At La Jolla Optiks, Dr. Colin R. Bernstein, O.D., with over 45 years of dedicated practice, transforms what was once a simple vision checkup at the local optometrist—yielding just a new eyeglass prescription—into a comprehensive gateway to lifelong eye health. In this new millennium, Dr. Bernstein and fellow optometrists have evolved into true doctors of the eyes, delivering not only precise vision exams but also expert treatment for eye diseases stemming from infections, inflammations, allergies, dry eyes, and a myriad of other conditions that demand his specialized touch.

Dr. Bernstein plays a pivotal role in the treatment and management of cataracts, LASIK consultations, glaucoma, and corneal refractive therapy (CRT), drawing on his deep expertise to guide patients through these processes with clarity and confidence. As a cornerstone of primary eyecare, he excels in diagnosing and monitoring systemic diseases like diabetes, hypertension, and other vascular conditions, often uncovering them during routine visits. Understanding how systemic medications’ side effects can disrupt eye health and vision is central to Dr. Bernstein’s patient-centered approach, ensuring your overall well-being remains his top priority.

Prescribing medications, collaborating seamlessly with primary healthcare physicians, and integrating into your full healthcare journey is now a hallmark of Dr. Bernstein’s daily routine at La Jolla Optiks, where empathy meets innovation.

Specialization Today, optometrists like Dr. Bernstein are honing expertise in niche areas of eyes and vision, becoming trusted authorities in their domains. It’s commonplace for him to counsel patients on every facet of LASIK surgery, recommend the ideal intraocular lens for cataract procedures, or provide tailored advice on eye nutrition to optimize long-term health. With his national acclaim for specialty contact lenses—particularly hybrid and scleral designs—Dr. Bernstein delivers exceptional comfort and vision to those navigating post-surgical eye traumas, corneal transplants, or severe dry eye conditions that standard lenses simply can’t address.

Moreover, as an expert in eyelid-related issues, which often underpin dry eye diseases, Dr. Bernstein offers advanced treatments to restore balance and relief. In the face of progressive conditions like macular degeneration, where even aggressive therapies such as eye injections may not fully preserve sight, Dr. Bernstein steps in as a low-vision specialist. After maximizing medical interventions, he crafts functional vision solutions that empower patients to maintain a near-normal visual life, from reading to daily tasks.

The era when optometrists like Dr. Bernstein focused solely on general eyecare—routine exams, eyeglasses, and basic contacts—is fading into history. There’s a compelling case for distinguishing “Optical Optometrists,” who handle everyday vision corrections with standard eyeglasses and contacts, from “Medical Optometrists” like Dr. Bernstein. While he continues to provide those foundational services, his true distinction lies in specializing in complex medical eye conditions, delivering comprehensive care that goes far beyond the basics.

CASE HISTORY

Before Dr. Bernstein even begins your exam, he invests time in a thorough overview to truly understand you. At the heart of it is your chief complaint: What brings you to La Jolla Optiks today? Struggling with nighttime vision, glare, light sensitivity, or double vision? When was your last exam, and have there been any shifts in your eyes or sight since?

A detailed Review of Systems follows, exploring your whole body across thirteen key areas to identify acute or chronic medical conditions that could impact your vision. Dr. Bernstein also assesses your mental status, mood, and alertness during the visit. He’ll inquire about medications—prescription, over-the-counter, nutritional, or herbal supplements—plus alcohol, tobacco, or recreational use, as all can influence your eyes. (Rest assured, every detail is safeguarded under strict privacy protections.)

From an optical standpoint, Dr. Bernstein requests your current eyeglass prescriptions, so bring all your pairs—especially that trusty old favorite—for a complete picture. This foundation sets the stage for personalized care.

PRETEST

These initial steps, often handled by Dr. Bernstein’s skilled optometric technicians, prepare the ground before he joins you. They include:

• Auto-Refraction: A computer-guided laser instrument objectively measures your optical prescription—no responses needed, just pure automation.
• Topography: This maps the cornea’s entire surface, pinpointing aberrations or distortions in the eye’s optical zone—crucial for Dr. Bernstein’s work with irregular corneas like keratoconus.
• Case History Integration: Family history and genetics reveal risk factors for eye conditions, informing Dr. Bernstein’s proactive strategies.
• CCT (Central Corneal Thickness): Measuring corneal thickness aids LASIK evaluations (as lasers reshape by ablating tissue) and glaucoma diagnosis, areas where Dr. Bernstein’s precision shines.

