Anup Kaur was worried about her blurred vision. The 35-year-old teacher had not been seeing clearly for a week, and had gone through simple vision tests twice. Both checks indicated that there was nothing wrong with her eyes.
Raj Anand, senior eye specialist at Vasan Eye Care Hospital, Delhi, suspected that the problem went deeper than the eye, and asked her to go through a more detailed diagnostic called a colour vision test.
“The findings were quite alarming,” Dr Anand says. “They showed that the patient had developed a tumour in her brain which was impacting her vision.”
Kaur is glad she got her eyes tested promptly. “Thanks to that test, the tumour was diagnosed early and I went through a surgery to remove it,” she says.
Eye care and examination is a a lot more than just vision correction. Even during a regular eye check-up, an ophthalmologist can detect other hidden diseases in the body.
“In Mrs Kaur’s case, blurred vision sent her to an eye doctor but very often there are no symptoms at all,” says Dr Anand. “That is the reason why a regular eye exam is essential. It lets us clearly see the retinal blood vessels, so we can detect potential warning signs of serious disorders like heart disease, high blood pressure (BP) and even diabetes, even before the symptoms show up anywhere else in the body.”
Dr Anand says high cholesterol often shows up as yellowish plaque within the retinal blood vessels; undiagnosed autoimmune diseases like rheumatoid arthritis show up as inflammation inside the eye; and red, itchy, watery eyes could be a red flag for an undiagnosed allergy.
“Similarly hypertension gives a silver or copper hue to the retinal arteries,” he says. “If left untreated, the condition can cause blood vessels in the retina and throughout the body to harden, increasing the risk for heart attack or stroke.”
Research done at Johns Hopkins University, US, and published in the October 2007 issue of the journal Neurology, indicates that a 5-minute eye exam might prove to be an inexpensive and effective way to gauge and track the neurological disease multiple sclerosis. According to the researchers, a damaged optic nerve can be an early warning sign that a person has multiple sclerosis.
The findings of another study, released on 19 April 2011, show that eye exams are often the first to detect chronic diseases such as diabetes and hypertension. It was conducted by Human Capital Management Services and commissioned by VSP Vision Care, a leading eye-care provider in the US.
Rohan Chawla, consultant, vitreo-retina and uveitis, Max Eye Care, Panchsheel Park, New Delhi, recalls a patient he saw a few months back. The 22-year-old man came to him with complaints of sudden blurring of vision in both eyes for a day. Vision was checked, and was found to be weak. A retina check-up revealed swelling of the retina with some haemorrhages and lipid oozing into it in both eyes, as well as swollen nerves. Immediately the blood pressure was checked—it was 200/110mm Hg (normal blood pressure is 120/80mm Hg).
“Everyone, including the boy and his family, were surprised as no one expected it to be so high at this young age,” Dr Chawla says. “Thankfully his timely eye check-up detected the problem and with BP control (due to faulty lifestyle choices—wrong eating habits, no sleep and examination stress), his eyesight improved fully and the retinal swelling too went away.”
Sanjay Dhawan, additional director and head of department, ophthalmology, at Fortis Healthcare, Gurgaon, points out that many of the common eye diseases, such as glaucoma and age-related macular degeneration, are often asymptomatic in the early stages. “Testing should begin for these in the early forties,” Dr Dhawan says (see “The testing schedule”). “A dilated eye exam is the only way to detect these diseases in their early stages, especially because once the symptoms set in, the effects on vision are often irreversible.” He adds, “Early cataract also does not have symptoms but can be detected in a routine eye examination. Another very important issue is advanced disease in one eye. This very often goes undetected as the other eye (being normal) continues to compensate for vision, and the patient never catches on. I see this many times during my OPD: When one eye is closed during routine check-up, then only the patient realizes that there is a problem with the vision of his other eye (see “A DIY test”).”
The testing schedule
What ophthalmologists recommend .
At birth: To rule out any congenital eye disorders, like cataract and glaucoma.
At year 1: To rule out developmental disorders of the eye, such as cataract, squint, retinoblastoma (eye cancer).
During school admission: To rule out refractive errors (the need for spectacles), amblyopia (lazy eye), squint, etc.
After year 5: Then every three-five years till the age of 40, or as symptoms occur.
Every one-two years after the age of 40: to detect presbyopia (far-sightedness), glaucoma, cataract, the effects of any other disease, like diabetes, etc.
—Sanjay Dhawan, additional director and head of department, ophthalmology, Fortis Healthcare, Gurgaon.
A DIY test
A simple home vision test
Look at a TV screen or a calendar with things written in various sizes from about 10ft. Look with one eye at a time (close the other eye), wear your distance glasses, if any, and answer the questions below:
u Can you see everything clearly with each eye?
u Is the clarity of vision equal in both eyes?
u With either eye, is there a distortion of what you are seeing? Does it appear a little wavy, or larger or smaller than its actual size?
u Is there a black patch in your field of vision with either eye?
— Rohan Chawla, consultant, vitreo-retina and uveitis, Max Eye Care, Panchsheel Park, New Delhi.
To do a self-administered vision test (free), visit www.titaneyeplus.com. The website is available in seven regional languages. If your vision is blurry, go to a doctor for complete testing and advice.