What a Medical Eye Exam Includes
When you see an ophthalmologist for a comprehensive medical eye examination, the assessment is fundamentally different from a standard optometry appointment. While optometrists provide excellent vision care — including glasses prescriptions, contact lens fittings, and routine screening — an ophthalmologist is a medical doctor who assesses the health of the eye as a medical organ, diagnoses disease, and provides treatments that range from medication to surgery.
At Dr. Sundaram's clinic, a comprehensive ophthalmology consultation includes a full history of your visual symptoms and eye health, followed by a structured examination of all components of the eye:
Visual Acuity Testing
Assessment of best-corrected visual acuity in each eye using a standardized chart — the foundation of every eye examination. Pinhole testing helps distinguish refractive from organic causes of vision loss.
Anterior Segment Examination
Slit-lamp biomicroscopy allows high-magnification examination of the eyelids, conjunctiva, cornea, anterior chamber, iris, and lens — detecting conditions such as corneal disease, uveitis, cataracts, and eyelid abnormalities.
Intraocular Pressure
Goldmann applanation tonometry accurately measures intraocular pressure — a critical screening measure for glaucoma and ocular hypertension, and a safety parameter for many eye conditions.
Dilated Posterior Segment Exam
After pupil dilation, the vitreous, retina, macula, optic disc, and retinal vasculature are examined directly. This provides the most comprehensive view of the back of the eye and is essential for detecting retinal pathology, optic nerve disease, and vascular conditions.
Advanced Imaging (When Indicated)
Optical coherence tomography (OCT), fundus photography, visual field testing, corneal topography, and other modalities are used as clinically indicated to document and characterize findings with precision.
Consultation & Care Plan
Dr. Sundaram reviews all findings with you in plain language, explains the diagnosis, and outlines a management plan. A full report is sent to your referring provider.
Conditions Screened and Diagnosed
A comprehensive medical eye examination can detect, diagnose, and initiate management for a wide range of ocular and systemic conditions affecting vision. Conditions commonly evaluated include:
- Cataracts
- Glaucoma and ocular hypertension
- Diabetic retinopathy
- Age-related macular degeneration (AMD)
- Retinal vein and artery occlusions
- Hypertensive retinopathy
- Optic nerve disease and optic neuritis
- Uveitis and intraocular inflammation
- Dry eye disease (severe or complex)
- Corneal disease
- Eyelid and orbital conditions
- Flashes and floaters (vitreous and retinal assessment)
- Sudden or unexplained vision changes
- Second opinions for planned eye surgery
The examination is also an opportunity to assess for systemic disease that manifests in the eye — including signs of uncontrolled diabetes, hypertension, multiple sclerosis, thyroid disease, and autoimmune conditions.
Who Needs a Specialist Referral?
Your family physician or optometrist may recommend a referral to Dr. Sundaram in the following circumstances:
- Suspected or confirmed cataracts requiring a surgical assessment
- Elevated intraocular pressure or suspicious optic nerve findings on optometry exam
- Annual retinal examination for a patient with diabetes
- Unexplained vision loss that has not resolved with glasses correction
- New onset of significant floaters, flashes of light, or a curtain over vision (requires urgent assessment for retinal tear or detachment)
- A red, painful eye that has not responded to initial treatment
- Ptosis (drooping eyelid) or other eyelid abnormality affecting vision
- Retinal findings such as drusen, pigment changes, or hemorrhages detected on screening
- Patients on hydroxychloroquine (Plaquenil) requiring surveillance retinal examinations
- Pre-operative assessment required before systemic surgery in a patient with known eye disease
Urgent situations: Sudden painless vision loss, a shadow or curtain over vision, a shower of new floaters, or sudden eye pain and redness may be emergencies. If you or your patient experiences any of these, please contact the office promptly or attend an emergency department. Do not wait for a routine appointment.
What to Bring to Your Appointment
To make the most of your consultation time with Dr. Sundaram, please bring the following:
- Your current eyeglasses and/or contact lenses
- A complete list of all medications, including eye drops and supplements
- Your BC CareCard (provincial health card)
- Any previous eye exam reports, OCT images, or visual field results
- Your referring physician's or optometrist's contact information
- A list of any questions or concerns you want to discuss
- A driver, if your pupils may be dilated during the visit (dilation causes blurring for 3–4 hours)
MSP Coverage for Eye Exams
Comprehensive eye examinations performed by an ophthalmologist for medical indications are covered by BC MSP. This includes the consultation fee, clinical examination, and diagnostic testing performed in-office (such as visual field testing, IOP measurement, and dilated fundus exam). Advanced imaging such as OCT and fundus photography may have associated fees depending on the clinical setting.
Routine optometry exams for adults aged 19–64 are not covered by MSP unless medically necessary. However, once your optometrist has identified a medical concern and referred you to an ophthalmologist, your specialist visits are covered. For BC Seniors (65+) and children under 19, routine eye exams remain MSP-covered through optometry.
Frequently Asked Questions — Eye Exams
An optometrist provides routine vision care — glasses prescriptions, contact lens fittings, and screening for common eye conditions. An ophthalmologist is a medical doctor (MD) who completed a full medical degree plus a 5-year surgical residency. Ophthalmologists diagnose and manage complex eye diseases, perform surgery, and provide subspecialty care. A medical eye examination with an ophthalmologist is a comprehensive assessment of eye health and disease — not just a vision test.
Yes. Medical eye examinations with an ophthalmologist for a medical indication are covered by BC MSP. The consultation, clinical examination, and standard in-office diagnostic testing are included. Routine glasses prescription checks are not covered by MSP for adults 19–64, but specialist ophthalmology consultations for eye disease are covered when referred by your GP or optometrist.
Yes. Dr. Sundaram's practice accepts patients by specialist referral from family physicians, nurse practitioners, and optometrists. Your referring provider can send a referral by fax or email. Once received, our office will contact you to schedule your appointment. If you are unsure whether you need a referral, ask your GP or optometrist to review your situation.
Please bring your current glasses and/or contact lenses, a full medications list (including eye drops), your BC CareCard, any previous eye exam reports or imaging results, and your referring provider's contact information. If your pupils may be dilated, please arrange a driver — your near vision will be blurry for 3 to 4 hours afterward.
A comprehensive ophthalmology consultation typically takes 60 to 90 minutes, including check-in, testing, pupil dilation when required, and the consultation with Dr. Sundaram. Some specialized testing — such as visual field testing or OCT — adds additional time. First appointments tend to be longer as a full history and baseline imaging are obtained.