David Watson has worn glasses to correct nearsightedness the majority of his life, and had his vision checked regularly to make sure his prescription was up to date. But when his wife convinced him to have a comprehensive dilated eye exam, he got a surprise. His doctor told him something didn't look right with his retina, the light sensitive tissue at the back of his eye. His retina was torn, and he had not had any symptoms.
After a successful treatment, Watson felt lucky that the tear was caught right away. "Like everyone else, I just thought I would go have my eyes checked and get an updated prescription," he said. "But the dilated eye exam made a big difference for me—without it, I could have lost my vision."
Comprehensive dilated eye exam
May is Healthy Vision Month and a good time to think about getting a comprehensive dilated eye exam—the best way to find out for sure if eyes are healthy. There are several key parts of the exam, for example dilation, which enables the eye care professional to view the inside of the eye. Drops are placed in each eye to dilate (widen) the pupil, which is the opening in the center of the iris, the colored part of the eye. Once dilated, each eye is examined using a special magnifying lens that provides a clear view of important tissues at the back of the eye, including the retina and the optic nerve, which connects the retina to the brain.
Other parts of the comprehensive dilated eye exam include tests for glaucoma, a group of diseases that can damage the optic nerve; measures of side (peripheral) vision; and a visual acuity test, which typically involves reading an eye chart to determine how well a person can see at a distance.
"The exam was pretty quick," said Watson. "My ophthalmologist did more than just screen me for glasses, she examined my eyes for signs of eye disease, and that's when she found the tear."
Experts recommend getting annual comprehensive dilated eye exams starting at age 60. "However, it's advisable for everyone to have a dilated eye exam at least once in their 20's and 30's, and certainly by the time they hit the milestone of 40," said Rachel J. Bishop, M.D., M.P.H., chief of the Consult Services Section at the National Eye Institute (NEI). She noted that after 40, the risk of eye conditions such as glaucoma become more significant, and that the risk of glaucoma is higher in African Americans. "It's also especially important for people with diabetes, who are at risk for diabetic eye disease, to have a comprehensive dilated exam at least once a year."
A torn retina
Watson's torn retina, a kind of retinal detachment, was found very early. One symptom of retinal detachment is an increase in floaters. "These can look like little cobwebs or specks that float around in your field of vision," explained Bishop. She added that floaters can be part of the normal aging process among people over 40. "But if you notice an increase in floaters, and flashes of light, that may be cause for concern." Ultimately, a curtain may appear over the field of vision. A retinal detachment is a medical emergency and anyone experiencing the symptoms should see an eye care professional immediately.
Watson never had any of these symptoms. But he was at risk because he is severely nearsighted. "What they explained to me is that when you're nearsighted, your eye is more oval shaped as opposed to round. That oval shape of your eye stretches the retina and that is what causes the tear."
Treatments for small holes and tears in the retina are usually performed in the doctor's office. Watson opted for a laser procedure that makes tiny burns around the tear to "weld" the retina back into place.
"It went well, it was actually rather quick and painless," reported Watson, who is scheduled for his next dilated eye exam this month.
Healthy Vision Month
During Healthy Vision Month, NEI encourages all Americans—especially those at risk for eye diseases—to talk to their eye care providers about having a comprehensive dilated eye exam. Four other ways to protect sight are to live a healthy lifestyle, know your family's eye health history, use protective eyewear during sports and other recreational activities, and wear sunglasses.
"These important steps can help you keep your eyes healthy and prevent vision loss from eye disease," explained Bishop.
Watson is definitely onboard with Healthy Vision Month: "I told my whole family to take the time to take care of their eyes and of course that includes having a dilated eye exam."
NIH, National Eye Institute (NEI)