Eye exams could prevent health problems down the road

WASHINGTON — The eyes are windows to the soul, but they can say a lot about your health.

This month, dubbed Healthy Vision Month, there’s a push to make sure patrons get the eye exams they need.

Basic vision checks at a pediatrician can pick up early signs of trouble that can be referred to a specialist. However, once you leave your teen years, it’s usually time for that first comprehensive exam.

“The recommendation really is to have a full dilated eye exam by the time you are 20,” said Dr. Holly Gross, an ophthalmologist in Rockville and Frederick, Maryland.

It may seem counterintuitive if your vision is fine, but Gross said many of the most serious eye diseases don’t have symptoms in the initial stages, and early intervention can prevent a big problem later on.

The big three are glaucoma, macular degeneration, and diabetic retinopathy, she said.

Macular degeneration, which affects the central portion of the retina, has a relatively late onset and usually isn’t detected until after the age of 60.

Indications of glaucoma can be seen decades earlier, and diabetic retinopathy is the leading cause of blindness among working-age adults.

If an initial screening at 20 is clean, usually that means a patient can wait until 40 for a second dilated exam. Exceptions are made for those with extra risk factors for eye disease — such as family history, ethnicity and certain vision issues.

Gross said glaucoma is more common in black people, so their screening needs to start earlier. People with a family history of glaucoma or macular degeneration also need early screening, as does anyone who is highly nearsighted. People who are obese or borderline diabetic should be more vigilant about getting tested for diabetic retinopathy.

“All of these things can be treated and vision loss prevented if it is caught early and intervention is done in a timely manner,” Gross said.

After 40, those screenings become more frequent; even those with healthy eyes should have a full dilated exam every few years. After 65, you need them annually.

And keep in mind that these exams are about far more than protecting your vision. The eye is the only place on the body where nerves and blood vessels can be seen directly.

“Looking into the eyes is a very good clue as to what is going on in the nervous system and the cardiovascular system,” Gross said.

She said an eye exam can pick up early signs of diabetes, as well as indications of blood-borne diseases like anemia and, sometimes, even leukemia.

For patients with autoimmune disorders, like arthritis, it is possible to track the progress of the disease through comprehensive eye exams.

“Multiple sclerosis is a classic example of that,” said Gross, adding sometimes a loss of vision with some eye pain and color deficiencies seen by an ophthalmologist is the first step in diagnosing MS.

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