Importance of regular and comprehensive eye check up

Dr T Lipoksanen Jamir

Our eyes are one of the most sensitive organs of our body and are considered to be one of the most important senses which helpsus to see the beautiful world that God has created. Without our eyes, we won’t be able to do anything by our own. We would have to depend on others to do even the smallest tasks. The Bible in the book of Matthew says that “The eye is the lamp of the body. So, if your eye is healthy, your whole body will be full of light”. The verse has deep meaning spiritually but it also can be interpreted that we need to take care of our eyes for without them our whole body will be without a lamp to guide us. We will be like a car driving at night without the lights on. Our lives will be without any direction or purpose. So we need to take care of our eyes and seek medical help for even the smallest to the biggest complaints in our eyes.

Regular visits to an eye doctor with comprehensive examination of our eyes should be an important aspect of our healthy lifestyle. Most of us are under the impression that as long as we can see well, we do not need a routine eye check-up. The reality is entirely different. Most of the vision-threatening diseases do not have symptoms in the early stages, and cannot be picked up by a test for refractive error (power of glasses) alone. A comprehensive eye examination includes vision assessment for both distance and near, measuring our eye pressure, eye alignment, as well as evaluation of the front (anterior segment) and back of the eye (including the retina and optic nerve).

Some of the important reasons for regular and comprehensive eye examination are:

1. More than 80 percent of what children are expected to learn in and outside the classroom requires good vision. An annual eye exam is the only way to ensure your child is seeing clearly and comfortably to succeed in the classroom. It’s also the only way to know for sure if kids are seeing their best for sports and other activities. Uncorrected refractive errors in children affects not only their ability to learn but also affects their overall development and if the refractive error is uncorrected then ultimately it may lead to amblyopia (Lazy eye).

2. People who have Myopia (Near –sightedness) have an increased risk of retinal detachment Prompt detection and treatment of risk factors which may lead to Retinal detachment can be done only when the retina is evaluated regularly.

3. In today’s fast paced ever changing world, all our work is computerised and all our leisure activities involve using our mobile phones watching videos or playing games. Even most of the classes for school going children are being done online.This increased use of gadgets in our life nowadays have led to lots of eye problems like ocular discomfort, muscular strain and eye strain. These leads to transient blurring of vision along with irritation and burning sensation in the eye.

4. Glaucoma: Early detection is important.

Of all serious eye diseases, glaucoma is probably the sneakiest. That's because there are no discernable symptoms in most cases of early glaucoma — nothing to alert you that something's going wrong.People who fail to have routine eye exams and develop glaucoma typically become aware of it only after they’ve sustained permanent vision loss from the disease. And by that time, controlling glaucoma to prevent additional vision loss can be very difficult. 

Without successful control with medical treatment and/or glaucoma surgery, the disease can lead to blindness.Early detection of high eye pressure and other risk factors for glaucoma is possible only with routine eye exams. Vision screenings do little to nothing to identify or prevent glaucoma.

5. Annual eye exams can detect other serious health problems such as diabetes, high blood pressure, high cholesterol and even cancer. Our eyes have been called "the window to our soul." It turns out, they also are often a very effective window to our overall health.

During a comprehensive eye exam, the eye doctor can observe and evaluate the health and condition of the blood vessels in your retina, which are a good predictor of the health of blood vessels throughout your body. Conditions such as diabetes, hypertension and hypercholesterolemia all are visible by changes in the appearance of the retinal blood supply and blood vessels.

Annual eye exams are especially important for anyone with diabetes or who might be at risk for the disease (due to obesity, family history or other reasons). 

6. Some studies have shown that uncorrected refractive errors impairs a driver's ability to operate a motor vehicle safely and was strongly associated with road traffic accident. Correction of such refractive errors will lead to a reduction in the number of RTA.

What will happen during the eye exam?

A routine eye check may be divided into two parts. The first part is carried out by an optometrist while the ophthalmologist does the second part. In some clinics or hospitals everything is done by the doctor. In either case, the final prescription is always supervised by the doctor.

•    Medical History: The doctor will talk to you about any concerns regarding your eye or general health, and also inquire about any past medical or surgical history. He or she will also ask you about family history of any disease and if you are currently on any medication.

•    Checking Visual Acuity: Your vision for near and distance will be checked. In case found deficient, you will be prescribed corrective glasses or contact lenses

•    Eye Pressure: Your eye pressure will be tested either with a non-contact tonometer or with a contact machine. The latter will involve the use of topical anaesthetic drops.

•    Slit Lamp Evaluation: Your eye will be examined on a machine called the slit lamp, which is a microscope with a built-in illumination. With this, the eye doctor can see a magnified image of all eye structures. 

•    Dilated Evaluation: A dilated evaluation involves instilling eye drops (which takes about an hour) to dilate your pupils so that the doctor can evaluate the retina and optic never in greater detail. A dilated evaluation makes your vision blurred for three to eight hours (depending on the dilating agent used). Also, you will feel an increased intolerance to light. If you have diabetes, have a high refractive error, or have an eye disease like retinal degeneration, AMD or glaucoma, chances are you will require a dilated eye evaluation.

•    Special Tests: In case your eye doctor suspects any disease process, he or she will schedule or order some specific tests which will help in diagnosis and management of that disease process, separate from the routine eye check-up.

The adage, a stitch in time saves nine, is especially true for a routine eye examination. If you are regular with your eye exams, you can be assured that your eye health is being regularly monitored, and any threats to your eye health and vision can be picked up and managed in time. 

The writer is MS (Ophthalmologist), Senior Consultant, Department of Opthalmology, CIHSR Dimapur.