When was your last eye exam? Think back a bit, and not just to the last time you fitted a pair of glasses. Specifically, think back to if and when you last had a dilated eye exam. We’re guessing that a lot of you are still thinking.
Dilated eye exams take more time and money, and there’s no denying that they’re a little unpleasant for patients, but they’re also absolutely key in catching some otherwise stealthy eye diseases, some of which are more than capable of knocking out vision entirely if left ignored.
Now, let’s talk eye exams. We’ll go over when and if you should be considering dilated exams and add a little more information to hopefully give you a solid idea of why they’re so important. But to make this easier for some readers, we’ll start off with an important question.
Why SHOULDN’T You Have a Dilated Eye Exam?
There are a couple reasons not to head in for a dilated eye exam. The main one: you’re young, healthy, and don’t have any conditions that call for frequent examination. Many of the diseases that dilated exams catch are heavily age-related, so if you’re a highly healthy 25-year-old, you should still get your eyes checked from time to time, but probably don’t need to schedule annual exams.
Cost, of course, is also a barrier. It’s a flat truth that dilated eye exams aren’t cheap. If you happen to be on Medicare, check your options – you’ll qualify for fairly extensive coverage if you have diabetes, or if you’re judged to be at an increased risk of glaucoma, but people not in those categories may need to seek extra help from local organizations.
The official recommendation from the National Institute of Health is that, if you’re over 60, you should aim to schedule at least one dilated eye exam per year. For some individuals, this is easy. Anyone with contacts or glasses is likely already used to dilated exams, as they’re generally included with a fitting or comprehensive exam.
For others, this means finding a physician and taking care to stick to that yearly regulation. Again, most of the conditions that a dilated exam can catch become more and more likely with age, so tailoring your exam schedule to account for that is crucial.
If you’re under 60, comprehensive exams are still recommended, just not as often. Some sources, such as the University of Utah’s Moran Eye Center, recommend exams every two years, barring any changes to vision in the meantime.
Several pre-existing conditions should also have you hustling in for more consistent exams. Diabetes is likely the most important, as the disease can cause rapid damage to eyes, which can only really be caught by a dilated exam. If you have risk factors for glaucoma, you should likewise be frequently examined. Same goes for cataracts, as well as a history of retinal damage.
So, What Exactly is a Dilated Eye Exam?
A dilated exam is your ophthalmologist’s way of “looking under the hood” of your eye. Before examining you, a physician will use eye drops to widen your pupil. Doing so allows more light into the eye and gives an examiner a better view of the aft portions of the eye – particularly the retina, a light sensitive membrane that sits at the very rear of your eye.
Doing so makes it possible to catch a variety of diseases in their early, early stages, as many of them will cause small, otherwise imperceptible changes to the eye before they lead to any appreciable loss or change of vision.
A word to the wise: bring sunglasses to your dilated exam, and preferably a designated driver as well. The drops used in the exam aren’t the most pleasant thing. They’ll cause a mild stinging when first inserted and will make you light sensitive for a couple of hours following the exam, since you’ll have dilated pupils. This second effect can make driving a risky proposition, so if possible, haul a friend along to make sure you get home safe.
Dilated Eye Diseases
So what can actually be caught in a dilated exam? It turns out that a few different diseases are on the list. Between them, they account for an enormous majority of new cases of blindness each year. All tend to progress quietly and can cause serious damage that, unless caught by a dilated exam, will go unnoticed until it’s too late.
Diabetic retinopathy is a prime example. This disease affects a high percentage of diabetics – particularly those who have had the disease for an extended period of time. Retinopathy occurs when small blood vessels in the eye are weakened by years of abnormal spikes in blood sugar. Eventually, they’ll rupture, leaking blood onto the retina (which can be caught by a dilated exam), and if left unchecked, will begin to regrow abnormally, causing scarring and permanent damage to the eye.
Age-related macular degeneration (AMD) is another disease that can only really be caught by a dilated exam. Many cases of AMD begin with the accumulation of deposits called drusen, which pile up on the macula – a central region of the retina. While these can be caught by a dilated exam, they’re hard to notice otherwise. These plaques, along with the blood vessel growth that characterizes later stages of the disease, can cause the loss of central, detailed vision.
Finally, let’s talk about glaucoma. Glaucoma is generally (though not always) characterized by a buildup of pressure inside the eye, which will eventually kill parts of the optic nerve, damaging vision. It’s a common disease and one so subtle that it’s earned itself the moniker “the silent thief of sight.” By dilating the eye, however, physicians can detect early signs of damage to the nerve, allowing them to prescribe treatment and hopefully slow the progression of the disease.
So, if you still can’t remember when your last eye exam was, or have never been in for a dilated exam, you might want to start thinking about scheduling an appointment. It could end up saving your vision.