What’s the future of your vision?

By Sasha L Radford, OD

Why do you go to the eye doctor? Maybe you aren’t seeing as well as you think you could. Perhaps your glasses are broken or you’ve simply run out of contact lenses. Or you may think your current glasses are unstylish and you’re ready for a new look. You go to the eye doctor primarily for the refraction – determining the glasses and contact lens prescription that best corrects your vision. You go to the eye doctor to see more clearly.

Do you go to the eye doctor to get your pupils dilated? If you have certain medical conditions such as diabetes, or an eye disease such as glaucoma, you go to the eye doctor to have the health of your eyes checked in addition to the refraction, glasses, or contact lens update. What if you are young and healthy? You see well and your eyes feel fine. Why would you go to an eye doctor? Do you need the dilation?

For those of you who think having an eye exam is about how well you can see today or next week, I’d like to change your mind. Yes, we help you see better while you’re in the office. But we care very much about how you see next month, next year, and all the years thereafter.

Many patients may not realize it, but a comprehensive eye exam involves so much more than checking your vision or what prescription you need. We do several tests which patients often find annoying but which give us valuable information about the structure and function of your visual system.

Checking eye pressure is typically the most dreaded procedure because most eye doctors use the “puff of air” method. Elevated eye pressure is a risk factor for glaucoma so it’s an excellent screening to have. (We don’t use the air puff test in either of our offices anymore – new technology has rendered it obsolete!)

The visual field test is another screening that patients don’t usually like – it measures the integrity of your peripheral vision by presenting a series of tiny dim lights; the patient must click a button each time he sees a spot of light. This is unpopular because it’s so mind-numbing and can be difficult – you’re constantly thinking, “was that a light or just my imagination?” But the visual field is a great way to check for glaucoma, other diseases of the optic nerve, or problems along the optic nerve’s path through the brain.

Checking your pupils with that bright light can not only identify ocular disease but can also detect neurological problems which would need treatment right away. An even brighter light is used in the “slit lamp” – the biological microscope we use to look at all the tiny structures of your eyes. Most people tolerate the light well but for those who are light sensitive, it’s unpleasant; I’ve been accused (hopefully in jest!) of trying to “blind” patients with this diagnostic instrument. There are no harmful light rays in the slit lamp microscope so it cannot damage your vision. In fact, this is one of our most valuable tools to detect cataracts, glaucoma, macular degeneration, and many others.

That brings me back to the dilation – the part of the exam where we use drops to enlarge the pupils so we can see the entire inside of the eye. No one likes this since the drops typically cause blurred vision and light sensitivity and patients often opt out of this part of the exam. They simply want to get their glasses or contact lenses and be on their way.

Fortunately, we have an alternative to dilation. The Optomap camera can capture a wide field image of the retina, making dilation unnecessary for many patients. Occasionally we still need to dilate the eyes – such as when the photos don’t turn out well or when there’s something suspicious on the photos that needs to be further evaluated. But generally, the Optomap can be used as an excellent screening for a multitude of diseases of the inner eye.

The problem with eye diseases is that so many of them have no symptoms in the early stages. Your eyes may look normal, feel normal, and see well while an underlying condition is wreaking havoc on microscopic tissues. Too often patients present too late – vision has already been lost and cannot be regained.

I think the solution to this problem is simple: a change of mindset.

I challenge you – young or old – to go to your eye doctor for the future of your vision. Not only for how you’ll see next week in your new glasses or contacts, but how you’ll continue to see for the rest of your life.