To Protect your heart "Get an Eye Exam!"

A great segment aired recently on Good Morning America titled "Get An Eye Exam: Arthritis to Cancer Seen in Eye".  If you didn't catch the segment, click here to see the video and read the related article.

Doctors have known for a long time that dozens of diseases show up in the eyes, often early enough to do something about them. And its not just eye diseases.  Many systemic diseases show up in the eyes first  like cancer, tumors, diabetes, high cholesterol, high blood pressure, arthritis, multiple sclerosis and heart disease. Even mental health issues like dementia and Alzheimer's disease are connected to eye health and vision. That's not even the complete list.  Studies have shown that eye exams are often the first to detect chronic diseases. That's why getting an eye exam is one of the best things you can do for your overall health.

One of the reasons so many diseases can be diagnosed from an eye exam is that the eye is a window to the rest of the body.  An eye exam is the only non-invasive way for a doctor to look at the condition of your blood vessels.  Using standard ophthalmic equipment, the doctor looks through the iris of your eye and can see the blood vessels at the back of your eye.  If there are problems in your body, chances are that they will show up in those blood vessels.

For example, recent research as shown that an imaging scan of the blood vessels in the retina, which is at the back of the eye, can potentially save thousands of lives by predicting who is at imminent risk of a heart attack.  The scan fast enough that it can be done by your optometrist during a routine eye examination.

The BC Doctors of Optometry blog recently featured a story on the eye-heart connection.  That article talked about two different ways that cardiovascular problems can show up in blood vessels and around the eyelids:

In patients who have cholesterol build up in larger arteries, it is possible for small pieces of plaque to break off and travel through the blood stream into the eye (these are called emboli). The emboli can get stuck in the small blood vessels and cause a blockage.

The particular signs mentioned in a New York Times article are called xanthelasma. These are elevated patches around the eyelids due to fatty deposits under the skin. These are usually considered to be benign but, as the article mentions, recent studies have shown a link to higher rates of heart disease.

Here are some public service announcements form the BC Doctors of Optometry that get the message out.

Eye exams for adults

  This video features Vision Source Vancouver optometrist, Dr. Mini Randhawa:

Eye exam saves a life

Chidlren's eye exams

Eye exam finds glaucoma

January 2013 is Glaucoma Awareness Month

January is Glaucoma Awareness Month. We urge everyone to take control of their eye health and have an eye exam to help minimize the risk of developing glaucoma.  When you lose vision to glaucoma, you never get it back.

Glaucoma is the second leading cause of blindness in Canada. Even so, public awareness around glaucoma is low. For example, according to a recent survey by the American Optometric Association:

• 90% of respondents think glaucoma is preventable. Only
10% know it's not, but that it's treatable.
• 86% don't know what part of vision glaucoma affects.
• 72% think glaucoma has early warning signs.

The truth is that the only defence against glaucoma is early diagnosis and treatment. People who wait until something noticeable happens to their vision are too late. They have already suffered permanent vision loss.

Regular eye exams are the first line of defense for early detection of glaucoma. Glaucoma is often called the silent thief of sight because it often strikes without pain or other symptoms. That's why it is critical for patients to receive a dilated eye exam from their eye doctor so that eye pressure and and the nerves in the eye can be examined for signs of glaucoma.

Ethnicity affects your risk of developing glaucoma. For example, South Asians have a higher risk than Europeans of developing glaucoma.

Recent studies show that Canadians are not taking basic steps (getting eye exams) to protect themseves against glaucoma. And by the time they are diagnosed, they have already lost vision that they will never get back. It does not have to be that way if you take control of your health and get regular eye exams.

Related Articles
The best protection against glaucoma
Feb 27, 2012

Vision loss from glaucoma - preventable if caught early
Nov 02, 2011

South Asians are at higher risk of glaucoma
Apr 28, 2011
Health warning on eye drop - glaucoma risks
Jan 05, 2012
The myopia epidemic: why it is so dangerous- myopia and glaucoma risks
Oct 12, 2011

Only 38 years old and risking blindness - man suffers permanent vision loss after avoiding the eye doctor for years 
May 24, 2011

Mad Cow Disease - visual symptoms - glasses won't help blurry vision caused by brain diseases

Mad Cow disease, also called Creutzfeldt-Jakob disease, is back in the news. The initial symptoms of this disease in humans include:

• Personality changes 
• Anxiety 
• Depression 
• Memory loss 
• Impaired thinking 
• Blurred vision 
• Insomnia 
• Difficulty speaking 
• Difficulty swallowing 
• Sudden jerky movements 

Mad Cow disease causes deterioration in the brain and all of the above are products of a brain that is no longer able to adequately control the body, including the visual system.

