How an Eye Exam is Performed

Optometrists and ophthalmologists use a wide variety of techniques to examine your eyes during a comprehensive eye exam. These tests range from the simple, like having you read an eye chart, to the complex, such as using a high-powered lens to visualize the tiny structures inside of your eyes. A comprehensive eye exam can take an hour or more, depending on your doctor and the number and complexity of tests required to fully evaluate you. It is through these tests that you can determine if you may a candidate for a procedure such as LASIK or cataract surgery. For more information on cataract and LASIK surgery in Orange County, contact the experts at Advanced Eye Medical to schedule your eye exam.

Here is what you can expect during a comprehensive eye exam:

Color Blindness Test

A color vision screening is often performed early in the eye exam process. In addition to detecting color blindness, this can also alert your doctor to eye health defects that affect your color vision.

Cover Test

During this test, your doctor will cover each of your eyes individually and ask you to look across the room at a far object, then closer at a near object. By having you fixate on these two separate targets with each eye, your doctor can see weather the eye has to move in order to “pick up” the target. If it does have to move, this could indicate strabismus or a subtler binocular vision problem that could cause eye strain or “lazy eye.”

Ocular Motility (Eye Movement) Testing

These tests show how well your eyes can follow a moving target or move rapidly between two targets. The more common test is of smooth eye movement, or “pursuits.” Your doctor will have you hold your head still and follow a small light or other object from side to side using only your eyes. Less frequently, doctors may test quick eye movements, or “saccades,” by having you move your eyes back and forth between two objects placed with some space in between. Potential problems with eye movements are problems with eye strain, reading ability, and sports vision.

Stereopsis (Depth Perception) Test

The term “stereopsis” describes the way your two eyes team up to create depth perception as well as a 3-D view of the world. In one commonly used stereopsis test, you are asked to wear 3-D glasses while looking at a booklet of test patterns. The booklet will have images of shapes that appear closer and farther away, and you will be asked to identify which shape appears to be closest to you. If you can identify the correct shape, it means you have excellent eye-teaming ability.


This test is performed early in the exam to get an approximation of your eyeglass prescription. Your doctor will ask you to stare at the big “E” at the top of an eye chart. As you stare at the “E,” your eye doctor will shine a light at your eye and flip lenses in a machine in front of your eyes. This test estimates which lens powers will best correct your distance vision.


While looking at an eye chart on the wall, the doctor presents you with various lenses to look through and asks which offers you the clearest view of the letters on the chart. This is how the doctor determines your exact eyeglass prescription.

Slit Lamp Exam

A slit lamp is a binocular microscope (or “biomicroscope”) that your eye doctor uses to examine the structures of your eye under high magnification. During the slit lamp exam, you will be asked to place your forehead and chin on rests on the front of the instrument. Your doctor will begin by examining the structures of the front of your eyes, including your eyelids, cornea, conjunctiva, iris, and lens.

With the help of a hand-held lens, your doctor may also use the slit lamp to examine structures located farther back in the eye, such as the retina and optic nerve.

A wide range of eye conditions and diseases can be detected with the slit lamp exam, including cataracts, macular degeneration, corneal ulcers and diabetic retinopathy.

Glaucoma Test

This is the “puff of air” test, technically known as non-contact tonometry, or NCT. Based on your eye’s resistance to the puff of air, the machine calculates your intraocular pressure (IOP). If you have high eye pressure, you may be at risk for or have glaucoma.

Pupil Dilation

Your doctor may use dilating eye drops to obtain a better view of your eyes’ internal structures. This allows for the most thorough evaluation of eye health. Make sure to bring sunglasses for the ride home, because you will be more sensitive to sunlight when your pupils are dilated.

Visual Field Test

In some cases, your doctor might check for blind spots, or scotomas, in your peripheral vision. These can be caused by eye diseases such as glaucoma, or brain damage from stroke or brain tumors.

