You might be surprised at how many tests eye doctors use to diagnose glaucoma. A proper diagnosis requires careful evaluation of many aspects of your eye’s health – from eye pressure to cornea thickness to the health of your optic nerve. This article describes how your eye doctor assesses your risk and all the tests needed to properly diagnose glaucoma.
Your eye doctor will begin by assessing your risk level for developing glaucoma. This will help determine the frequency and extent of testing needed. Through a family history and medical questionnaire, the eye doctor is looking for the following risk factors:
Over the age of 60
Ethnic background such as African or black Caribbean descent, Hispanic, or Asian
Family history of glaucoma, such as a sibling or parent with glaucoma
History of eye conditions, injuries or surgeries
Prolonged corticosteroid use (eye drops, pills, inhalers or creams)
Chronic conditions that affect blood flow, such as migraines, diabetes, low blood
pressure or hypertension
Current or former smoker
If you’ve already had a comprehensive eye exam, your eye doctor will also consider these risk factors:
Eye pressure higher than normal (above 21 mm Hg)
Thin corneas (less than 0.5 millimeters) such as post LASIK patients
Your type of eyesight is also important. People with farsightedness are at a higher risk for narrow-angle glaucoma, a more serious type that can advance quickly. While nearsightedness is associated with open-angle glaucoma, which progresses slowly without any symptoms.
During a comprehensive eye exam, your eye doctor will always check for glaucoma, regardless of the risk level. This provides a baseline for comparison as you age. There are two tests: tonometry and ophthalmoscopy.
Macular degeneration, commonly referred to as age-related macular degeneration (AMD), is the single largest cause of sight loss in the developed world and affects more than 10 million Americans. It usually affects people over the age of 60, but has been known to affect those who are younger. It is a painless condition that usually affects both eyes with the loss being experienced in the central vision. It does not affect the peripheral vision, meaning that it does not cause total blindness.
The macula is the most sensitive part of the retina and is responsible for our central vision and what allows us to see fine details with clarity.
Wet AMD is one variety of the condition in which abnormal blood vessels grow into the macula, leaking blood or fluid which then causes scarring and a rapid loss of central vision. Wet AMD can develop suddenly and rapid referral to a specialist is essential as it can be treated if caught quickly.
Dry AMD is the most common variety of age-related macular degeneration and is a gradual deterioration of the retina as the cells die off over time and are not regenerated. Up to 15% of people with dry AMD go on to develop wet AMD, and so any sudden changes in your vision should be followed up with your optometrist as soon as possible.
Macular degeneration affects each person differently, which means that it can sometimes be difficult to diagnose, particularly as you may not notice any change in your vision early on in the condition. However, as the cells deteriorate, you will start to see an increasing range of symptoms, including:
Distortion or bends in what should be straight lines (such as lampposts or door frames)
Dark spots in your central vision
Difficulty adapting from dark to light environments
Objects may appear to change shape, size or color, or may move or disappear
Bright lights may be difficult to tolerate
Words may disappear while you are reading
Unfortunately, there is no clear reason as to what triggers the process that causes macular degeneration. However, you are at an increased risk if you have a family history of the condition, or if you are over 60.
Experts suggest that the best thing you can do to minimize any potential risk is to ensure that you live a healthy, active lifestyle. You can do this by:
Eating a healthy, balanced diet with plenty of fruit and vegetables
Moderating your alcohol consumption
Maintaining a healthy weight
Getting regular exercise
There is also some limited research that suggests that eating leafy, green vegetables can slow the deterioration of vision in cases of dry AMD.
Sadly, there is currently no cure for either variety of AMD. In the case of dry AMD, the treatments suggested are done so with the aim of aiding the patient to make the most of their remaining vision. This can include things such as using magnifying glasses to help with reading.
Wet AMD can be treated with anti-vascular endothelial growth factor medication. This should stop additional blood vessels from developing and stop your vision from deteriorating further.
Occasionally, laser therapy is suggested as a possible treatment for destroying abnormal blood cells, but this is only suitable for cases of wet AMD and usually only around 1 in 7 sufferers may be potential candidates for this procedure.
If you have any questions or concerns regarding macular degeneration, we highly recommend that you speak with your optometrist who will be happy to assist you.
If you’ve been diagnosed with cataracts, you may wonder if cataract surgery is right around the corner. Not to worry. There are many preventive steps you can take to slow the progression of cataracts and preserve your vision. That doesn’t mean you won’t eventually need surgery, but you can at least delay the need for quite a while.
