More Than An Eye Examination

Mrs. J., a long time patient of mine, commented, as I was doing her eye examination, “You have found everything with me.” I asked, “What do you mean?” “Well not only did you find my retinal tear, but you were the first one to suspect my high blood pressure and diabetes.” This is one example which illustrates the value of an eye examination to not just assess the eyes and vision but to sometimes find general health disorders. Some of the more common ones are hypertension, diabetes, thyroid disease and some arthritic conditions.
Generally, hypertension is a symptomless disease. The person does not know it exists unless it is specifically tested. However signs of hypertension can often be found in an eye examination when the optometrist examines the retina (at the inside back of the eye). Viewing the retina is like looking into a window on the body’s vascular system since veins and arterioles can be clearly seen. Typical signs of hypertension would include narrowing of the arterioles, and flame shaped hemorrhages in the retina.
Diabetes is one of the leading causes of blindness in North America and thus extremely important in eye care. It is suspected in an eye examination if the patient reports fluctuating vision and/or an unusual change in the lens prescription is found. These findings may be accompanied by retinal signs such as characteristic dot/blot hemorrhages and microaneurisms (which appear in the form of tiny red dots).
Eye signs of thyroid disease, in particular hyperthyroidism, can be obvious and unlike hypertension do not require a retina assessment to determine. They include a retraction of the lids often accompanied by a bulging forward of the eyes. These produce a conspicuous, wide eye stare appearance. The person may have double vision and general eye irritation due to dryness.
As to arthritis, one form called ankylosing spondylitis will be among the suspects if a person develops a recurrent pain and inflammation of the anterior segments of the eyes called iritis. Iritis is detectable by using a slit lamp biomicroscope (which is universal in optometry offices). Further medical testing is needed to confirm the arthritic condition.
Many more diseases, some of them life threatening, may be detected through an eye examination such as brain tumors, lung tumors, sickle cell anemia, multiple sclerosis, Lyme disease -the list goes on.
Thus there often is more value to your well being by having your eyes regularly examined than just to determine the condition of your eyes or whether you need a change of glasses.
Dr. John Astles, Optometrist