It’s been said that eyes are the window to the soul. That may be true, but they’re absolutely the window to eye health and other systemic diseases like high blood pressure, diabetes, and some neurological disorders.
This spring, CNN reported on a few cases of a rare, fatal form of cancer called ocular melanoma. This cancer affects approximately six in every 1 million people.
Our experts at the Eye Center of the Rockies would like to alert you to the importance of a dilated eye exam to screen for ocular melanoma, even though alternative methods may be offered.
For those who haven’t had a dilated eye exam, drops are instilled in the eyes, and after about 15 minutes the pupil enlarges significantly. This lets your doctor see all throughout the back of the eye, not just the center.
During the exam, your doctor looks at tiny blood vessels in the back of the eye. Are the arterioles narrowed more than usual? Are the vessels leaking? Something else?
There is much to glean from a dilated eye exam. Narrowed arterioles could be the result of high blood pressure; vessels leaking fluid may point to diabetes. Signs of melanoma can also be observed during a dilated eye exam.
Melanoma, a malignant tumor of pigmented cells, can be found in the back of the eye in the pigmented layer known as the uvea.
Unlike melanoma, which is rare, it’s very common to find small nevi or moles in the back of the eye. These smaller, benign tumors of pigmented cells are like freckles on your skin. They should be monitored annually to spot changes. Significant change could signal early malignancy.
That’s why our team stresses the importance of a dilated eye exam every two years, until you reach the age of sixty, and then yearly.
Here in the Vail Valley, it’s become common practice among several optometric eye care practices to skip a dilated eye exam.
Patients commonly complain about light sensitivity and blurred vision. Plus, after the exam, patients have to wear sunglasses to avoid injury; some people even prefer a friend or family member drive them home.
None of us relish the thought of having our eyes dilated, so many practices offer an alternative. For a fee ranging from $35 to $70, a photo is taken of the back of the eye instead. Specifically, a wide-angle lens takes a photo through an undilated pupil.
There are several problems with this approach. The photograph is a wide angle, low magnification view and doesn’t deliver a complete view of the back of the eye—serious problems could be missed.
Even Optos, the camera manufacturer, admits their camera only captures about 80 percent of the back of the eye. Moreover, other fine details are lost when the eyes aren’t fully dilated.
Avoiding a dilated eye exam only benefits the optometry practice: more patients can be seen in a day when the doctor doesn’t have to wait for the eye to dilate.
At the Eye Center of the Rockies, we’ve diagnosed several patients with ocular melanoma previously seen by doctors who rely on low resolution, wide-angle photography.
We also meet many patients looking for a second opinion on ‘spots’ or ‘hemorrhages’ that could be easily misinterpreted on these photographs.
This causes significant anxiety for the patient, and often results in expensive additional testing—at the very least, another round of photographs.
While sometimes inconvenient, the patient gains much confidence with a thorough dilated eye exam. It’s an important part of what you’re paying for in an eye exam, so why risk your vision on anything less than the best?
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