Medical Eye Exams

Glaucoma

You might be surprised at how many tests eye doctors use to diagnose glaucoma. A proper diagnosis requires careful evaluation of many aspects of your eye’s health – from eye pressure to cornea thickness to the health of your optic nerve. This article describes how your eye doctor assesses your risk and all the tests needed to properly diagnose glaucoma.

Risk Factor Assessment

Your eye doctor will begin by assessing your risk level for developing glaucoma. This will help determine the frequency and extent of testing needed. Through a family history and medical questionnaire, the eye doctor is looking for the following risk factors:

• Over the age of 60

• Ethnic background such as African or black Caribbean descent, Hispanic, or Asian

• Family history of glaucoma, such as a sibling or parent with glaucoma

• History of eye conditions, injuries or surgeries

• Prolonged corticosteroid use (eye drops, pills, inhalers or creams)

• Chronic conditions that affect blood flow, such as migraines, diabetes, low blood
  pressure or hypertension

• Current or former smoker
  
  

If you’ve already had a comprehensive eye exam, your eye doctor will also consider these risk factors:

• Eye pressure higher than normal (above 21 mm Hg)

• Thin corneas (less than 0.5 millimeters) such as post LASIK patients
  
  

Your type of eyesight is also important. People with farsightedness are at a higher risk for narrow-angle glaucoma, a more serious type that can advance quickly. While nearsightedness is associated with open-angle glaucoma, which progresses slowly without any symptoms.

Standard Glaucoma Tests

During a comprehensive eye exam, your eye doctor will always check for glaucoma, regardless of the risk level. This provides a baseline for comparison as you age. There are two tests: tonometry and ophthalmoscopy.

Macular Degeneration

Macular degeneration, commonly referred to as age-related macular degeneration (AMD), is the single largest cause of sight loss in the developed world and affects more than 10 million Americans. It usually affects people over the age of 60, but has been known to affect those who are younger. It is a painless condition that usually affects both eyes with the loss being experienced in the central vision. It does not affect the peripheral vision, meaning that it does not cause total blindness.

What is the macula?

The macula is the most sensitive part of the retina and is responsible for our central vision and what allows us to see fine details with clarity.

Varieties of AMD

Wet AMD

Wet AMD is one variety of the condition in which abnormal blood vessels grow into the macula, leaking blood or fluid which then causes scarring and a rapid loss of central vision. Wet AMD can develop suddenly and rapid referral to a specialist is essential as it can be treated if caught quickly.

Dry AMD

Dry AMD is the most common variety of age-related macular degeneration and is a gradual deterioration of the retina as the cells die off over time and are not regenerated. Up to 15% of people with dry AMD go on to develop wet AMD, and so any sudden changes in your vision should be followed up with your optometrist as soon as possible.

Symptoms of macular degeneration

Macular degeneration affects each person differently, which means that it can sometimes be difficult to diagnose, particularly as you may not notice any change in your vision early on in the condition. However, as the cells deteriorate, you will start to see an increasing range of symptoms, including:

• Distortion or bends in what should be straight lines (such as lampposts or door frames)

• Dark spots in your central vision

• Fading colors

• Difficulty adapting from dark to light environments

• Blurred vision

• Objects may appear to change shape, size or color, or may move or disappear

• Bright lights may be difficult to tolerate

• Words may disappear while you are reading

Is there any way I can reduce my risk of developing AMD?

Unfortunately, there is no clear reason as to what triggers the process that causes macular degeneration. However, you are at an increased risk if you have a family history of the condition, or if you are over 60.

Experts suggest that the best thing you can do to minimize any potential risk is to ensure that you live a healthy, active lifestyle. You can do this by:

• Stopping smoking

• Eating a healthy, balanced diet with plenty of fruit and vegetables

• Moderating your alcohol consumption

• Maintaining a healthy weight

• Getting regular exercise
  
  

There is also some limited research that suggests that eating leafy, green vegetables can slow the deterioration of vision in cases of dry AMD.

Treatment for AMD

Sadly, there is currently no cure for either variety of AMD. In the case of dry AMD, the treatments suggested are done so with the aim of aiding the patient to make the most of their remaining vision. This can include things such as using magnifying glasses to help with reading.
Wet AMD can be treated with anti-vascular endothelial growth factor medication. This should stop additional blood vessels from developing and stop your vision from deteriorating further.

Occasionally, laser therapy is suggested as a possible treatment for destroying abnormal blood cells, but this is only suitable for cases of wet AMD and usually only around 1 in 7 sufferers may be potential candidates for this procedure.

If you have any questions or concerns regarding macular degeneration, we highly recommend that you speak with your optometrist who will be happy to assist you.

Cataracts

If you’ve been diagnosed with cataracts, you may wonder if cataract surgery is right around the corner. Not to worry. There are many preventive steps you can take to slow the progression of cataracts and preserve your vision. That doesn’t mean you won’t eventually need surgery, but you can at least delay the need for quite a while.

Protect Your Eyes From The Sun

The National Eye Institute recommends protecting your eyes from the sun's harmful ultraviolet (UV) and high-energy visible (HEV) rays by always wearing good quality sunglasses while outdoors. Look for sunglasses that block 100 percent of UV rays and absorb most HEV rays with large lenses or a close-fitting wraparound style. Remember that the peak hours for sun exposure are between 10 am and 3 pm or 11 am and 4 pm during daylight savings time and that the sun’s rays are strong enough to pass through clouds, so you need your sunglasses every day.

Quit Smoking/Vaping

If you haven’t quit already, here’s another good reason to do it: over time, the damage from smoking or vaping can double or triple an individual's risk of developing cataracts. If you’ve been a smoker/vaper, your habit was probably a big contributor to the diagnosis. The good news is – by quitting smoking and vaping now, you can slow the progression of cataracts.

Follow Eye Health Diet Guidelines

Studies have shown that certain vitamins and nutrients may reduce age-related decline in eye health, particularly antioxidants. If you’ve already been diagnosed with cataracts, adding foods rich in antioxidants to your diet will help slow the progression. This list isn’t exhaustive, but here are some examples to get you started: dark chocolate, blueberries, strawberries, pecans, carrots, sweet potatoes, artichokes, kale, red cabbage, beans, beets, spinach, apples, and plums.

Doctors also recommend eating more fish high in omega-3 fatty acids. This has been linked to a potentially reduced risk of cataracts or their progression. You may also consider taking a multivitamin that contains Vitamin C and E. Talk to your doctor or nutritionist about how you might adopt a healthy eating plan that’s designed to prevent cataracts.

Fortunately, making these healthy modifications to your diet can prevent many other lifestyle diseases such as diabetes. Studies have shown that a diet rich in processed carbohydrates can increase your risk of both developing cataracts and speeding up its progression. It’s important to develop a plan that works for you and supports your holistic health.

Take control of your cataract diagnosis by getting regular eye exams, communicating with your doctor, and putting these tips into practice. You’ll have better vision and prevent the need for cataract surgery in the near future.