What Can A General Eye Exam Tell Us?

We all know we should see an eye doctor at least once a year, especially after childhood. We know we’ll find out whether our vision has stayed the same or deteriorated, and we’ll get advice about how to deal with any changes. But you may not realize this same general eye exam can tip us off to undiagnosed conditions ranging from high blood pressure to diabetes.

General eye exams

What You Might Expect: Evaluating Common Eye Issues and Disease

A doctor begins by assessing common eye issues, such as increasing nearsightedness or the need for reading glasses. Cataracts affect virtually every patient by late middle age. A doctor will consider whether cataract surgery can help at that time.

A check of pressure in both eyes plus questions about family history reveal whether glaucoma may be an issue. The doctor will also check your field of vision to see if macular degeneration could be a problem. Only a fraction of the population will suffer from those conditions or from tumors of the eye. These issues can also be observed during an ordinary examination.

If you take oral steroids, inhaled steroids or steroids by injection, you’re a candidate for glaucoma and a kind of cataract called the posterior subcapsular. An eye doctor can catch those in their early stages in a general eye exam, which is crucial: Vision loss from steroid-induced glaucoma usually goes unnoticed until it’s advanced.

Drugs other than steroids also cause side effects in the eye. These may be severe enough to make you stop taking the medication. Hydroxychloroquine (also known as Plaquenil) can cause vision loss. A person on a high dose or using the medication for more than five years must be tested by an eye doctor to lower the chance of irreversible vision problems. Amiodarone, prescribed for heart rhythm problems, can also affect your eyes but rarely causes vision loss.

What You Might Not Expect: Diseases Originating Outside the Eye

Remarkably, a standard eye exam also provides a small encyclopedia of information about conditions elsewhere in the body. People with new onset diabetes (more commonly Type 1) may experience a sudden nearsighted shift in vision. This condition is caused by swelling of the lens when blood sugar runs high. (Weight loss and increasing thirst may be other symptoms.) Poorly controlled diabetes of any type can lead to retinopathy; without treatment, that can cause blindness from retinal swelling, retinal detachment and glaucoma.

Damaged blood vessels at the back of the eye suggest longstanding high blood pressure. This increases the risk of blood vessels closing in artery or vein occlusions, especially if a patient has atherosclerosis (hardening of the arteries). Cholesterol plaque from neck arteries and calcium from heart valves can get dislodged. Sometimes these end up in the arteries at the back of the eye, causing sudden but painless loss of vision.

Eye doctors don’t ordinarily find evidence of blood disorders, such as leukemia and lymphoma. Yet clotting disorders or high-viscosity disorders can cause blockages or hemorrhages at the back of the eye. An exam may detect those or metastatic cancers that have spread from more distant sites but appear in the eye; those most commonly turn up in the layer under the retina but can be seen in areas around the eye (known as the orbit) and eyelids.

That’s why Horizon doctors don’t think of a “routine” eye examination as “routine.” The eye may not be a window into the soul, as poets claim, but it’s definitely a window into our general state of health.

Schedule Your Eye Exam Today

To schedule a general eye exam at Horizon Eye Care, use our Patient Portal or call 704-365-0555 Monday – Thursday, 8:00 a.m. to 5:00 p.m. and Friday 8:00 a.m. to 3:00 p.m.