Comprehensive Eye Exam vs. Online Vision Screening
Do you really have to do all of these tests again doc?
A really common question I get almost every day is when patient's ask me why we have to do so many tests every year as part of the eye exam. The comprehensive eye exam that we perform at Optique covers not only a vision check, but also a thorough health check of all parts of the eye and vision system. There are many very important health issues that can be detected on a vision exam, and many of these do not cause any symptoms until very late in the disease. A patient may think they need a simple glasses check only, but there are many other potentially dangerous conditions that can be causing damage without a patient even knowing about it. I am going to share three very interesting cases of ocular diseases that were discovered when a patient came in for a routine exam.
I have been having some headaches, so maybe I just need new glasses
A male patient in his mid thirties came into the office a few weeks ago with a complaint of headaches for the last 6 months. This patient had not had an eye exam for awhile, and he thought that the new headaches were possibly related to how much he was using the computer for work. This is a really common cause of eye strain related headaches, so the symptoms made sense. Once I took a look inside of his eyes, however, this was anything but a normal case. This patient showed signs of widespread bleeding within his retina and a swelling of his optic nerve called papilledema. This can be caused by several different pathologies ranging from an increase in blood pressure to a mass behind the eye. Once I saw this, I immediately contacted a ophthalmology retinal specialist and had this patient examined within a few hours. Once the retina specialist saw the same findings, he determined that this was related to a drastic increase in blood pressure, and this patient was sent to the ER that same day for imaging tests and blood pressure lowering treatment. This patient was immediately placed on blood pressure lowering medications to reduce the risk of not only eye related issues, but also of heart attack and stroke. In this case, the appearance of the patient's ocular health gave me a direct view of a potentially much more dangerous situation. Once the blood pressure returns to a normal level, the eye should hopefully return to normal, but this is a perfect example of why a comprehensive eye exam is so much more important than just doing a glasses check.
I have never had my eyes examined, but they're probably fine.....right?
A few months ago I had a male patient in is twenties come in for his first eye exam ever, and the findings were very interesting. This patient had no vision complaints, and he had never needed glasses before. When we performed the eye pressure test (yes the annoying air puff test) it was discovered that this patient has significantly elevated eye pressures. There is a normal range for eye pressure, but when it falls outside of this range, we get worried about the increased risk of developing glaucoma. Glaucoma has no symptoms until it is late in the disease when a patient's vision becomes affected. This is generally a slow process, but the disease causes permanent damage to the eye that cannot be reversed. There are many types of glaucoma, and the most common type generally affects older adults more commonly, but certain types can present in young adults as well. In this patient's case, he had what is called pigmentary glaucoma which means that little flecks of pigment from his colored iris clog up the drainage channels in the eye causing the internal eye pressure to increase. This eventually leads to retinal damage that first causes peripheral vision loss that eventual creeps into the central vision. Once this was discovered, the patient was placed on eye pressure lowering medications to bring the pressure down to a safe level where hopefully no further damage can occur. Left untreated, this patient would have had permanent irreversible progressive peripheral vision loss for years until the field of vision got so small it started to encroach on the central vision. This is a great example of why at any age a regularly scheduled eye exam is so important even for people that have no vision issues and do not need vision correction.
Those online eye exams are good enough for me....aren't they?
This case just recently happened, and it was one of the most interesting cases I have seen in years. A young female patient came in for an exam to get some new contact lenses. This was the first time she had been into our office, but the last exam she had was on an online eye test. These types of tests give a basic vision screening, but they do nothing to address potential eye health issues. Beyond needing new contact lenses, this patient was having no other vision symptoms at all. When I looked inside her eyes I was shocked to find that she had extensive retina damage and retinal detachments in, not one, but both eyes! Retinal detachments generally cause vision symptoms of light flashes, or floaters, but in this patient's case these were not present at all. If left untreated, a retinal detachment can lead to permanent irreversible blindness in the affected eye. Needless to say, this patient was sent to an ophthalmology retinal specialist, and she is soon going to undergo surgery to repair the damage to both eyes and hopefully reduce any future risk of vision loss. Personally I cannot believe that these online eye exams actually exist, and a case like this perfectly illustrates why they could miss very important eye health issues.
These are a few interesting case that I have seen recently, but these are not exceptions. Patient's may sometimes think that we should just do a basic vision test only so they can get new glasses, but these cases illustrate why a regular comprehensive eye exam is so important. I would recommend everyone get an exam even if there are no vision complaints. It is very possible that by checking the health of the eye early, potentially sight or life threatening conditions can be discovered before it is too late. Please contact us at Optique so we can schedule your comprehensive eye exam and put your mind at ease.
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