Much of this can be explored via search engines like Google—we encourage your curiosity! But as Dr. Bernstein often notes, “Dr. Google” offers information, while he delivers knowledge, honed by decades of experience tailored precisely to you and your eyes.

VISUAL ACUITY

This benchmark reveals what you can see—with or without glasses—at distance and near, quantified as “20/something.” The first “20” denotes 20 feet (optical infinity in the exam room), while the second indicates the letter size a normal eye discerns at that distance. For instance, 20/40 means doubling the 20/20 size to see clearly at 20 feet; 20/200 requires 10 times that.

This leads to the perennial question: “What is legally blind?” Dr. Bernstein clarifies that it’s not just a number—it’s about usability for gainful employment and daily tasks with optimal correction. Media often misleads by citing 20/200 or worse as “legally blind,” yet most people uncorrected reach that level but correct to 20/20 with glasses or contacts. True legal blindness applies to the rare cases of severe disease where vision can’t surpass 20/200 despite best efforts. If you can perform visually demanding work, you’re likely not legally blind—Dr. Bernstein’s exams confirm this with accuracy.

EYE EXAMINATION

Dr. Bernstein’s exams blend two vital threads: routine vision correction for glasses or contacts, and health-focused assessments for medical concerns—often intertwined. A standard prescription visit might reveal undiagnosed issues like cataracts, glaucoma, or retinal problems, while also flagging systemic conditions such as diabetes or hypertension—many first detected in his chair. Conversely, if you’re there for an acute eye issue, Dr. Bernstein prioritizes resolution before refining your prescription. Regardless, his comprehensive approach encompasses eyes, vision, and holistic health.

THE ACTUAL EYE EXAM

Dr. Bernstein employs a spectrum of tests to craft your prescription and evaluate eye health, adapting based on your needs. For medical concerns, he may defer full refraction until stability returns.

In routine exams, he favors time-tested methods to pinpoint your ideal prescription—approaches that vary among doctors but converge on optimal results for you.

Objective Testing

(No patient input needed—pure observation, ideal for children or non-verbal cases):

• Retinoscopy: Dr. Bernstein shines light on the retina, observing reflections and tweaking lenses to reveal your prescription—remarkably accurate, akin to the “old-school” precursor to auto-refraction.
• Cover Test: Uncovers eye alignment; misalignment can spark strain, headaches, or double vision, especially during prolonged near work—Dr. Bernstein watches for refixation movements to guide interventions.
• Pupillary Test: Tracks pupil responses to light, signaling brain health issues like tumors, strokes, or medication effects—vital for his systemic disease monitoring.
• Biomicroscopy: His slit-lamp microscope scrutinizes the eye’s front, middle, and back, yielding a wealth of health insights in every exam.
• Tonometry: Measures internal eye pressure to prevent glaucoma’s silent damage—Dr. Bernstein prefers the precise Goldmann Applanation method (enabled by modern scope-of-practice laws) over the “puff test,” and he treats various glaucomas with targeted drops.
• Dilated Fundus Exam (DFE): Those dilating drops open a window to the retina, where Dr. Bernstein inspects blood vessels for signs of hypertension, diabetes, cancers, or other systemic clues—often diagnosing “healthy” patients with hidden issues. A healthy retina is essential; damage creates blind spots, and full compromise means total vision loss.

Subjective Testing

(Your feedback refines objective findings):

• Visual Acuity: Reiterates far/near sharpness with/without correction—the classic 20/20 gauge.
• Manifest Refraction: Dr. Bernstein flips lenses, querying “Better one or two?” to fine-tune your final prescription.
• Phorias: Assesses eye alignment (vertical and horizontal) for sustained binocularity—precision matters, as eye muscles demand 200-300 times the accuracy of limbs, preventing fatigue from reading or screens.
• Accommodation Test: Gauges your eye’s shift from distance to near focus, tied to lens flexibility and age. Dr. Bernstein notes it reliably predicts presbyopia’s onset around 42-45 (earlier near the equator due to UV exposure, later toward the poles). Exceptions are rare, but the myth of “Granny never needing reading glasses” dissolves under exam—denial fades when small print blurs, and Dr. Bernstein’s solutions bring it back into focus.