Eye Exams and LASIK in Orange County

At Advanced Eye Medical, we have been helping patients with eye care in Mission Viejo, Laguna Niguel, Aliso Viejo, and throughout Orange County since 1982. Our team prides itself on the personal relationships we develop with each of our patients. Contact us for your personal eye exam and for information about receiving LASIK in Orange County.

Why Contacts May Not Be the Right Choice for You

If your vision is a problem, it’s a big one. Being able to see clearly is a luxury that people with great vision do not realize they have, and people who struggle with poor vision are all too aware of. Luckily, today, we have many ways to correct vision issues, from traditional glasses to laser surgeries. At Advanced Eye Medical, we encourage our prospective patients to reach out for a consultation to find out if LASIK in Orange County would serve them well, because we are strong believers in the LASIK procedure’s success and positive impact on our patients’ lives.

Disadvantages of Contacts

Though contacts are an easy, short-term solution for vision issues, they are simply that: a Band-Aid. They are not a long-term solution, nor do they contribute to increased eyesight. Though they are a very mainstream medical tool, contact lenses have many drawbacks, and users should consider a long-term solution like iLASIK to actually solve their vision issues.

Contact lenses can restrict oxygen from reaching your eye, causing dry eyes and irritation, can contribute to computer vision syndrome if you work at a computer often, require very specific and sterile day-to-day care and upkeep that many users do not take seriously, which leads to infection and serious eye damage. Additionally, if one falls asleep wearing contact lenses, serious eye irritation and inflammation can occur. Contact lenses require lots of upkeep and care, and if you cannot, or do not want to, commit to so much work, a more permanent solution is for you.

What is the difference between LASIK and iLASIK?

Although both procedures use laser technology to improve the eyesight of our patients, they bear a few differences. Traditional LASIK is a 2-step procedure where a flap is created in the cornea with a small metal blade. Then, a laser vision correction treatment continues on the inner layer of the cornea. This method has been highly effective for years, but has a few risks and is unpredictable. Though LASIK issues are extremely rare, error in this process is usually the source of any reported complications.

iLASIK is performed using a very precise laser to cut the corneal flap with unparalleled accuracy by any other vision correction technology. The advanced nature of this procedure allows Dr. Ghoshesh to tailor each surgery to the specific patient, and due to iLASIK’s consistent, extreme accuracy, patients who were eliminated from candidacy for LASIK due to thin corneas are now treatable. iLASIK has been around since 2001, and after over 22,000 procedures there have been no reported significant complications.

Benefits of iLASIK Over Contacts

Laser vision correction is a procedure that we encourage anyone (who meets the general health requirements) with bad vision to consider. Not only is this procedure quick and easy, but it permanently improves your quality of life. At Advanced Eye Medical, we perform a series of exams to establish whether or not the characteristics of your vision qualify you for this procedure. Once we do, you’re set to undergo iLASIK.

Not only can you return to work the day after your procedure, iLASIK is a procedure that typically only requires your presence at our office for 2-3 hours and only needs roughly a day to heal. Your vision will improve immediately, with continued positive improvement over the following few days. This surgery is simple, effective, and has great results. Not only that, but it’s a one-time procedure yielding great eyesight, an issue that contacts and glasses only put a Band-Aid over.

iLASIK is a procedure available virtually everywhere. If your eyesight is hindering your quality of life, you should look no further. Laser vision correction will change your life, and is done through iLASIK technology that is not only proven to be highly effective, but is completely safe. LASIK is so safe that is available to almost anyone who satisfies the age and general health requirements of the procedure, which require that you are 21 years old, in good general health, have had a stable vision prescription for at least one year, and have no current eye disease.

LASIK in Orange County

Like all forms of surgery, there are risks, though they are very rare. During your consultation at Advanced Eye Medical, Dr. Ghosheh will explain in detail what these risks are, and answer any questions you may have about receiving LASIK in Orange County.

Contact our office to schedule a consultation where we will assess your needs and answer any questions you may have regarding your eye health and further procedures!

