Don’t wait until you see a problem to get an eye exam

A new survey reveals more than one-third of Canadians say they’d only book an eye exam if they feel there’s something wrong with their vision, but experts say it’s best not to wait that long.

By the time an eye condition becomes noticeable, there might already be significant damage or vision loss, which isn’t always reversible.

“That is often too late because a lot of ocular conditions can actually have no symptoms, so we wouldn’t know what’s happening,” says optometrist Dr. Natalia Nowakowska.

The survey conducted by Leger for Specsavers and the Canadian Council of the Blind, says 38 per cent of Canadian adults are overdue for their regular eye exam.

“Seventy-five per cent of vision loss is actually preventable and treatable,” says Nowakowska, explaining why regular checks are necessary.

“As an example with glaucoma — it starts in the periphery and it’s a tunneling of the peripheral vision. You wouldn’t notice that there’s actually any change until it starts to impact the central vision — and the vision that is already lost, we can’t get that back. So it’s very important for patients to come in and have their eyes checked to catch these things as early as possible.”

In many provinces, eye exams are covered by provincial health insurance for those under 19 or over 65 and for those with specific medical conditions.

Nowakowska advises that those who have private or workplace benefits with vision coverage should be sure to use them because comprehensive eye exams can reveal a lot about both the state of the eyes and overall health.

“Even if you don’t [have benefits] it’s so important to come in and have a screening,” she says.

Conditions like macular degeneration, diabetic retinopathy, inflammatory conditions and retinal tears can be caught early during an eye exam, but insights into other health conditions can also be revealed.

“In terms of systemic health — looking at the back of the eye [we could see signs of] high blood pressure, signs of higher cholesterol, early signs of diabetes,” says Nowakowska.

To get a clear look at the back of the eye, doctors use an Optical Coherence Tomography (OCT) scan.

“It’s a 3D scan of the back of the eye … so it takes a photo of the back of the eye, it also screens the retina layer by layer … and actually goes between the layers of the macula and the retina to find conditions as early as possibly detectable,” she explains.

High blood pressure for example can be detected by changes in the blood vessels in the retina.

“We could see slight waviness of the blood vessels. So blood vessel tortuosity – indicates that there’s a little bit of stress on the blood vessels in the back of the eye from fluctuating blood pressure. We could also see hemorrhaging, so we could see leakage of the blood vessels in the back of the eye,” says Nowakowska.

Eye exams also include a vision test — which primarily checks how well you can see. Nowakowska says it’s important to note the difference between such a test and a full eye exam.

“It’s not just checking whether or not we need glasses. It’s so important to understand that an eye exam is so much more than just updating your prescription. It’s actually updating a full picture of what the general health is,” she says.

What to expect at an eye exam

When going for an eye exam, you can expect to be asked questions about your health history, including the last time you saw the doctor, any pre-existing conditions or genetic predispositions.

A full refraction test is conducted using a machine called an autorefractor. It provides refractive error measurements which help determine whether prescription glasses are needed or if your prescription has changed.

Another machine called a tonometer may be used to take corneal measurements and pressure readings. Eye pressure is particularly important when determining the risk of glaucoma.

A basic vision test is also conducted which requires you to cover each eye one at a time and read a chart a few feet away as well as a card up close — to test for distance as well as reading.

Thereafter a Dilated Fundus Exam (DFE) is carried out, which involves putting drops in the eye that dilates the pupil to have a thorough look inside the eye.

A device called a slit lamp is then used to shine a focused beam of light into the eye which allows the doctor to get a good look at the structure of the eye including the iris, cornea and retina.

“With dilation we can have a look at the far periphery. We’re screening for things like retinal tears, retinal detachment, any tumors, etc.,” says Nowakowska.

If the facility you go to offers OCT scans, it may also be conducted to take a photo of the back of the eye which can be helpful in early detection of possible eye conditions.

Thereafter the optometrist will brief you on any findings and next steps.

It’s usually suggested to get a full eye exam every one to two years, based on the findings and your overall health.