Seventy-eight-year-old retired mortgage broker Robert Waters walked into his ophthalmologist's office in Nashville, Tenn. for a routine annual eye exam, and walked out with something he wasn’t expecting—an urgent follow-up with his cardiologist. "I saw a microscopic clot in the blood vessels of his retina," said Rebecca Taylor, M.D., of Nashville Vision Associates. The follow-up revealed a much bigger mass residing in his carotid artery, putting him at high risk for a stroke.
An Eye Exam May Be Life-Saving
A potential stroke is just one of the health conditions that might be visible in the eyes, which are not only the windows to our soul, but also to our body's overall health. Diabetes, high blood pressure, autoimmune diseases, sexually transmitted diseases and cancers are among the illnesses that can be detected during an eye exam. "People may not know they have these problems," Dr. Taylor said. "In some cases, an eye exam may be life-saving."
That's because the eye is the only place in the body where a doctor can have an unobstructed view of our blood vessels, nerves and connecting tissue — without any need for surgery. Because the eye has the same microscopic tissue as our other major organs, and is an important part of our larger nervous system, abnormalities spotted in the eye may signal the same changes in other parts of the body.
"There is an intricate communication between the eye and the rest of the body through the blood, blood vessels and nerve connections. The eyes can reflect illness that begins in another tissue far away from the eyes themselves," Dr. Taylor said.
For example, ophthalmologists often detect diabetes during the dilated portion of the eye exam by observing changes or damage in the blood vessels of the retina, known as diabetic retinopathy. In these cases, the disease may show up in the eye tissue even before it does in a blood sugar test. Thanks to early detection during eye exams, people diagnosed in this beginning stage of diabetes potentially can avoid vision loss and other serious complications.
Loss of side vision, which can be a symptom of glaucoma, also can indicate serious health issues that go beyond vision. It can map back to a problem in certain regions of the brain, indicating a stroke, head trauma, tumor, or brain bleed.
Eye Exams: How Often and What to Expect?
The American Academy of Ophthalmology recommends all adults get a baseline eye exam from an ophthalmologist — a medical doctor who specializes in the diagnosis of eye diseases and conditions and the medical and surgical treatment of those conditions — by age 40, when early signs of disease and vision changes may start to occur. If you have an eye disease or a risk factor for developing one, such as diabetes, high blood pressure or a family history of eye disease, you should see an ophthalmologist even if you are younger than 40.
Adults age 65 and over should have a comprehensive eye exam every one to two years, or as recommended by your ophthalmologist. Seniors concerned about the cost of eye exams may be eligible to receive an eye exam at no out-of-pocket cost from the Academy's EyeCare America program. Learn more about EyeCare America and whether you or a loved one qualify. Some seniors may need more frequent eye exams if they have a disease or condition that may impact their eyes.
An eye exam is a relatively simple and comfortable procedure, and shouldn't take more than 45 to 90 minutes. Your eye doctor will check:
- Your medical history
- Your visual acuity
- Your pupils
- Your side vision
- Your eye movement
- Your prescription for corrective lenses
- Your eye pressure
- The front part of your eye
- Your retina and optic nerve
Learn more about what happens during an eye exam.
When ophthalmologists spot something unusual during your exam, they may refer you back to your primary care physician or to a specialist for further examination and testing.
Dr. Taylor sent Robert Waters to his cardiologist, who performed an ultrasound that uncovered a 90 percent blockage in his right carotid artery. If left untreated, this obstruction could have prevented blood flow to his brain and been life-threatening.
Within weeks Mr. Waters had surgery to widen his narrowed artery for better blood flow. He went back to his normal routine and had some advice to share: "I was not aware that you could spot that type of thing in my eye, and I don't think most people are. Get your eye exam. Do it not only for your eyes, but for what it could tell about the rest of your body."