Eye Disease: Early Detection and Treatment

Why is early diagnosis important?

One of the most important reasons for having an eye examination is to take care of the health of your eyes. Many people think of an eye exam in terms of getting a new prescription for glasses or contacts. Seeing clearly, by having a correctly optimized prescription is very important, but there is much more to it than that. One of the main reasons for having an eye examination is to prevent eye disease or minimize damage to the eyes by undetected eye diseases.

Many eye diseases and problems are silent. Silent meaning it is not possible for the individual having the problem to detect the problem early on. Many people think they will know if something is going wrong with their eyes. While this is sometimes true, diseases like glaucoma, macular degeneration, diabetic retinopathy, cataracts, retinal detachments and other conditions can be detected during the course of a routine eye examination. Early treatment can prevent loss of precious sight.

Some of the most common eye problems we see include:

• Cataracts
• Keratoconus
• Glaucoma
• Dry Eyes
• Diabetes
• Macular Degeneration
• Allergies
• Eye Infections
• Eye Injuries
• and more

So you may be asking, are things done any differently in our office compared to other providers? That is a good question that perhaps could be answered by a further explanation of our eye examination process.

Tests to detect eye disease: How it works

Most eye diseases are detected by observing subtle changes in appearance and structure of eye anatomy. Those patients that have had an eye examination are familiar with having their eye doctor look at the front of their eyes using a slit lamp microscope, and at the back of the inside of their eyes using an ophthalmoscope of some type. Eyes are often dilated as a way to improve the doctor’s view using these older type devices. This is because without dilation, the eye pupil becomes very small from the light emitted by the examination device. These older examination instruments do not provide the doctor a good view inside the eye without being dilated in most cases.

Patients often find having their eyes dilated to be an uncomfortable experience due to significant blur and light sensitivity for many hours following a dilation procedure. Fortunately, more modern examination tools exist that can greatly enhance the doctor’s view inside the eye without having to resort to dilation. These more modern tools not only provide the patient with a more comfortable experience but also have significant clinical benefit in terms of diagnostic accuracy and detection of long term changes to eye anatomy. For some conditions, dilation may still be diagnostically beneficial. However, using modern technology, dilation is often not necessary or helpful in the diagnosis or management of eye disease.

Most modern instruments such as a digital retinal camera, wide field retinal scanning (Optos), or Optical Coherence Tomography (OCT) provide a digital image of the inside of the eye. We are all familiar with the saying, “A picture is worth a thousand words.” This is very true when it comes to an eye examination. A doctor without imaging technology and past images to compare with is significantly hobbled when it comes to being able to detect subtle changes over time.

These types of changes can be critical in the decision making process for management of macular degeneration, glaucoma and intraocular tumors as well as other conditions. Through the use of digital imaging, valuable diagnostic information can be obtained that is not obtainable in any other way. Digital images should become a permanent part of the medical record and is an important part of eye examinations at Powers Eye Center.

Wide Field Retinal Imaging

Standard digital retinal cameras are capable of capturing an excellent image of the central retina in most eyes. Sometimes, a patient’s pupils are small enough that dilation may still be needed to capture a high quality image.

Wide field scanning laser ophthalmoscopy can capture a much wider angle view of the inside of the eye. This increases the doctor’s ability to find tumors, retinal detachments, bleeding or other diseases of the eye that might be missed by other forms of eye examination, including standard retinal digital imaging. This instrument has a smaller minimal eye pupil diameter for image capture than other instruments and can be used as a strategy to avoid the negative side effects of eye dilation.

Advanced Intraocular Pressure Measurement

One of the cornerstones of glaucoma diagnosis and treatment involves the measurement and manipulation of fluid pressure inside the eye. Measurement is accomplished using either a contact or non-contact method. Contact tonometry involves using some type of probe to push on the eye. Non-contact tonometry is accomplished by blowing on the eye with air and using a sensitive electronic system to detect how the eye responds to the air stream.

A recent development in testing technology is the ability for non-contact tonometers to measure more than just pressure. Pressure readings can be affected by corneal thickness and rigidity. Until recently, rigidity was assumed to be the same for all eyes. Technology now exists to adjust pressure measurements for this factor leading to better measurement and diagnostic decisions. Powers Eye Center uses such a device.

Visual Field Testing

Visual field testing is useful in the detection of glaucoma, retinal disease, optic nerve disease and even brain tumors. Previously undetected brain tumors have been detected in our office through this method. Testing is painless and takes only a few minutes. The patient is seated comfortably at a machine that presents a series of light stimuli. The patient responds simply by pressing a button when a stimulus is seen. These stimuli are presented at different brightness or contrast levels to map a patient’s ability to detect light. Diseases of the optic pathway tend to produce very defined patterns that can be evaluated by the doctor.

Visual field testing is often omitted, or “charged extra” for in many eye doctor offices. At Powers Eye Center we feel visual field testing is an important part of an eye examination and is “included” in comprehensive and complete routine eye examinations at no additional cost.

Intraretinal Imaging

Optical Coherence Tomography or OCT for short is a newer technology that allows the doctor to view cross sections of tissue with greater precision than ever before. OCT scanning allows detailed analysis of retinal nerve layers for diagnosis of glaucoma and macular degeneration. It can also be used for many other conditions but those two are the most common. Powers Eye Center has this technology on site.

Call our office today at 719-598-5068 to schedule an appointment with our Colorado Springs eye doctor.