It’s easy to forget to have an eye exam. After all, if you can see, there’s nothing that can be wrong, right? Not quite.
“There are many eye problems that are not noticeable to the patient, but that are already causing problems,” says Tracy Klein, OD, an optometrist who practices at UW Health Specialty Clinic in Prairie du Sac and at UW Health Deming Way Eye Clinic in Middleton.
Even some people who wear glasses or contacts only go in to have their vision checked. A comprehensive eye exam from an optometrist or ophthalmologist can detect eye problems before they steal your vision.
Adults and young adults should have a baseline eye exam if they have not been to an eye doctor in a few years, Dr. Klein says. “At that exam, an optometrist or ophthalmologist will measure vision (performing a refraction) and will ask personal and family medical history questions.” Those questions will be about vision issues, of course, but also about a history of diabetes, high blood pressure, heart disease and other factors that may contribute to vision loss.
At that appointment, your eye doctor also will recommend a frequency for follow-up exams based on your medical history. For example, a person with diabetes needs a dilated eye exam every year. This is important for checking for damage, which can be slowed, but not reversed.
People who wear contact lenses also need exams every year, to look for changes that might affect lens fit and eye health.
Eye doctors also look for clinical findings, such as thinning of the retina and high refractive error, both of which may increase risk for retinal tears and detached retina. Pigmentary changes may increase risk of glaucoma, in which the optic nerve is damaged by increased pressure inside the eye.
Glaucoma is an optic nerve disease and may not simply present as increased eye pressure. A careful examination of the optic nerve under dilated conditions is required to rule out glaucoma and may lead to other tests such as a visual field exam.
Diabetic retinopathy, a result of damaged blood vessels in the eye, is also discoverable with a dilated eye exam. Both glaucoma and diabetic eye disease can steal sight without any noticeable changes in vision for many years, but the vision lost cannot be restored.
Less common problems may be vision or life threatening, including choroidal melanoma, a cancer that can be detected during a dilated eye exam. Sometimes tumors, in your eye or brain, do not have symptoms, and sometimes a seemingly innocuous complaint like “blurry vision” leads to a diagnosis of a tumor in the eye or brain. “Early detection is critical for a positive outcome in those cases,” Dr. Klein says.
Children should have their first eye exam at the start of kindergarten. If parents notice problems, including pediatric cataracts and eye muscle problems, a pediatrician can help determine when a referral to an optometrist who sees children or to an ophthalmologist who specializes in eye muscle disorders is appropriate.
“When we talk about some of these issues, it can be very scary, especially for parents,” Dr. Klein says. “There are so many ways we can help people see better, and improve their quality of life.”
Risk of many vision-threatening issues increases with age. Glaucoma, age-related macular degeneration and diabetic eye disease all increase after age 40. Treatments can help slow or stop vision loss, so regular exams can help ensure a lifetime of clear sight.
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