The Annual Eye Exam- More Than Seeing 20/20

Another year goes by and you get the notice in your mailbox, email inbox or on your cell phone; it is time for your annual eye exam. Maybe your contact lens prescription has expired and you need to order more, maybe your arms are too short for you to read the small print on the dinner menu or maybe you feel your vision hasn’t changed over the past year and you can skip this appointment, you have a lot of things to do anyway.

A lot of things come to mind when people consider their annual eye exam; sometimes there is the cost associated with the exam and new eyewear, the time it will take to get into the optometrist’s office for the appointment, dealing with your insurance, or maybe even the hassle of getting your eye dilated. So many factors come into play, so many reasons to just deal with it another day. So many reasons why you are headed down the wrong track if you push this off to the side.

Did you know that your vision is the only primary sense that has a direct link to your brain? Light enters your eyes and immediately goes through the optic nerve to be processed by your brain, a critical pathway for information to travel and an irreplaceable relationship within your body. There are numerous ways that this vital pathway for information can be damaged; trauma, diet, disease, genetics and age are just some of the most common ones.

Considering the number of ways that your eyes can be impacted by general health related factors and the importance of your vision for the quality of day to day life, seeing your optometrist annually should be something that is done without question. Sure, your primary care physician checks your eyes when you go in for a visit, but that cursory glance is generally done to make sure the pupils are responding to light and that you are able to track movement, to rule out severe head trauma that might impact the reason you are in to see them. They generally do not have the tools or time immediately available to them to conduct a comprehensive eye examination.

That is they key, a “comprehensive eye examination”; a specific type of eye exam that is more than just a refraction (where your prescription comes from), it includes a full evaluation of the health of your eye and check for health conditions that manifest in your eye. During this exam the optometrist will use instruments to check your visual field for any loss of vision along the outside edges of your field of vision, the pressure of the fluid inside of your eye, the thickness of your cornea and any unusual deviations in that thickness. It should also include an evaluation of the interior of the eye checking the lens, retina, optic nerve, macula, blood vessels and the gel (vitreous humor) that gives your eye its shape.

By comparing the examined areas with a clinical “normal”, your optometrist is able to look for signs of disease, trauma and genetic concerns. With repeat visits, your optometrist can begin to better recognize the impact of your diet, age, and other lifestyle factors on your vision and general health by establishing a baseline for your results. Consistent visits to the same optometrist can only improve the chances that your health is improved and that disaster is avoided.

“How bad can it be, really?”

You might not think that your eyes can really have that big of an impact on your overall health, but you would be wrong. Sure, things like glaucoma, macular degeneration and cataracts are all things that you know your eye doctor can (and should) look out for, but what else is there for them to be concerned with?

Well, the most common non-eye specific disease generally found by optometrists is diabetes. Undiagnosed and treated, diabetics can lose partial or full vision due to the increased blood flow to the eye. Even with proper treatment for diabetes, diabetic retinopathy can damage vision. Only regular eye exams can help prevent damage from being done by detecting the early stages of permanent damage.

Brain tumors can cause the optic nerve to swell, which can cause a patient to experience blurry vision and have absolutely no other symptoms. By examining the optic nerve and comparing it against an established baseline, an optometrist can detect abnormalities and refer patients to a specialist, as Dr Lee of Boise, Idaho did.

In New York City, a patient named Evan had been having recurring bouts of iritis (a painful inflammation of the eye) and persistent back pain that no one had ever thought to consider a linking cause to. Until he went to his optometrist, it was there that the doctor suspected something more was going on and sent him to see a rheumatologist. Evan was diagnosed with ankylosing spondylitis, an incurable form of inflammatory arthritis, and thanks to his optometrist he was able to begin treatment so that serious damage was not done to his heart and other vital organs.

Optometrists check for new blood vessels in the retina and look to see if there is bleeding from those vessels; a clear sign of advanced hypertension which can suggest the possibility of blindness causing retinal detachment.

High cholesterol can cause xanthelasma, where fatty deposits appear on the eyelids, and if those deposits are only on one eyelid there might be a blood flow problem that your optometrist would refer you to a specialist to have looked at.

Think of it this way, the blood vessels in your eye are all a part of the same systems as the ones in your thighs, feet and elbows. The difference is that we cannot see any of those vessels through the skin, only the eyes are the windows that give us a view of how our blood vessels are doing and only your optometrist has the daily exposure to ensure proper care is taken.

Many other conditions are looked for during the course of your annual eye exam, things that your optometrist is on the lookout for; sickle cell anemia, jaundice, thyroid disease, multiple sclerosis and strokes are just a few of the concerns that are screened for when you are in that high-backed chair staring at the chart on the wall across the room. When the doctor tells you to look over his right shoulder and he shines the light into your eye or when you have your head pressed tight against an instrument and are looking for the light that the optical tech keeps telling you is there, remember that these few awkward moments are well worth the investment. The few brief moments where your eyes sting from the dilation drops and the couple of hours after where your vision is blurry up close and you are sensitive to light, that time has been an investment in your health. From checking for brain tumors and indicators of sight stealing retinal detachment, to screening for diabetes and painful glaucoma; there is more to your annual eye exam than simply getting a piece of paper with some numbers on it, more to it than new contact lenses or glasses.

An annual comprehensive eye examination by a qualified optometrist that you have an established history with might be the most valuable relationship you can have with a health care provider and is certainly well worth the investment of time and money, in fact you are getting far more than you will ever know, hopefully.

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