Here’s Why Routine Eye Care is Crucial

Loss of sight is feared more than loss of hearing, memory, speech, a limb or contracting HIV/AIDS, according to a New York Times poll of adults. The good news, however, is that much of what is diagnosed as vision loss can be caught early and prevented with routine comprehensive eye care, says an MUSC Health optometrist.

We talked with James F. Hill III, OD, director of primary eye care and low vision services at MUSC Storm Eye Institute, about the importance of preventive eye care and how it can help preserve vision and eye health. Dr. Hill also explains the difference between an optometrist and an ophthalmologist and how they work together at the Institute.

At what age should someone begin regular eye exams?

The American Optometric Association and the American Ophthalmology Association recommend an eye exam in the first year of life. We check binocular vision to make sure the eyes are aligned and seeing correctly, and visual processing to make sure that the brain sees what the eyes see. We also check for retinoblastoma, a cancer that can be very deadly, and eye turn, which can lead to lazy eye, or amblyopia, caused when one eye is weaker than the other.

What exam schedule is recommended after infancy?

A second, comprehensive eye exam with dilation of pupils is recommended for children before they start school – usually age four or five. If eyes are healthy and vision is normal, children and adults should have a comprehensive eye exam every two years until age 65. Adults 66 and older should have an eye exam annually because eye diseases such as cataracts, glaucoma, macular degeneration and diabetic retinopathy tend to increase as we age. I emphasize, however, that this schedule is for healthy eyes. Someone who is diagnosed with ocular issues should be seen more frequently, and anyone experiencing pain, blurry vision or some other eye problem should seek treatment immediately.

What does a comprehensive eye exam involve?

During the eye exam we follow 27 to 30 steps to check the key elements of vision and ocular health to make sure that everything is in order or if there’s anything abnormal. A comprehensive eye exam begins with asking the patient about their health and family history, whether they’ve having any vision problems or have experienced any in the past and what medications they’re taking. We dilate the pupils with painless drops to examine the eye’s structure ─ the cornea, retina, macula, the natural lens and the optic nerve, and check for cataracts, diabetes, diabetic retinopathy and macular degeneration.

We measure:

• Acuity to assess how clearly the eye can see and to make sure the patient does not have a lazy eye, or amblyopia
• Eye pressure for risk for glaucoma
• Refraction to determine what corrective lens might be needed if the patient is farsighted, nearsighted or has astigmatism)

Why are exams important?

Regular eye exams are an essential part of our overall health. Good vision does not necessarily mean that the eye is healthy. Certain conditions and vision problems don’t have symptoms and are not caught until someone has an eye exam. Diabetes and impending stroke are two examples.

We can also detect genetic conditions and refer patients for additional testing. The younger a patient is when diagnosed with a genetic eye problem, such as retinitis pigmentosa, the better. Early diagnosis increases their options for care and the likelihood of a better outcome. The eyes are truly a gateway to our systemic health, and if we catch something early enough, we can prevent systemic disease and vision loss.

How does a comprehensive exam differ from a vision screening?

Unlike a vision screening that you might have when applying for or renewing a driver’s license, a comprehensive eye exam can be done only by a trained specialist with special equipment to examine the eye thoroughly. Most importantly, only a comprehensive eye exam can detect a serious eye condition or rule it out.

In addition to regular eye exams, what else can we do to protect our vision?

I recommend the following to protect your eyes:

• Wear protective eye wear and sunglasses when outdoors can help protect against harmful UV rays. Avoid first- and second-hand cigarette smoke. This protects the ocular surface and can help reduce the long-term risk of diseases such as macular degeneration.
• Apply warm compresses and massage your eyelids daily to help stimulate your meibomian glands, which are located along your eyelids, to help prevent dry eyes.
• Use soap and water to remove eye makeup.
• When using a screen for work, reading or games, follow the 20/20/20 rule. This means that for every 20 minutes you look at a screen, look away at an object 20 feet away for 20 seconds.

How does optometry differ from ophthalmology?

Optometrists provide primary care for the eye, much like a primary care physician does for patients’ general health. Optometrists can treat, manage diseases and prescribe medications for patients of all ages.

An optometrist must have a college degree, followed by four years of education and training in a school for optometry to earn a doctor of optometry degree. Residency and fellowship training in a specialty are optional. Optometry subspecialties include pediatrics, geriatrics, sports vision, low vision and contact lenses. When our patients require specialized care or surgery, we refer them to an ophthalmologist.

Ophthalmologists must have a four-year college degree, a medical degree and four to five years of surgery-based training. Subspecialties require additional training. Although many ophthalmologists also do primary eye care, at Storm Eye, optometrists provide primary care and ophthalmologists provide tertiary, or specialty care.

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For more information, visit MUSC Health’s Optometry Services. To make an appointment, call 843-792-2020.