The National Eye Institute recommends protecting your eyes from the sun's harmful ultraviolet (UV) and high-energy visible (HEV) rays by always wearing good quality sunglasses while outdoors. Look for sunglasses that block 100 percent of UV rays and absorb most HEV rays with large lenses or a close-fitting wraparound style. Remember that the peak hours for sun exposure are between 10 am and 3 pm or 11 am and 4 pm during daylight savings time and that the sun’s rays are strong enough to pass through clouds, so you need your sunglasses every day.
If you haven’t quit already, here’s another good reason to do it: over time, the damage from smoking or vaping can double or triple an individual's risk of developing cataracts. If you’ve been a smoker/vaper, your habit was probably a big contributor to the diagnosis. The good news is – by quitting smoking and vaping now, you can slow the progression of cataracts.
Studies have shown that certain vitamins and nutrients may reduce age-related decline in eye health, particularly antioxidants. If you’ve already been diagnosed with cataracts, adding foods rich in antioxidants to your diet will help slow the progression. This list isn’t exhaustive, but here are some examples to get you started: dark chocolate, blueberries, strawberries, pecans, carrots, sweet potatoes, artichokes, kale, red cabbage, beans, beets, spinach, apples, and plums.
Doctors also recommend eating more fish high in omega-3 fatty acids. This has been linked to a potentially reduced risk of cataracts or their progression. You may also consider taking a multivitamin that contains Vitamin C and E. Talk to your doctor or nutritionist about how you might adopt a healthy eating plan that’s designed to prevent cataracts.
Fortunately, making these healthy modifications to your diet can prevent many other lifestyle diseases such as diabetes. Studies have shown that a diet rich in processed carbohydrates can increase your risk of both developing cataracts and speeding up its progression. It’s important to develop a plan that works for you and supports your holistic health.
Take control of your cataract diagnosis by getting regular eye exams, communicating with your doctor, and putting these tips into practice. You’ll have better vision and prevent the need for cataract surgery in the near future.
You have almost certainly heard of diabetes, which is one of the most common chronic health conditions in the United States with an estimated 100 million adults currently living with diabetes or pre-diabetes. This metabolic disorder occurs when the body is no longer able to regulate its own blood sugar levels and requires intervention to keep them stable. Most people are aware that diabetes can have serious consequences for our health. However, you may be surprised to learn that it can also influence our vision. This is because patients who are diabetic can go on to develop a complication that is known as diabetic retinopathy. Without prompt treatment, diabetic retinopathy can cause permanent vision loss. It is for this reason that patients who suffer from diabetes are asked to attend regular diabetic-related eye exams.
For us to be able to see clearly, our eyes need to be healthy and functioning perfectly. The most important component of our eyes are the retina. Found at the very back of the eye, the retina is a patch of light-sensitive cells that have the job of converting the light that passes into the eye into messages that are passed up the optic nerve and into our brain. Our brain then receives them and tells us what we can see and how clearly we can see it.
The retina relies on a continuous supply of blood, which is delivered using a network of tiny blood vessels. Over time, having continuously high blood vessels can damage these blood vessels causing a leak of blood and other fluids onto the retina. If this happens, scarring may occur which could compromise the quality of your vision.
Technically, anyone who suffers from diabetes, whether it be Type 1 or Type 2, could be at risk of developing diabetic retinopathy. However, the condition is more likely in certain situations. These include if:
Regular diabetic-related eye exams will enable your eye doctor to monitor your condition and ensure that any signs of diabetic retinopathy are detected and acted upon immediately.
The process of a diabetic eye exam is very simple and straightforward. In fact, in most instances, it is included within the other elements of comprehensive eye exam and you may not even realize that you have had a specific test to check for diabetes-related complications.
Diabetic eye screening is non-invasive. The doctor will dilate your eyes and take a picture of the back of your eye to better assess the blood vessels and to evaluate all the layers of your retina. These pictures are kept on file for future comparisons and baseline testing. As they say, a picture is worth a thousand words.
In addition to the images of the back of your eye being taken, you will also be given a visual acuity test. This is where you will be asked to read letters off a chart a short distance away, as well as reading from a card held in front of you.
The information that your eye doctor will obtain from your examination will be able to tell them if you are experiencing any of the signs of diabetic retinopathy. If so, they will discuss the best way to get your condition under control. This could involve a combination of elements, including controlling your diabetes more effectively, taking medications or more invasive treatment to preserve your vision. Your eye doctor will give you more specific information based on your individual circumstances.
If you have further questions about diabetic-related eye exams, please contact our knowledgeable eye care team.