What is Macular Degeneration?

Macular Degeneration is presently considered an incurable eye disease, and is the leading cause of vision loss – it affects more people than glaucoma and cataracts combined. Macular degeneration affects over 10 million Americans.

For more information on macular degeneration and receiving Orange County LASIK eye surgery, visit Advanced Eye Medical today.

Macular Degeneration

The macula is the central and most sensitive area of the part of the eye that “sees.” In a healthy eye, the macula records detailed images and sends them up the optic nerve to the brain, so they can be recorded as “sight.” As the macula deteriorates, the quality of these images is affected. At first, there may be little to no change in sight. But as the disease progresses, central vision may become blurry or wavy, and eventually central vision may be completely lost, leaving the patient with only their peripheral vision. At these advanced stages, patients may be considered legally blind.

Types of Macular Degeneration

There are two basic types of macular degeneration: “wet,” or exudative, which affects approximately 10-15% of patients, and the far more common type which is “dry,” or atrophic, which affects 85-90%.

There is also a third type which is much less common and occurs in children, called Stargardt disease.

Wet (exudative) Macular Degeneration

In this type, abnormal blood vessels known as CNV (choroidal neovascularization) grow under the macula and retina. After a while, the new blood vessels can bleed or leak fluid, causing a bulge which lifts the macula from its normally flat position. For people with “wet” macular degeneration, this is the cause of their distorted or lost central vision. In these cases, vision loss can be rapid and severe.

Dry (atrophic) Macular Degeneration

In this type, small yellow deposits known as drusen form under the macula. This leads to a thinning and drying of the macula in the areas where the drusen are present. This causes the macula to lose its function, and the patient to lose his or her central vision.

An interesting fact: nearly all people over the age of 50 have at least one small drusen in one or both eyes. However, only eyes with large drusen are at risk for “dry” macular degeneration.

This type of macular degeneration is much more common than the “wet” type, and progresses much more slowly. In some cases, people with the “dry” type can develop the “wet” type over time.

Stargardt Disease

This type of macular degeneration is passed down genetically from the parents. It develops in children ages 6-20. “Stargardt Disease is the result of a gene called ABCA4 and is usually a recessive trait. When both parents carry the ABCA4 mutation, there is a 25 percent chance their children will have Stargardt disease.”

What happens in Stargardt disease is that flecks of waste material build up in the nutritional support layer (RPE) for the rods and cones of the retina, causing all three to break down and impair vision.

Stages of Macular Degeneration

There are three stages of age-related macular degeneration (AMD).

Early AMD

Most patients do not experience vision loss at this stage. This highlights the need for regular eye exams, so that onset can be detected by your ophthalmologist. In the early stage, AMD is diagnosed by the presence of medium-sized drusen (yellow deposits beneath the retina.)

Intermediate AMD

At this stage there may be some vision loss in some patients; others still may not notice any symptoms. A comprehensive eye exam with specific tests will look for larger drusen and/or pigment changes.

Late AMD

Vision becomes noticeably impaired at this stage.

Macular Degeneration Risk Factors

The most important risk factors for macular degeneration are:


The largest risk factor for AMD is age. Those who are 55 or older are most likely to experience AMD, and your risk factor increases as you age.


If you have a family history of AMD, you are at a higher risk. For Stargardt disease, you are at risk if both your parents carry a recessive gene.


Caucasians are more likely to develop AMD than African-Americans and Latinos.


Smoking Cigarettes doubles (!) your risk of developing AMD.


There is currently no known cure for AMD, but there are things you can do to keep your eyes as healthy as possible. Staying healthy will reduce your risk of developing AMD and might even slow the disease’s progression once it has developed. Don’t smoke, get enough exercise, eat healthy, get enough sleep, and wear sunglasses to protect your eyes from ultraviolet light.

Read about some promising new treatments for AMD here.