For an optometrist, this is an opportunity to highlight a fact hat most people probably do not consider. Their blurry vision may be the product of a problem in the brain such as a tumor or some rare disease like mad cow.

People that respond to blurry vision by simply buying some off-the-shelf reading glasses without going to the eye doctor first don't really know if their blurry vision is just a refractive error easily corrected with glasses or something more serious and life threatening. Remember our slogan: See an eye doctor, see for life. Its good advice.

Here is our favorite news anchor, Dianne Sawyer on ABC News, presenting the mad cow story:

Saving on Eye Care: Bargains and Risks

In a feature article WebMD explains why why cutting costs on eye care sometimes goes too far.  Learn about the dangers of skipping annual eye exams and the the safety and quality issues associated with online eye wear.  In case you haven't heard, research shows that half the eye wear sold online is junk and even unsafe.

The WebMD article is worth reading but here is a nice quote to give you a taste:

"Never equate how well you see with how healthy your eyes are," Pierce says. "That is the biggest misconception out there." 

Ophthalmologist Mark Fromer, MD, agrees. 

"There are all kinds of systemic diseases, but people like to think it is all about eyeglasses and don't see the bigger picture," says Fromer, who practices at Lenox Hill Hospital in New York and is the eye surgeon for the New York Rangers hockey team. 

Fromer says that patient education plays a big role in how often people see the eye doctor, but budget is an important factor as well. When he talks to patients, he puts eye health in perspective by comparing it to skydiving and brain surgery. 

"You don't want a budget parachute or a budget neurologist, do you?" Fromer says. 

The American Optometric Association recommends adults ages 18-60 who have no risks for eye disease have an eye examination every two years. Adults 18-60 at risk for eye disease should get an eye exam every one to two years or as recommended by your eye doctor. Those who are ages 61 and older should get an eye exam annually or as recommended by your eye doctor. 

"There are lots of blinding diseases without symptoms up front," Fromer says. "That's why it is so important to come in early and be tested."

More information on buying online eye wear

Here is a video of Vision Source Vancouver Optometrist, Dr. Mini Randhawa talking about the problems you may experience with online eye wear.

Here is a link to a cool info-graphic on the results of the Pacific University study showing that half the eye wear sold online is junk: http://seeforlife.blogspot.ca/2012/04/study-proves-that-half-eyewear-sold.html

To read the Pacific University study on online eyewaer, click here: http://optometrists.bc.ca/upload/documents/Speak_Out/Safety_and_compliance_of_prescription_spectacles_ordered_by_the_public_via_the_Internet.pdf

Here is the link to the WebMD article: http://www.webmd.com/eye-health/features/saving-eye-care-bargains-risks?src=RSS_PUBLIC

Eye Exams first to detect chronic diseases - the benefits of eyecare insurance

A study released earlier this year confirms that eye exams by an optometrist or ophthalmologist are often the first to detect chronic diseases like diabetes and hypertension. The researchers found that eye doctors detected signs of certain chronic conditions before any other health care provider recorded the condition—65 percent of the time for high cholesterol, 20 percent of the time for diabetes, and 30 percent of the time for hypertension.

The study has important implications for the heath care system as a whole, as we try to save money by focusing on prevention and early detection. Annual eye exams are critical in detecting signs of chronic diseases at the earliest stages because eye doctors have the only unobstructed, non-invasive view of the body's blood vessels - which they observe through the eye in an eye examination. 

Predictably the research also showed that people with insurance coverage for eye exams are three times more likely get an annual eye exam than a routine eye exam.  It seems that providing employees - and citizens generally - insurance coverage for annual eye exams is an important step to promote wellness and to reduce health care costs in the long run.  Unfortunately, like many important parts of the Canadian health care system, eye exams are not covered except for children and seniors.

The researchers looked at the health records of 56 million members of a large vision insurance provider and after crunching the numbers concluded that billions of dollars were saved through early detection and treatment.  Here are the numbers:

• 65 percent of the 2.2 million members with high cholesterol (1.5 million), resulting in two year savings of $1.7 billion
• 20 percent of 1.5 million members with diabetes (296,800), resulting in two year savings of  $827 million
• 30 percent of 2.2 million members with hypertension (667,800), resulting in two year savings of $2 billion

Vision insurance plans that cover annual eye exams are also a benefit to employers.  Employers who provided such plans experienced 7 percent less absenteeism, 4 percent less employee turnover and savings on insurance and workers’ compensation costs. Early detection of chronic diseases like diabetes and hypertension also increased the likelihood employees would be proactive with their health care and more likely to see their family doctor to receive follow-up care.

Here is a chart showing the money saved by providing vision insurance.

 

Keep in mind that the study was funded by a vision care insurance provider and so there may be some bias.  However, the results simply confirm what most health care professionals already know about eye exams and the early detection of disease as well as the costs savings associated with early detection and treatment.