Do I Really Need an Eye Test?

If you have eyes – and if you’re reading this post right now I’ll bet you have at least one – then the answer is yes!

I know people who are so resistant to having regular optometry exams because they say “I can see things in the distance that my wife can’t”, “my vision has always been 20/20”, “I don’t have any problems with my eyes” etc. Firstly, benchmarking your vision against someone else who potentially has visual problems themselves is not particularly accurate nor a prudent decisive factor in whether you need an eye test or not. Secondly, in Australia we don’t say 20/20, we say 6/6. Are we in America right now? No. And thirdly, no problems with your eyes? I’ll be the judge of that, mister.

The point is that your eyes are about more than whether you can see the tiny numbers in the crossword grid or the street signs in the distance. Your eyes are the only part of the body where we can see blood vessels in vivo without slicing you open. They can show me signs of elevated cholesterol (Hollenhorst plaques), hypertension (blood vessel changes and retinal haemorrhaging), diabetes (retinal haemorrhaging), toxicity to your arthritis medications (maculopathy), liver disease (green ring in the cornea), bacterial endocarditis (retinal haemorrhage with Roth spot), breast cancer metastasis, and maybe even whether you’ve been constipated lately (not that I really want to know that one). Don’t forget your eyeballs are attached to the rest of your body.

It is also important to keep in mind that even though you may not feel like anything is wrong, something could still be wrong. Or about to go wrong.

rettear
This patient has a peripheral retinal tear with impending risk of a blinding retinal detachment. The tear is painless and it is currently still possible to have 6/6 visual acuity.

In other cases I have patients who attend for their first ever eye test in their 50s and have been happily living their lives til that point when I have to tell them “uhh… with this vision you’re actually not legally allowed to drive”. They have no idea because there is no real way of comparing whether their vision is “normal” without having had an eye test.

 

papilloedema
This patient had been seeing the chiropractor for headaches for a month until his GP suggested he have an eye test. The big fluffy white patch is a swollen optic nerve secondary to a brain tumour and intracranial hypertension. He was airlifted to hospital for emergency surgery that same day.

By now I hope you get my point but in case you haven’t, glaucoma is another silent blinding disease; in most cases by the time you’ve realised something is weird with your peripheral vision there is already a significant amount of irreversible nerve damage that could have most likely been prevented with eye drops. Wouldn’t that suck, realising your visual loss could have been halted if only you heeded that pesky recall letter from your last optometrist.

In conclusion, keep up with your regular eye exams! For healthy patients with no risk factors or known visual/ocular problems I would recommend every 2-3 years, or on the advice of your local optometrist. You don’t realise how much you use them eyeballs until they’re gone.

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