A ‘routine’ eye exam potentially saved this patient’s life

Johnny Morgan just wanted his contact lens prescription refilled. But his prescription had expired, and the optometric staff member on the phone gently insisted Morgan come in for a comprehensive eye exam.

What Morgan thought was going to be a routine errand and quick doctor’s appointment likely saved him from a life-altering stroke or even death. It was all thanks to his optometrist, Joe Sugg, O.D., owner of Heber Springs Eye Care in Heber Springs, Arkansas. Dr. Sugg didn’t just fill a prescription and send his patient on his way. Instead, he conducted a comprehensive eye exam, which is recommended at least once a year.

This story happened about nine years ago, when Morgan was 67-years-old. On exam day, he had no complaints or changes in his eyes, at least that he had noticed. In his mind, his prescription had not changed. But when Dr. Sugg looked at the photos his staff had taken of the back of Morgan’s retinas, he saw several hemorrhages in the left eye.

Hemorrhages are caused by damaged blood vessels. The eyes are the only part of the body where you can look at blood vessels in their natural state, without having to use a dye and/or perform an angiogram, Dr. Sugg explained.

“If you’ve got enough reduced blood flow to the eye, then those blood vessels can start to break down and leak,” he said. “So that’s where the hemorrhages in the retina came from.”

The hemorrhages were only on the left side, so Dr. Sugg immediately suspected a problem with Morgan’s carotid artery. There are two carotid arteries, one on each side of your neck. These are the main blood vessels that carry oxygen and blood to your eyes and your brain.

“When you see those hemorrhages in one eye and not the other, then that’s a pretty good indication that for some reason, there’s reduced blood flow just on that specific side,” Dr. Sugg explained.

Following up on his suspicions, Dr. Sugg used a stethoscope to listen to Morgan’s carotid arteries. Only on the left side, he heard a whooshing sound that shouldn’t be there. This sound is called a “bruit” and can mean that plaque has built up dangerously in the artery. This causes the arteries to narrow, which reduces the blood flow to the brain. The reduced blood flow can cause a life-threatening stroke and other problems.

Next, Dr. Sugg dilated Morgan’s eyes and used a slit lamp, which is a specialized magnifying microscope, to look at the back of Morgan’s retinas. All of his tests confirmed his suspicions that Morgan’s left carotid artery was severely blocked and he was at high risk of having a stroke.

He calmly asked Morgan, a Vietnam veteran, when his next appointment was scheduled with his physician at the nearby Veterans Affairs (VA) hospital. The appointment was coming up, so Dr. Sugg contacted the VA, explained his findings and recommended a carotid ultrasound.

Soon after, the ultrasound “found that he did have significant blockage,” Dr. Sugg said, “and within the next week or so, he was in surgery to have his carotid artery repaired to reduce his risk of stroke.”

Morgan’s ultrasound showed his right carotid artery was about 50% blocked and his left was 100% blocked. Since his surgery, known as a carotid endarterectomy, Morgan has had no more mini strokes or any other symptoms in the past nine years.

“I never dreamed your eyes were able to tell you that much,” Morgan said.

After his diagnosis, Morgan said he had been experiencing a few mini strokes, where he would say something weird that he didn’t remember saying or lose a few seconds. But he admitted he ignored his symptoms and continued his work as a salesman for portable buildings.

Reflecting back, Morgan said he thought about how even a survivable stroke could have damaged his speech. As a salesman, he depended on his ability to converse easily. “Dr. Sugg really saved me in every way, form and passion,” he said.

Know the warning signs

Carotid artery disease decreases your blood flow, causing your eyes and brain to not work properly. You may notice that one side of your body is weak or numb. You may lose vision on the same side of your body. Without treatment, you are at risk of a stroke, as well as permanent damage to the eye. The damage may come from blood clots in the eye, known as retinal vascular occlusions, or glaucoma, which is damage to your optic nerve from pressure that builds up in the eye.

Another vision problem that can be a warning sign of carotid artery disease is when it looks like a curtain has been drawn over your eye, lasting a few minutes to an hour.

People who are at increased risk for carotid artery disease include adults older than 55 who smoke, have diabetes, frequently drink alcohol, are obese, have high blood pressure, or have a family history of carotid artery disease.

Remember the warning signs and if you think you are having a stroke, call 911 immediately. Anytime you are experiencing vision changes, call your primary care doctor or optometrist right away.

As primary eye health care providers in the U.S., doctors of optometry can diagnose, advise and refer patients who may be at risk of carotid artery disease for further care and testing.

A doctor of optometry can identify more than 270 serious conditions, including diabetes, hypertension, cancer and stroke — all by looking at your eyes. And they can often do this before you start having worrisome symptoms, putting you on a path to early treatment.

Like Morgan, you may think an optometrist only writes prescriptions for glasses or contact lenses. But a regular comprehensive eye exam by a doctor of optometry is critical to your overall eye health and can detect other health issues.

Dr. Joe Sugg

Dr. Joe Sugg is a native of Jonesboro, Arkansas and has lived and practiced in Heber Springs since 2009. He graduated from the Southern College of Optometry in Memphis, Tennessee with honors in 2009 with his Doctorate of Optometry. Dr. Sugg earned multiple awards recognizing outstanding clinical performance while in optometry school. He is a Diplomate of the American Board of Optometry. In 2013, Dr. Sugg received the “Young O.D. of the Year Award” presented by the Arkansas Optometric Association. In 2015, Dr. Sugg and the staff at Heber Springs Eye Care Center received a “Practice of Excellence Award” presented by the Hayes Center for Practice Excellence at Southern College of Optometry. He currently serves as the Immediate Past President of the Arkansas Optometric Association as well as on various committees within the Association. He has previously served on the Exhibits Committee for SECO International, and he currently serves on the Industry Relations Committee for the American Optometric Association. He participates in the Brandon Burlsworth Eyes of a Champion program and also helps provide eye exams at the Arkansas Special Olympics.