Modern ophthalmology – individual & personal

1. 01Examination & visionWhen and how often should I have a preventive eye check-up?

   A regular check-up is worthwhile even without symptoms, because many eye diseases – including glaucoma and macular degeneration – remain symptom-free for a long time. As a guide, we recommend:

   • Age 15–40: every 5–10 years
   • Age 40–65: every 2–3 years
   • From age 65: every 1–2 years

   With risk factors – a family history (e.g. glaucoma), diabetes, hypertension, autoimmune disease, high myopia or certain medications – earlier and more frequent examinations are advisable. Whatever the interval, sudden changes in vision should be assessed promptly.

2. 02Examination & visionWhat happens during an eye examination?

   The examination is tailored to your concern. It begins with a conversation about symptoms, previous conditions, medication and family history. Depending on the indication, the following steps then take place:

   • Visual acuity testing and determination of your spectacle prescription (refraction)
   • Assessment of the anterior segment of the eye at the slit lamp
   • Measurement of intraocular pressure (tonometry)
   • Examination of the back of the eye, including the retina and optic nerve head, often with dilated pupils
   • Where needed, additional diagnostics: optical coherence tomography (OCT), visual field testing, retinal photography or corneal topography

   The examinations are painless. Afterwards we explain the findings clearly and discuss the next steps.

3. 03Examination & visionWhy are my pupils dilated – and may I drive afterwards?

   Only with a dilated pupil can the retina, macula and optic nerve head be assessed reliably out to the periphery – for example when retinal tears, diabetes, glaucoma or age-related macular degeneration are suspected. The eye drops (mydriatics) usually take effect within 15–30 minutes.

   Afterwards, near vision and glare sensitivity are impaired for roughly 3–5 hours. During this time, reading and driving are not safe. Please plan your journey home accordingly (accompanying person, public transport) and bring sunglasses. When booking, ask whether pupil dilation is planned for your examination.

4. 04Examination & visionWhat should I bring to my appointment?

   • Your current glasses and your contact lenses with their case
   • A list of your medication (including eye drops and over-the-counter products)
   • Previous findings and medical reports, if available
   • Your insurance card and, if applicable, your referral
   • Sunglasses for the journey home

   Please let us know if you wear contact lenses – depending on the examination, we may ask you to remove them beforehand.

5. 05Examination & visionHow does an ophthalmological examination differ from a sight test at the optician?

   A sight test at the optician determines visual acuity and spectacle strength (refraction). An ophthalmological examination goes further: it assesses the health of every part of the eye – cornea, lens, intraocular pressure, retina and optic nerve – and detects diseases that initially cause no symptoms.

   If visual acuity remains reduced even with optimal glasses, a medical assessment is always indicated: the cause may be a disease of the retina, the optic nerve or the lens.

6. 06Examination & visionHow often should my prescription be checked?

   For adults with stable prescriptions, a check every two years is usually sufficient. Come sooner if you notice increasingly blurred vision, headaches, or rapid fatigue when reading or working at a screen.

   From around the age of 40–45, the lens loses its ability to focus on near objects (presbyopia); reading or varifocal correction becomes necessary, and the prescription often changes gradually over the following years. Children and adolescents need more frequent checks because of growth – every 6–12 months, depending on the findings.

7. 07ChildrenAt what age should children have their eyes examined?

   We recommend a first preventive examination from around 3 years of age. It is advisable earlier with a family history (squint, amblyopia, high refractive error), after premature birth, with developmental delay, or when there are signs such as a visible squint, light sensitivity, a clouded cornea, an unusually pale pupil, trembling eyes or a drooping eyelid.

   The reason: vision develops during the first years of life. Disturbances in this sensitive period can lead to permanently reduced vision – the earlier they are detected, the better they can be treated.

8. 08ChildrenHow can I recognise a squint or amblyopia (lazy eye)?

   A squint is often visible but may also occur only intermittently. Signs include a tilted head posture, squeezing one eye shut in sunlight, frequent tripping, or holding books and screens very close.

   Amblyopia – reduced visual acuity resulting from disturbed development of the visual pathway although the eye itself is healthy – often goes unnoticed because the better eye compensates. Causes include a squint, differences in refractive error between the two eyes, or congenital changes. This is why preventive examinations matter. Treatment consists of glasses, temporary patching of the better eye and orthoptic training; our orthoptist supports your child throughout.

9. 09ChildrenCan the progression of myopia in children be slowed?

   Myopia progression can nowadays be slowed in a targeted way; there is no cure. Monitoring eye length is key: in myopia the eyeball grows too long. Regular axial length measurements let us assess how fast the eye is growing and whether a measure is working.

   Studies show effects for low-dose atropine eye drops and for special spectacle lenses (e.g. DIMS technology); spending enough time outdoors is regarded as effective prevention. Which measure is appropriate depends on age, baseline values and course. We summarise current studies in our Insights section.

10. 10Eye diseasesWhat is glaucoma – and why is early detection crucial?

    Glaucoma is a group of diseases in which the optic nerve is damaged step by step. The most important risk factor is raised intraocular pressure, although there are also courses with normal pressure. Further risk factors are older age (from about 40), a family history, high myopia and diabetes.

    Because the peripheral visual field is lost first and central vision is preserved for a long time, the disease is usually noticed late – lost optic nerve fibres do not regenerate. Diagnostics include measuring intraocular pressure, assessing the optic nerve head, visual field testing and OCT.

    Treatment consists of pressure-lowering eye drops, laser procedures (selective laser trabeculoplasty, SLT) or surgery. The aim is to preserve the remaining vision. Treatment is usually reviewed every six months.