Orange County LASIK

Since 1982, our optometrists and ophthalmologists have delivered a premier Orange County LASIK center. Dr. Gosheh has authorized several books on high definition LASIK and custom cataracts surgery. Email your info requests to or call us at (866)997-2020 (LASIK) or (888)439-6565 (Cataracts) for a free consultation!

The Best Vitamins for Healthy Eyes

If you’ve heard it once, you’ve heard it one hundred times: declining vision is an inevitable part of aging. Right? We all have a relative who has dozens of pairs of plastic readers littered all over the house, and we’ve all been at a restaurant with someone who used the flashlight on their cellphone to read the menu. Don’t doom yourself to a life of reliance on readers and squinting just yet. There are plenty of things you can do to preserve (and even improve!) your eyesight. The best place to start? Your diet!

What you put into your body is, quite possibly, the most important part of your health. If you eat food low in nutrients, you’re not going to be healthy. It’s truly as simple as that. On the flip side, if you nourish your body with vitamins and nutrients on a daily basis, things are going to run a lot more smoothly, including your vision. For more information about maintaining your vision through diet and when to look into receiving LASIK in Orange County, contact the experts at Advanced Eye Medical.

There are 6 vitamins that you can easily incorporate into your regular diet that have potential to greatly improve your vision. Whether you want to incorporate foods into your diet that incorporate these vitamins or you’re more of a supplement-taker is totally up to you, but if your eyes are fading, check these out:

1. Lutein

Lutein, nicknamed “The Eye Vitamin,” helps fight free radicals that have been caused, over time, by a number of external factors, and helps protect the eye’s tissues. It helps fight the effects of aging on both your eyes AND your skin (bonus!) and is an anti-inflammatory carotenoid that is found in leafy green veggies, citrus fruits, and orange vegetables (like carrots and sweet potatoes).

What are some good sources of Vitamin C? Spinach, kale, carrots, broccoli, eggs, peppers and tomatoes.

2. Vitamin C

Vitamin C helps protect your vision by striking down free radicals, helps your body absorb more nutrients, repairs damaged tissues, reduced inflammation and inflammatory responses, prevents cellular mutations; the list could go on. There’s a reason so many doctors swear by a daily dose of Vitamin C! Studies have shown Vitamin C takers to have a much lower probability of cataracts.

What are some good sources of Vitamin C? Peppers, citrus fruits, broccoli, strawberries, cabbage, brussels sprouts, tomato juice and cantaloupe.

3. Vitamin E

Vitamin E is a strong inflammation fighter and helps protect eye tissue and keep cells healthy. Taking it in conjunction with Vitamin C is going to give you more bang for your buck, as the two are able to work together to keep that eye tissue as healthy as possible. Vitamin E is a great antioxidant that helps fight age-related eye health issues.

What are some good sources of Vitamin C? Almonds, seeds, tomatoes, avocados, broccoli, spinach, dried apricots and asparagus.

4. Zinc

Zinc, one of the most important nutrients to aid in the body’s absorption of other nutrients, is known to protect the retinas and both fight and prevent inflammation. Zinc plays a key role in proper cell development, circulation, and hormone maintenance, which is why it is important to tissue health in your eyes.

What are some good sources of Vitamin C? Fish, grass-fed meat, oysters and nuts!

5. Zeaxanthin

Another carotenoid similar to Lutein, Zeaxanthin also helps to protect and maintain the tissues of the eye, like the lenses and macula, which in turn helps clear up your vision and prevent issues with glare, sensitivity to light and cataracts. Both Zeaxanthin and Lutein are key for optimal eye health because they are delivered in high quantities to the eyes, having the largest impact on future eye health.

What are some good sources of Vitamin C? Spinach, kale, carrots, broccoli, eggs, peppers and tomatoes.

6. Vitamin A

Vitamin A is a beta carotene that the Journal of the American Medical Association of Ophthalmology says we need an adequate amount of in order to prevent night blindness and xerophthalmia. A known antioxidant, Vitamin A prevents vision loss from chronic and degenerative conditions and has been shown to slow the progression of certain types of nerve damage in the eyes.

