eye2eye interview with the Phoropter

Posted on May 23, 2011 · Posted in Eye Exam, Instruments

Perhaps no instrument is more recognizable or more associated with the eye exam than the phoropter.  It’s that big black thing with all the spinning wheels and dials that prompts the person looking through it to make the monumental decision of “1” or “2”.  The bane of the indecisive and the foe of fourty-somethings, one of our phoropters recently took some time out of her busy schedule to discuss her work.

FV:  Hi phoropter!  Thank you for taking some time to talk with us today.
Phoropter:  My pleasure.
FV:  Can you explain your work a little bit?
Phoropter:  Sure…I think the easiest way to think of me is as a big pair of glasses containing almost all possible prescription combinations.  I also have different types of lenses, called prisms, that allow the doctor to measure things like the natural resting position of the eyes or the ability of the eyes to hold themselves in alignment at different distances.
FV:  Why is that second part important?
Phoropter:  Well, if a person has a large muscle imbalance when they try to read, they will get tired quickly or the words will get blurry.  Imagine a school-age child who can’t read comfortably and how that’s going to affect their ability to learn.
FV:  Oh, we don’t have to imagine.  We’ve seen many cases like that where a child will even get tracked into remedial classes as a poor reader or learner when the problem is simply that they have uncorrected prescription or that their eye muscles don’t allow the reading to be done comfortably.
Phoropter:  What can be done about that?
FV:  Hey..who’s doing the interview here?
Phoropter:  Well, I’d like to know.  Maybe others would, too.
FV:  The treatment really depends on the nature of the problem, but in most instances prescription glasses, prism, or vision therapy (or a combination of the three) can be all that’s needed.
Phoropter:  Wow!  Cool to know that I can help in that process.
FV:   We think so, too.  Think of all the people you’ve helped see…people of all ages.  They come in unable to see as clearly as they would like and with the turn of a dial here and the rotation of a knob there, presto!  Back to clear, comfortable vision.
Phoropter:  I think I’m blushing.
FV:  Hard to tell.  So I take it you’ve enjoyed your career?
Phoropter:  For the most part, yes.  It is very gratifying work.  But I dread when you move me into position and the patient proclaims, “I hate this part”.
FV:  I wouldn’t take that personally.  It can be hard for anyone to make a choice between two very similar options.  But I think if patients knew that the “wrong” answer will not result in a bad prescription, they’d be more at ease with your presence.
Phoropter:  What do you mean?
FV:  I mean that we already have a pretty good idea of what a person’s prescription is before we start questioning them about which picture they like better.  Automated and manually-operated instruments give us a big head-start before we even have the patient look through you.  If an answer is given that seems a bit different than what we were thinking, then we will test the comparison again later.  No single answer will “ruin” a patient’s glasses prescription.
Phoropter:  Really?  The patient is more or less just fine-tuning for you then?
FV:  Exactly. Think about a young child’s eye exam…how do we come up with prescriptions for them without being able communicate as we do with adults?  We can’t ask a 1 year old which picture she likes better.  Well, we can, but we most likely won’t be getting an answer.  We have to determine the prescription based fully on our automated and manually-operated instruments.
Phoropter:  I never knew that.
FV:  I’m glad you learned something today.  I feel like we learned a lot about you, too.  Thanks for taking the time to talk with us.
Phoropter:  You’re welcome.