker who is also proficient in Korean.

Dr. Song spends her free time in various ways. She enjoys watching basketball, hiking, and traveling, while also appreciating simple pleasures such as tending to houseplants at home.