Written by Dr. Brent Segeleon
The increasing role optometrists have in diagnosing, managing and treating disease
Did you know that your optometrist, most commonly known to treat refractive disorders with corrective glasses or contact lenses, actually plays an integral part in your health care?
In recent years, technology has helped to revolutionize optometry and patient care by allowing optometrists to accurately diagnose and manage many diseases of the eye. Optometrists not only prescribe glasses and/or contacts, but can diagnosis and co-manage countless eye and systemic bodily diseases. They can also prescribe oral and topical medications to treat eye diseases.
These days it is not uncommon for your optometrist to offer retinal photography, visual field screenings, corneal topography and optical coherence tomography—all these instruments now play an important role during your yearly comprehensive eye exam.
Annual dilated-eye examinations are considered the standard of care to preserve healthy eyes and good vision. During a comprehensive eye exam, your optometrist will examine the external and internal structures of your eyes, looking for signs of eye disease or disease progression.
Five common eye diseases that your optometrist can test for are diabetic retinopathy, age-related macular degeneration, glaucoma, cataracts and dry eye syndrome. Early detection is the key to maintaining 20/20 vision.
Diabetic Retinopathy
Diabetes is a disease that interferes with the body’s ability to use and store sugar, and it is the leading cause of kidney failure, non-traumatic amputations and blindness. As of 2010, 10.9 million U.S. residents ages 65 years and older were diagnosed with type 2 diabetes.
Diabetic retinopathy is a condition occurring in patients with uncontrolled blood sugar, which causes progressive damage to the back of the eye, or retina. Damage to small blood vessels in the retina causes bleeding, which will lead to vision loss.
Symptoms of diabetic retinopathy include spotted vision and having a dark spot in the center of your vision. Risk factors related to diabetes include poorly controlled blood sugar, the length of time a patient has been diabetic and pregnancy (i.e., if a woman has gestational diabetes). Often there are no visual symptoms in the early stages of this disease.
Age-Related Macular Degeneration (ARMD)
ARMD is the leading cause of severe vision loss in adults older than 65. This disease is the result of age-appropriate changes to the macula, a section of the retina that typically provides your central vision. It’s estimated that more than 1.75 million U.S. residents currently have significant vision loss from ARMD, and that number is expected to grow to almost 3 million by 2020, according to the National Eye Institute at the National Institutes of Health in Bethesda, Md.
Genetics, sunlight, smoking, poor diet and being older than 65 all increase your chance of developing ARMD. In all cases, central vision will become fuzzy or distorted, and tasks such as reading, driving and seeing faces will become extremely difficult.
Glaucoma
Glaucoma is a progressive eye disease that causes permanent damage to the optic nerve—a vital structure located in the back of the eye that helps transmit visual signals from the eye to the brain. The disease is the result of increased fluid within the eye, which creates pressure within the eye (not related to high blood pressure). The increase in pressure can result in slow, irreversible vision loss that initially affects peripheral vision but can progress—without any symptoms—to central vision loss or blindness. Treatments range from medicated eye drops to laser and ocular surgery.
Risk factors include being older than 60, race (African-Americans have an increased risk), a family history of glaucoma, chronic eye inflammation and using medications that increase the pressure in the eyes. If untreated, the person will begin to notice a significant loss of peripheral vision.
Cataracts
A cataract is a cloudy or opaque area in the normally clear lens of the eye. The opacification is caused by the thickening and clumping of proteins, which reduces the amount of light that enters the eye and clouds vision. Although this is part of the natural aging process, ultraviolet sun exposure, diabetes, smoking and trauma can accelerate early cataracts.
Cataracts generally form very slowly; although their signs and symptoms can vary, the most common symptoms include blurred vision, increased sensitivity to glare from lights and reduced intensity of colors.
Dry Eye Syndrome
Dry eye syndrome, an increasingly common condition, results from insufficient tears and inflammation of the glands found in
the eyelids. Tears are necessary for providing front surface lubrication and clear vision. Considered a chronic problem, most patients experiencing this condition need multiple follow-ups throughout the year. With so many over-the-counter lubricating eye drops available, it’s best to consult your optometrist before starting any medications.
Common complaints are uncontrolled tearing; a sandy, gritty feeling; foreign body sensation (as if a foreign object is scratching the eye, even if nothing is there); and fluctuating blurry vision. Risk factors for dry eye syndrome include environmental conditions, medications, long periods of reading or computer use, and the natural aging process, especially among women older than 40.