Demystifying the role of the optometrist

A comprehensive eye exam is so much more than checking whether your vision has changed. It’s a privileged moment where your optometrist thoroughly evaluates the health of your eyes to prevent issues, detect conditions early, and support you in your day to day life. Curious about what really happens behind all those instruments? Let’s take you behind the scenes of an eye exam with Dr. Stéphanie Bourque, optometrist and clinic owner at Opto Réseau Terrebonne. 

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Stéphanie, you’ve been an optometrist for over 30 years. What do you love most about your profession?

First of all, I want to say that it’s the most beautiful profession in the world. We spend between 30 and 45 minutes with our patients - what other area of healthcare can proudly say they offer that much quality time?

We build a relationship of mutual trust. Our patients stay loyal because we listen to them and we find solutions that give them the best possible vision and the most comfort, so they can enjoy life and do all their activities safely.

On top of that, the profession is constantly evolving! We’re developing complementary services that help relieve more patients dealing with dry eyes, eye misalignment, headaches, dizziness, screen related discomfort, ocular diseases, and learning difficulties.

Thank you, it’s so inspiring to see how passionate you are about your work. When you talk about “better vision,” what does having healthy eyes mean to you?

To me, having healthy eyes means not only seeing well, but also feeling good and being as comfortable as possible doing everything you love: reading, working, going about your daily activities safely, and practicing your favorite sports.

It’s really about being able to enjoy every moment of life with optimal visual comfort. This is made possible through comprehensive eye exams that allow us to check your vision quality, eye alignment, retina, visual fields, and intraocular pressure, among other things.

I want us to dig deeper today! So… what exactly is a retina?

The retina is a membrane lining the back of the eye. It contains photoreceptor cells (cones and rods!) that capture light and transform it into electrical signals. These signals travel through the optic nerve to the brain, where they are interpreted as images. Without a healthy retina, vision is compromised, because it’s the structure that translates light into visual information.

And what does it actually look like? Can you see the cones and rods?

A healthy retina looks like an orange red surface with well defined blood vessels and a clear optic nerve. The cones and rods? No, you can’t see them with the naked eye — they’re microscopic — but they’re incredibly important because they capture light and colors!

During your eye exam, your optometrist will take the time to show you your retina with imaging tests and confirm whether it appears healthy.

What exactly is the optometrist looking for at the back of my eye?

We make sure your eye is healthy by using our expertise and specialized instruments to inspect the retina and detect abnormalities that you wouldn’t be able to see yourself. We look for signs such as hemorrhages, deposits, tears, retinal detachment, or early signs of glaucoma. We can also detect conditions like diabetes or macular degeneration by examining your retinal images.

In fact, many retinal diseases are asymptomatic. Without screening, they can lead to irreversible vision loss.

What is macular degeneration?

Macular degeneration is a disease that affects the central part of the retina — the macula. It can make reading or recognizing faces very difficult. Often age related, it progresses silently… which is why screening is so important.

Our instruments help us detect this disease, and your optometrist can help you prevent it through recommendations like wearing sunglasses, eating well, exercising, and avoiding smoking.

So if we detect macular degeneration early, can something be done?

Yes, early detection really helps. We can slow its progression with treatments and lifestyle adjustments. That’s why we say an eye exam is much more than updating your glasses - it’s your eye health insurance.

Click here learn more about what to include in your diet for healthy eyes.

And other than the retina, what else do you check?

To ensure your eyes are healthy, aside from the retina, we analyze your visual field results, measure your intraocular pressure, and review all the tests performed during your eye exam. It’s the full picture that allows us to conclude whether your eyes are healthy.

Your eyes can reveal diseases like diabetes, hypertension, multiple sclerosis, certain neurological conditions… and an optometrist can detect them even before symptoms appear. After all, vision is what allows us to enjoy everything we love seeing every day. So we might as well take good care of it!

What is intraocular pressure?

It’s the pressure inside the eye. If it’s too high, it can indicate a risk of glaucoma — a disease that damages the optic nerve and affects peripheral vision.

How do you measure it, and why?

There are several methods: a puff of air (yes, the one that always startles you!), applanation, or a small probe. All methods are reliable, but some patients respond better to one than another. They all evaluate the cornea’s reaction to estimate the pressure inside the eye.

Why do we measure it? Intraocular pressure can fluctuate over time, and as we age, glaucoma risk increases. For at risk patients, regular monitoring is essential. Regular measurements help prevent permanent damage and allow us to introduce preventive treatments to protect the optic nerve and vision.

For 3 tips for healthy eyes this winter, consult our article on the matter. 

And after assessing eye health, what comes next?

After evaluating the health of your eyes and screening for risks, we measure your visual performance. This includes visual acuity — the sharpness of your near and distance vision — as well as how well your eyes work together for optimal comfort.

And why is that important?

Because a prescription isn’t just about “seeing clearly.” It’s what ensures that:

• You can read without squinting or getting headaches.
• You can work at a computer without visual fatigue, even after a long day.
• You can drive safely with clear vision day and night.
• You can enjoy your activities (sports, crafting, reading) without discomfort.

A good prescription means adapting your vision to your lifestyle — and only a complete eye exam can guarantee that.

Thank you Stéphanie for your time. This is so much clearer and so reassuring. Looking forward to seeing you again at the clinic.

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