Respect, love, and value your health

What can an optician tell from an eye test?

Most people think that eye tests are about eyesight. That’s only a third of it. An eye test is also about the health and efficiency of your eyes. Perhaps you can see reasonably well, but a health issue with your eyes may benefit from early intervention. For instance we look for cataracts (clouding), glaucoma (excess pressure) and macular degeneration (poor central vision) as well as dry eye (blurring and discomfort) among other things.

If a third is about your sight, and a third about your eye health and efficiency, then the final third is about the health of the rest of your body.

You might think “why would someone who can see perfectly well come for an eye test?” We wouldn’t encourage you to come if there wasn’t good reason. So when we encourage you to come for an eye test, it is genuinely because it is our role in society and in Scarborough as eyecare professionals to take care of your health and help you be your best you. We want to check everything’s fine, and if so, everyone’s happy.

What can an optician see in your eyes?

At the back of your eyes, we can see your blood vessels that everywhere else are covered by your skin. That means opticians may be the first people to notice any circulatory issues you may be having and although it may be worrying to think we might find something, it’s always best to know about issues early while they are easier to treat and before they develop.

Remember, arteries contain high pressure oxygenated, nutrified blood being pumped around from your heart, lungs and digestive system. Veins carry depleted blood back from your cells to your heart for replenishment, helped by valves and muscle movement. Arteries and veins can be seen in the eye.

In hypertension (high blood pressure) caused by fatty deposits building up on the walls of your arteries (atherosclerosis) we can measure the ratio between the inner width (the bore) of your arteries and that of your veins. Normally, arteries are 70% of the width of a vein, but in some health conditions can be as low as 30%.

This condition is also called hardening of the arteries and on the rear surface of the eye we can see its effect. When a hardened artery crosses over a vein, being less flexible it presses onto the vein and causes what’s called arterio veinous nipping.

That pinch point makes it harder for your blood to get back to your heart, causing it to back up. The vein can swell and may ultimately burst. In the retina (the rear ‘screen’ of your eye) these haemorrhages can be sight-threatening, we can see them in an eye test and they presage trouble so we would normally refer you to your GP for further treatment. The leaked blood may get in the way of your eyesight too depending where it is, and you may not even see it because your brain cleverly overlays the view from your other eye so you don’t notice.

What we see in the blood vessels at the back of your eye can represent what is happening all over your body.

Can an optician diagnose diabetes?

Both types of diabetes are key issues for opticians. If there is a lot of sugar in the body it leads to blood vessel walls bulging and eventually leaking. These micro aneurisms can be sight-threatening so again this is a health condition that needs management and opticians are able to spot this early when it can be more easily managed.

Without wishing to raise anyone’s anxiety, not many people know that you can get skin cancer on your retina. You can also get freckles there too, so if we see a pigmentation we need to decide which it is.

We also look at the optic nerve. It’s actually about seven million nerves for each eye, packed together, which connect the light sensitive cells in your retina to neurons in your brain. Sight is processed in the rearmost part of our brains, so these nerves pass through the brain front to back. If a brain tumour is growing, which fortunately is rare, depending on where it is it may press on some of these nerves. If they die as a result, we can see a change in colour in part of the optic nerve as it leaves the back of the eye. In short, opticians can sometimes spot a brain tumour early when there’s a better chance of treating it and we refer the patient to hospital.

One of the early symptoms of multiple sclerosis can be a change to the optic nerve. These are things an optician may encounter only a handful of times in their career, but again it’s all best caught early.

By far the majority of people go through their eye test stress free without a problem. A few puffs of air to the eye, and news no worse than hearing what they know already: their sight has got slightly worse because they are getting older, and new glasses will put them back on track. Of course no-one would wish to hear they have a health problem but please don’t avoid an eye test for fear of it. It is always better to know about any condition early so that you can access timely treatment. I’m sure you’ll agree, it’s better to know.

Many thanks to all of the team. Good pleasant eye test. Adele afterwards taken great care to make sure everything else was spot on including arranging delivery of new glasses.

Ian P