A wide range of health issues can impact your vision. That’s why eye doctors are often the first ones to detect such conditions as diabetes, high blood pressure, and autoimmune diseases.
Your eyes have a unique structure, including pigmented cells, a rich network of blood vessels, and the optic nerve that carries visual messages to your brain. These features make them vulnerable to many medical issues. Contact Eye Doctor Ellicott City MD now!
A typical eye exam begins with the doctor asking you about your vision problems and any health issues that might affect your eyes, such as high blood pressure or diabetes. Then they’ll use a variety of tests and medical apparatus to examine the inside and outside of your eyes.
They may start by shining a bright light into your eyes to see how well you can focus (eyesight test). You might also be asked to read from an eye chart while they watch to ensure the letters get smaller as you move down the line. This test is called visual acuity.
The doctor might also use a special instrument to measure the thickness of your cornea, which could indicate glaucoma. During this test, you will sit in front of a machine with your head resting on a chin rest. A thin probe is inserted into the front of your eye, where it touches the cornea for a few seconds to make a measurement.
You might also have an ocular motility test, where the doctor asks you to follow a penlight or light with your eyes without moving your head. This can detect weak muscle control and help identify problems such as strabismus (crossed eyes) or amblyopia (lazy eye).
The last part of the exam usually involves the slit lamp examination, in which your doctor shines a light from a small device called an ophthalmoscope directly into your eye. Your pupil will be dilated using drops before this happens, and your eye doctor can then take a close look at the back of your eye through the pupil to examine the retina, optic nerve, blood vessels and choroid coat.
Diagnosis
A comprehensive eye exam is the medically recognized standard for ensuring healthy vision and detecting eye diseases, including glaucoma, which can lead to blindness. Eye exams also safeguard overall health by detecting conditions such as diabetes, high blood pressure and autoimmune diseases before they can damage other organs of the body.
Eye diseases often have no symptoms in the early stages, so it’s important to visit your eye doctor regularly. An ophthalmologist can perform a detailed, dilated eye exam by injecting you with medication that widens your pupils, giving them a better view of the inside of your eyes. This allows them to assess the strength of your vision, check how well your eyes are aligned and examine the retina and optic nerve for signs of a disease such as macular degeneration.
An ophthalmologist can also use other tests to diagnose eye diseases and disorders, such as an Amsler grid, which makes lines appear fuzzy and warped when you have macular degeneration, or a fluorescent dye test called a fluorescein angiogram, which detects leaking blood vessels in the retina. They can also prescribe medications, low vision rehabilitation therapy and spectacle lenses and contact lenses.
There are several warning signs that indicate you need to see an eye doctor, ranging from pink eye (which is caused by a virus or bacteria) to blurry vision. Red eyes, especially if they are accompanied by pain or a discharge, could indicate a serious problem like a broken blood vessel in the retina. Other signs that should prompt you to make an appointment include sudden double vision and seeing black spots or flashes of light, which may indicate a retinal tear or macular degeneration.
Treatment
Whether you’re dealing with eye allergies or the effects of aging, both optometrists and ophthalmologists can treat common eye conditions. The two types of doctors work closely together to ensure patients receive comprehensive care.
Optometrists are medical doctors (OD) or osteopathic doctors (DO) who specialize in eye health and vision care. They’re trained to diagnose refractive errors—including myopia, hyperopia, and astigmatism—and prescribe corrective lenses like eyeglasses or contact lenses. Optometrists can also perform a variety of in-office procedures, such as foreign body removal and instillation of medications.
Ophthalmologists have completed medical school, a transitional year internship, and a residency in ophthalmology or a related field. They can provide a wide range of services, including removing foreign bodies from the eyes, conducting laser vision correction surgery, and treating cataracts, macular degeneration, diabetic retinopathy, glaucoma, and other eye-related problems.
After completing their undergraduate degree, ophthalmologists must complete four years of medical school. During their medical training, they’re assigned to various rotations in internal, family, and pediatric medicine, obstetrics/gynecology, and surgery, among others. They can also choose to focus on a subspecialty in ophthalmology, such as pediatric ophthalmology or retinal disease.
During an in-office dry eye treatment, an ophthalmologist will use a special device that heats and massages the eyes at the same time. This combination of LED-based heat and gentle pressure works to unclog clogged oil glands and reduce dry eye symptoms. The treatment typically takes just a few minutes and is very effective. It’s a great option for those who suffer from chronic or severe dry eye and want relief. Often, the treatment can be repeated as needed. You can purchase a similar device from a dry eye specialist to use at home, such as the TearLab Ocular Surface Treatment.
Prescriptions
The prescription that your eye doctor fills in tells the makers of your glasses or contact lenses how strong (or weak) your eyes are and what kind of lens you need. It also identifies whether you are farsighted, nearsighted or have astigmatism.
There are several methods that an eye doctor can use to determine a prescription for your glasses. These include retinoscopy, autorefraction and subjective refraction. The first two do not require the patient to provide feedback and are therefore ideal for infants, bedridden patients and non-communicating adults. Subjective refraction is the most accurate method, however it requires a trained technician to perform and can be time consuming.
Your prescription will include abbreviations like RE (right eye) and LE (left eye), as well as a number between 1 and 180 indicating the strength of your astigmatism correcting lens. It will also include a spherical number and cylinder power for each eye. The spherical number is the amount of diopters needed to correct your nearsighted or farsighted vision, while the cylinder power indicates the orientation of the astigmatism correction in your lens (it can be positive or negative).
Some eye doctors may add other information to your prescription such as PD (pupillary distance) or BVD (back vertex distance), which refers to the distance between your pupils. Others may include a notation of the shape of your corneas (toric, mono-scleral and irregular), as this can help ensure that your new lenses fit correctly. In addition, your prescription should contain a date of expiration and any restrictions on the type and brand of lenses you can purchase. In most cases, you have the right to get a copy of your prescription from your eye doctor at no extra cost. You should always keep a record of your prescription in a safe place, or at least take a picture of it with your smartphone, to make it easier for you to access it when you need it.
Referrals
In some cases, an eye doctor may need to refer a patient to another ophthalmologist or medical specialist. This is a vital part of ensuring the best care for a patient. However, effective comanagement of referrals requires more than just knowing what to do. It also means building relationships, addressing challenges and knowing when to tap into the expertise of your colleagues.
For example, if an eye doctor wants to take advantage of the advanced diagnostic capabilities available at a tertiary center, they may need to build relationships with those ophthalmologists. This can be challenging, especially for newer optometry practices, but it’s important to reach out to those in the community and establish a network that will last throughout your career.
Similarly, it’s important for eye doctors to build relationships with primary care physicians and other medical specialists. This can help ensure that patients receive the appropriate care, and it can prevent unnecessary or overlapping tests. In addition, medical insurance providers require a referral from a physician before they will approve treatment.
Finally, a referral is often required in order to qualify for special services, such as cataract surgery. This is because the surgeon will need to know the eye condition of the patient in order to provide an accurate diagnosis and treatment plan.
To avoid violating the anti-kickback statute (AKS), ophthalmology practices should obtain expert legal advice before offering any incentives to their referral sources. While expensive meals and tickets to sporting events might seem like a good way to build rapport, they could be considered illegal inducements and subject the ophthalmology practice to a whistleblower lawsuit. Likewise, ophthalmology groups should carefully consider the implications of hosting educational courses for optometrists, as the provision of such educational materials may violate the AKS and lead to a whistleblower lawsuit.
