Routine Eye Examinations Are Critical to Overall Wellness

by Lindy Keane Carter 

The importance of regular eye exams to good health cannot be overstated. A complete ophthalmic examination and evaluation can detect not only issues with ocular health, but also issues throughout the body. “An eye exam is truly the gateway to systemic health,” says James F. Hill, III, O.D., Associate Professor and Medical Director of Optical Services at the Medical University of South Carolina (MUSC) Storm Eye Institute. “There are numerous conditions we can identify through our evaluations.” 

The American Optometric Association (AOA) recommends that adults 18 to 64 years of age get a comprehensive eye exam every two years (if no underlying health concerns). People 65 and older should have an exam every year.¹ 

A thorough exam comprises evaluation of peripheral vision, depth perception, color vision, eye muscle movements, pupils’ reaction to light, visual acuity, refractive error, eye focusing, digital retinal image, eye pressure, slit-lamp anterior segment assessment, and ophthalmoscopy. 

Early detection of the leading causes of blindness and low vision in the United States -- age-related macular degeneration, cataract, diabetic retinopathy, and glaucoma² -- is critical so that therapies can begin. 

Eye exams can also reveal disease elsewhere in the body. The presence of Hollenhorst plaque in the retina, for example, indicates a high risk for stroke. This plaque originates at the carotid artery or the aorta and travels to the central retinal artery, so it can be a sign of carotid disease arising from atherosclerotic lesions. Most patients have no symptoms. In fact, approximately, 75% of Hollenhorst plaques seen in ophthalmic practice are asymptomatic.³

Other systemic health issues that can be detected in the eye include:

• High blood pressure,
• High cholesterol
• Heart disease and vascular disease
• Diabetes
• Rheumatoid arthritis
• Thyroid disorder
• Parkinson’s disease
• Cancer
• Multiple sclerosis
• Medication toxicities
• Sarcoidosis
• Sickle cell disease
• Sexually transmitted diseases 

Changes in eye health or vision can be red flags

“Sudden blurry vision is a tell-tale sign of possible systemic disease,” says Dr. Hill. Other symptoms that warrant further investigation include red or discolored eyes, eye strain, and lingering eye floaters. 

In children, headaches or eye strain can indicate several problems, but myopia (nearsightedness) is an increasingly common one. Myopia in children is on the rise. “Myopia is a true epidemic worldwide,” says Dr. Hill. “We think a lot of it has to do with excess screen time.” This puts patients at risk of sight-threatening eye conditions later in life. The clinical focus is now on controlling myopia’s progress. A three-year trial at MUSC studies the effectiveness of low-concentration atropine for myopia progression.⁴ In a separate analysis of data from clinical trials, pharmaceutical agents (eye drops) were shown to be effective in slowing myopia progress. Multifocal lenses, either spectacles or contact lenses, were shown to confer a small benefit.⁵ 

Another advancement in vision impairment prevention is the scleral contact lens. This lens was previously used for severely compromised eyes, but the indication range has expanded as clinicians have found that this lens protects the eye and improves quality of vision better than was previously thought. A scleral lens does not directly touch the cornea, allowing a saline bath to protect from ocular trauma and alleviate irregular corneas and astigmatism from diseases such as keratoconus. Because of the protective nature of the lens, it has also become a new treatment paradigm for severe ocular surface disease and dry eye syndrome. 

Routine eye exams are clearly an effective window into a person’s overall health. To make an appointment or refer a patient to the MUSC Storm Eye Institute and Eye Surgery Center, please call 843-792-2020. 

For more information, visit Eye Care at MUSC Health. 

References:

1 American Optometric Association. Comprehensive Eye Exams.
2 Centers for Disease Control and Prevention. Common Eye Disorders and Diseases.
3 National Library of Medicine. Hollenhorst Plaque.
4 Yam, JC, Zhang JX, Zhang Y, Wang YM, Tang SM, Li FF, Kam KW, KO ST, Yip BHK, Young AL, Tham CC, Chen LJ, Pang CP. Three-year clinical trial of low-concentration Atropine for myopia progression (LAMP) study: Continued versus Washout: Phase 3 Report. Ophthalmology. 2022 Mar;129(3):308-321. doi: 10.1016/j.optha.2021.10.002.Epub 2021 Oct 7.
5 Walline JJ, Lindsley KB, Vedula SS, Cotter SA, Mutti DO, Ng SM, Twelker JD. Interventions to slow progression of myopia in children. Cochran Database Syst Rev. 2020 Jan 13;1(1):CD004916. doi:10: 1002/14651858.CD004916.pub4.