11. 11Eye diseasesWhat is a cataract, and when is surgery appropriate?

    In a cataract, the natural lens of the eye becomes cloudy over the course of life. Typical signs are increasingly blurred, low-contrast vision, greater glare sensitivity (especially at night), muted, yellowish colours and frequently changing prescriptions.

    The clouding cannot be corrected with drops or glasses; only surgery is effective, in which the clouded lens is replaced by an artificial lens. The procedure is usually performed as an outpatient under local anaesthesia. The right time depends on how much it affects daily life (reading, driving, work) – not on a particular degree of “ripeness”.

    We clarify the indication, discuss lens options and look after you before and after the procedure. The surgery itself is performed by specialised surgeons with whom we cooperate.

12. 12Eye diseasesWhat is age-related macular degeneration (AMD)?

    AMD affects the macula, the area of sharpest vision at the centre of the retina, and is among the most common causes of severe vision loss in older age. Warning signs are straight lines that appear distorted or wavy, a grey or dark spot in the centre, and increasing difficulty reading – you can check this yourself with an Amsler grid.

    A distinction is made between the dry form, which progresses slowly and is not curable (in certain stages, a nutritional supplement based on the AREDS2 formula, taken after medical advice, can slow progression), and the wet form with abnormal blood vessel growth. Untreated, it can lead to rapid vision loss and is now treated with medication injected into the vitreous (intravitreal anti-VEGF therapy). Risk factors are age, smoking and family history.

    If new distortions appear, an assessment with OCT should take place within a few days.

13. 13Eye diseasesHow can diabetes affect the eyes?

    Persistently raised blood sugar damages the small vessels of the retina (diabetic retinopathy) and can lead to macular oedema – an accumulation of fluid at the centre of the retina. Both cause no symptoms for a long time.

    This is why regular eye examinations, including examination of the back of the eye, are important for everyone with diabetes – usually once a year, more often if there are findings. The most effective prevention is good control of blood sugar, blood pressure and blood lipids. Depending on the stage, laser treatment, intravitreal medication or – rarely – surgery may be considered.

14. 14Eye diseasesHow do I recognise an impending retinal detachment?

    Warning signs are sudden flashes of light, a swarm of black dots or threads (“floaters”), and a shadow or curtain moving into the visual field from the edge. Risk factors include high myopia, previous cataract surgery, eye injuries and a family history.

    This is an emergency: please have your eyes examined the same day. Retinal tears can be treated early with a laser; an already detached retina requires surgery – the earlier, the better the prognosis.

15. 15EmergenciesWhen is it an eye emergency – and what can I do myself?

    Common eye emergencies include:

    • Eye injuries (e.g. from foreign bodies or trauma)
    • Red eyes, particularly in contact lens wearers
    • Visual disturbances such as flashes, dark spots or floaters
    • Sudden loss or reduction of vision
    • Sudden double vision

    First aid: For chemical burns (e.g. from cleaning products), rinse the eye immediately with plenty of clean water (at least 10–15 minutes, keeping the eyelids open) and then seek medical examination without delay. With foreign bodies or injuries, do not rub or remove anything yourself; cover the eye loosely. Contact lens wearers with a red, painful eye should remove their lenses and not reinsert them. During our consultation hours you can reach us on 044 798 18 69.

16. 16EmergenciesHow can I reach you outside opening hours?

    Our consultation hours are Monday to Thursday from 8:30–13:00 and 14:00–17:00, Friday and Saturday by appointment. Outside these hours, please contact the Doctors' hotline on 0800 33 66 55: you will be connected directly to the ophthalmologist on duty in the Zürcher Unterland/Winterthur region.

    In life-threatening situations, call the emergency number 144.

17. 17Practice & appointmentsHow can I book an appointment?

    The easiest way is the online appointment booking (“Appointment” button in the header of this page). Alternatively, reach us by phone on 044 798 18 69, via WhatsApp (076 721 60 21), by email or through the request form. Please do not send health data or medical findings through these channels – we are happy to discuss details in person.

18. 18Practice & appointmentsDo you carry out aeromedical eye examinations?

    Yes. Dr. Oroumchi has been a recognised ophthalmology expert for the Federal Office of Civil Aviation (FOCA) since 2019 and performs aeromedical eye examinations for professional and private pilots, air traffic controllers and cabin crew – in line with EASA and FOCA requirements.

    Please bring any existing documents as well as the requirements of your aeromedical examiner (AME) and mention the examination when booking.

19. 19Practice & appointmentsIs the practice wheelchair accessible?

    Yes. The practice is on the first floor of the Rietbach Center in Bachenbülach and is reached from the main entrance by stairs or lift – wheelchair- and stroller-friendly. By bus, take line 504 (Bramenstrasse stop, directly in front of the centre), lines 530/531 (Bachenbülach Alte Post) or line 501 (Bramenländli). Parking is available at the Rietbach Center (paid) and free of charge in the surrounding area.

20. 20Practice & appointmentsWho covers the cost of the examination?

    Cost coverage depends on the reason for the visit. Examinations for symptoms, or for the assessment and follow-up of a condition, are generally billed through compulsory basic health insurance. Purely preventive check-ups without symptoms, refraction for glasses, or certificates (e.g. aeromedical examinations, fitness to drive) may have to be paid for wholly or partly by yourself. Your insurance model and deductible are decisive.

    If in doubt, please clarify cost coverage with your health insurer beforehand; we are also happy to inform you before the examination.

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