By: Beth A. Steele, OD, FAAO UAB School of Optometry Associate Professor and Associate Dean for Clinical Affairs
With March designated by the American Optometric Association as Save Your Vision Month, I thought I would take a moment to remind everyone of the importance of annual eye health exams. The AOA currently recommends annual comprehensive eye exams for most age groups, particularly when known risk factors for eye disorders are present. Unfortunately, much of the general public is not aware of this, and does not fully realize why these recommendations exist. These exams are critical in aiding in the management of systemic disease, but in certain cases, may be life-saving.
When I think about the importance of regular eye exams, there are a few patients that come to mind. I share these stories and others with my patients, and students, to emphasize the value of regular, thorough eye examinations.
About two years ago, a 48 year-old man reported for his first eye exam ever. He had never had any problems with vision, and so never pursued eye care. He reported for this particular exam because he was struggling to read small print – something that virtually all 48 year olds struggle with, unless it has occurred earlier. The dilated portion of the eye exam revealed several hemorrhages in the mid-peripheral retina of one eye, a classic presentation for carotid artery disease. A subsequent carotid Doppler ultrasonography revealed 99% blockage of the ipsilateral carotid artery, which led to urgent endarterectomy. This patient was at severe risk of stroke and heart disease and had no idea. Since the time of the exam and subsequent surgery, the patient has committed to serious lifestyle changes, including regular health and eye care, and smoking cessation. He now feels better, is happier, and is convinced that the eye exam saved his life.
Another memorable patient was a 52 year-old who reported because her eyes felt dry. It had been 10 years since her last eye exam. The dilated exam revealed a large choroidal melanoma, the most common primary malignant tumor found inside the eye. Choroidal melanoma is both sight-threatening and deadly, as 90% metastasize to the liver. Unfortunately for this patient, the lesion had become so large that the eye had to be enucleated. These growths often cause visual disturbance, but in her case due to its specific location, it had not. With annual eye care, the growth might have been noticed early on, and not only prevented removal of the eye, but increased her chances for survival.
And then there is glaucoma …. Glaucoma is a commonly encountered condition, which if detected early, can often be treated before vision loss occurs. Unfortunately, when discovered in late stages, irreversible vision loss has occurred. There are many many more conditions that can present without any hint of a problem at all, both ocular and systemic, which can then be revealed by an eye exam.
But what about the things that do actually cause symptoms? Why do these still not always result in the eye care that is needed to correct them? Binocular visual dysfunction, for example, is commonly overlooked simply because the symptoms may seem to be as a result of a non-ocular problem. A school-age child who is struggling with reading might be assumed to have a learning disability, or a hyperactivity disorder, while quite often the difficulties can be improved or even eliminated with the proper eye care and vision therapy. The binocular vision disorder known as convergence insufficiency effects one in 10 school age children.
The eyes are highly valued by our patients for the precious sense they provide, but they can also serve the health care provider as what is often referred to as a “window” to the body. A comprehensive dilated eye exam allows a vascular and neurologic assessment, which can provide signs indicative of both ocular and systemic disease. Encourage your patients to receive annual eye care! For more information regular eye exam recommendations go to www.aoa.org
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