What are some good sources of Vitamin C? Liver, carrots, sweet potatoes, kale, spinach, butter, eggs, and squash.

Eye Doctor and LASIK in Orange County

Your eye health is important. Taking care of your eyes starts with what you put into your body. If supplements and a healthy diet aren’t enough, that’s where we come in. The specialists at Advanced Eye Medical Group have the experience and knowhow to help you in your quest for better vision, and after 40 years of serving Orange County, we’re ready to help you, too.

Call us for a free consultation for more information on eye health and LASIK in Orange County.

The Difference Between Cataract and LASIK Surgery

LASIK and Cataract surgery are two of the most popular ocular surgeries today. Because we hear so much about both kinds of surgeries, it is common for people to get the two of them confused. People not only forget which surgery serves what purpose, but they wonder if both can be performed at the same time. For example, people with cataracts often ask if they should have LASIK to help with their vision loss. Although these two surgeries share some similarities, in truth they are two different procedures that correct vision in separate ways.

For more information about Cataract or LASIK surgery in Orange County and to see if you may be a candidate, contact Dr. Ghosheh at Advanced Eye Medical today.

LASIK v. Cataract Surgery: The Differences

The most obvious difference between these two surgeries is in their purpose. LASIK surgery is meant to correct vision. It allows you to see well without glasses or contacts, and generally corrects distance vision. Cataract surgery corrects foggy vision, allowing you to see more clearly.

The next difference lies in how the two surgeries are performed. LASIK surgery aims to reshape the cornea, which in vision deficient patients can be football shaped. The doctor makes a small incision in the center of the cornea, allowing it to reshape itself into a more natural baseball shape. This changes the way the eye focuses light on the retina. During cataract surgery, by contrast, the doctor removes the cloudy lens and replaces it with a plastic implant called an Intraocular Lens (IOL.)

Another difference is that LASIK is performed at a laser center on an outpatient basis, while cataracts surgery is performed on an inpatient basis in an operating room. The doctor can perform LASIK surgery on both eyes during one session, but cataract surgery needs to be scheduled for each eye separately.

Finally, there are major differences in the way these surgeries are covered by insurance. LASIK surgery is not reimbursed by insurance. However, you may want to look into paying for surgery with a Flexible Savings Account (FSA.) Cataract surgery is covered by insurance, although there are various out of pocket costs that you may want to add on. These include premium IOLs and laser rather than diamond scalpel surgery.

LASIK v. Cataracts Surgery: The Similarities

Still, there are many things that these two surgeries have in common. LASIK surgery uses two kinds of lasers: one to create a corneal flap and another to change the corneal shape. If you elect to have a laser surgery to remover your cataracts, one of these types of lasers will be used to remove the natural lens from the eye.

Other similarities are that both surgeries provide patients with 20/20 vision or better. They are both performed under general anesthesia while awake, require less than 15 minutes to perform, and boast of virtually no recovery time.

Can You Have LASIK and Cataract Surgeries on the Same Eye?

Yes. Since LASIK works on the cornea and cataract surgery works on the lens, it is possible to have both surgeries on the same eye if the doctors find you need to. Although it is less common, you can even undergo both procedures at the same time. Sometimes, when undergoing cataract surgery, the doctor finds that vision is still not perfect even after applying the IOL. In these cases, they may provide LASIK surgery to complete the procedure and provide the patient with 20/20 vision.

LASIK surgery addresses myopia, astigmatism or hyperopia. These are issues which are usually addressed at a younger age. Cataracts are the clouding of the lens, a condition which generally occurs with old age. Therefore, most people receive LASIK surgery when they are younger and cataract surgery when they are older.

Cataract and LASIK Surgery in Orange County

Visit Advanced Eye Medical for a LASIK screening or complete eye exam to find out if you are a candidate for either cataract or LASIK surgery in Orange County. Schedule your appointment or come in for a consultation.