What your optometrist needs to know about your health

The next time you go to your eye care provider, don’t be surprised if you come home with more than a prescription for new glasses or contacts. Optometrists and ophthalmologists can find a whole range of health conditions. That includes some that could threaten your vision and even your overall health.

“Every day, eye doctors examine asymptomatic patients who come in for comprehensive eye exams. And they end up diagnosing serious eye and health issues,” says Tiffany Gates, O.D., of Visionary Eye Care in Bloomfield, Colorado. “I’ve personally found ocular melanoma a handful of times in patients who are coming in with no complaints.”

While ocular melanoma is rare — there are about 7,000 new cases worldwide each year¹ — other eye-related health conditions are not. That’s why it’s important to get an annual comprehensive eye exam, and to be thorough when your eye care provider asks about your health history.

Before we look at specific conditions, it helps to know a couple of things — the first is the difference between a vision screening and a comprehensive eye exam. A vision screening checks your vision and whether you have good or bad visual acuity. A comprehensive eye exam goes much further — it looks at every aspect of your eye health (and, yes, it includes your vision screening).

“There can be situations where a person’s vision is measuring 20/20, but they have a health problem in the eye that would not be detected unless a full comprehensive eye exam was done,” Gates says.

The other thing to know is the difference between an optometrist and an ophthalmologist. An optometrist holds a doctor of optometry degree. An ophthalmologist holds a medical degree and specializes in eye pathology. Both can diagnose and treat a range of eye-related conditions — and both know when to connect you with other health care professionals.

Diabetes is a chronic condition that affects your body’s ability to turn food into energy. As a result, you end up with too much sugar in your bloodstream. That puts you at risk of heart disease, kidney disease and vision loss. About 10% of Americans have diabetes, and 1 in 5 don’t even know it.^2,3

During a comprehensive eye exam, your eye care provider will look for damage to the blood vessels in your retina (the back part of the eye). In most cases, your pupils will be dilated (widened) by eye drops, although digital retinal scans are also available. If your eye care provider already knows that you have diabetes, dilation is the standard of care.⁴

More than half of people with diabetes go on to develop diabetic retinopathy. That’s when the retinal blood vessels start leaking, causing spots or streaks to appear in their vision. Treatments are available, but it’s also important to manage your diabetes.⁵

Diabetes and high blood pressure can damage the blood vessels in your retina. High blood pressure affects nearly half of U.S. adults. Hypertensive retinopathy, which can also damage the nerves in your eyes, cause headaches, double vision and blurred vision. You typically won’t notice any symptoms until you’ve had it for a long time. That’s why regular eye exams are so important.^6,7

“Early detection is key to preventing permanent vision loss,” says Gates.

Of course, high blood pressure is linked to many other health conditions. Those include heart attack, stroke, kidney disease and even dementia. So, when you get it under control, your whole body will be better off.⁸

Glaucoma damages the optic nerve at the back of your eye, which can lead to vision loss or blindness. Since it affects peripheral (side) vision first, many people don’t even realize they have it until it has already caused damage. In fact, it’s often called a silent thief of sight.⁹

Glaucoma is the result of elevated pressure inside the eye. As part of a comprehensive eye exam, your eye care provider will check your eye pressure.

But your eye care provider will also want to know about your family history. If other family members have had glaucoma, you’re at a higher risk of developing the disease. You’re also at a higher risk if you’re African American, over age 60, or severely nearsighted.¹⁰

“If we hear someone has a family history of glaucoma, we’re going to be extra careful about checking their eye pressure and looking at the optic nerve,” says Gates.

Another condition in which family history can be a factor is macular degeneration. Up to 20% of people with age-related macular degeneration have a parent or sibling with the condition.¹¹

A leading cause of blindness in older adults, macular degeneration mostly affects the central vision. It occurs because of damage to the light-sensing cells that make up the macula (the center of the retina). Treatment is available, but you need to start it early and address other risk factors.¹²

“Many eye conditions are hereditary,” says Gates. “But there are other modifiable risk factors — not smoking, UV protection, controlling systemic diseases — which we can better advise on if we know your genetic risk.”

These aren’t the only conditions where eye health and overall health intersect. If you have an autoimmune disease, for example, it can cause eye inflammation such as uveitis or iritis. This is something one of Gates’s patients with juvenile arthritis experienced. “We worked with her rheumatologist to get her on systemic medications to control the arthritis,” she says.

That’s the sort of thing your eye care provider does all the time. After all, they’re an important member of your health care team.