Medical Eye Services and Exams for Seniors

Judith Johnstone (not her real name) was nagged by her family to her doctor for medical eye services for years until finally she did so. She had not seen an ophthalmologist or an optometrist in over 30 years, and she insisted her vision was just fine.

When the doctor finally took a look at her eyes a few days before her seventieth birthday, however, Judith was in for an unpleasant shock.

Judith's vision had been 20/20, but over the years without medical eye services it had deteriorated to 20/100. The doctor found twists and turns in the vessels in her retina that indicated that she had uncontrolled diabetes. And Judith had been losing her peripheral vision so slowly that she had no idea that she had glaucoma.

Fortunately, Judith's sight could be saved and her diabetes was brought under control. Ten years later she still has her vision, and she is happy, healthy, and grateful she allowed her family to persuade her to see the doctor. But Judith's story is hardly unique.

There are five critically important medical eye services that everyone over the age of 60 should have done at least once a year:

  • Eye pressure
  • Dilated retinal examination
  • Peripheral (side) vision
  • Slit lamp
  • Refraction
  • Eye pressure is the way the doctor tests for glaucoma, a condition of excessive pressure inside the eyeball. Glaucoma can cause some mild pain or blurred vision, but for many seniors it produces no symptoms at all as it insidiously robs sight. Fortunately, all but the most advanced cases of glaucoma can be treated if the disease is detected.

    Dilating the eyes so the ophthalmologist gets a clear view of the blood vessels in the retina is a key method of detecting diabetic retinopathy. Twisted, contorted blood vessels can eventually tear and break, leaving tiny blind spots behind them.

    Detecting damage to the retina in time is essential so the doctor will know that there is a problem with high blood sugars or high blood pressure that needs to be corrected, and so that new tears in the retina do not occur.

    The dilated retinal eye exam can also detect:

  • Changes in the optic nerve caused by glaucoma
  • Cloudiness in the lens indicating the formation of cataracts
  • Changes in the part of the lens involved in focusing that giving early warning of macular degeneration and
  • Damage to the blood vessels that indicate diabetes or high blood pressure, but that may also indicate damage to blood vessels elsewhere in the body.
  • The peripheral or side vision test shows the presence or progression of glaucoma. In seniors, it is also useful for detecting aneurysms, stroke, and brain tumors while they are still treatable.

    A slit lamp examination allows the detection of lumps and bumps on the white of the eyes (sclera) and cornea known as pingueculae and pterygia, dry eyes, eyelid disease, and precancerous changes.

    The refraction test is the familiar process of trying different lenses to see which lenses give the clearest vision. This seems very straightforward, and for purposes of prescribing lenses, it is.

    The refraction test, however, can give early warning signs of nearsightedness (unusual swings into nearsightedness) and thyroid disease (double vision) as well as the signs of nutrient depletion by prescription drugs (such as double vision caused by vitamin B depletion after treatment with the common diuretic drug Lasix).

    Regular medical eye services save eyesight, and they can lead to early diagnosis of other conditions that can save your life. Regular eye exams are an essential ingredient in good health care for anyone over 60.


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