No symptoms, no need for regular eye exam? Think again

June 10, 2016
Study reinforces the importance of routine, comprehensive eye exams.

In a case of "an ounce of prevention," a new study finds patients with no perceived vision changes were more likely than not to have some change in ocular health uncovered during a routine eye examination.

Published in April's Optometry and Vision Science, the Canadian study found 58% of asymptomatic patients presenting for a routine comprehensive eye exam had either a change in ocular status or care-management plan, as compared to 77% of symptomatic routine eye exam patients.

Reviewing data compiled in the Waterloo Eye Study database, researchers identified 2,656 asymptomatic patients (of 6,397 total patients) and found 41% had a change in eyeglasses prescription, 31% had a change in management of an existing condition, and 16% had new critical diagnoses. Additionally, researchers noted that as age and exam interval increased, so, too, did the number of detected changes in these areas.

Elizabeth Irving, O.D., Ph.D., professor with the School of Optometry and Vision Science at the University of Waterloo and study author, says finding 58% of asymptomatic patients with at least one change is "quite striking."

"Many people believe they will know if they have a vision problem, and this is simply not true," Dr. Irving says. "Although this paper does not specifically report on visual acuity, given that a substantial number of these individuals required a spectacle prescription change, it does reflect on the ability—or lack thereof—of patients to detect reduced vision."

Dr. Irving also notes the number of individuals in the 20-40 (59%) and 40-65 (74%) age groups with a significant change, as these age groups typically do not have insurance coverage.

"Routine, comprehensive eye exams uncover a significant number of issues including those critical to eye health in asymptomatic people," Dr. Irving stresses. "(This study) provides peer-reviewed scientific evidence for the efficacy of routine eye exams. This has been lacking in the literature and gives advocates of routine eye exams numbers to back their position. (Secondly), the numbers are high, indicating that routine eye exams are, in fact, productive and therefore worth advocating for."

Learn more about the importance of routine, comprehensive eye exams.

Importance of timely care

Early diagnosis and treatment of eye and vision problems help prevent vision loss, but it's only through a comprehensive, dilated eye exam that a complete picture of patients' ocular health is determinable. The AOA contends there are severe pitfalls in separating purely objective refractive tests or inadequate vision screenings from a comprehensive eye exam, which provides doctors with a complete ocular health assessment.

Refraction is only 1 of 12 parts of a comprehensive eye exam, and within that refraction are numerous objective and subjective measures that cannot be accurately replicated through online or app-based "vision tests" that are, at best, approximations of refractive error.

"When a patient comes in to the office for an examination, we do so much more than just update a prescription for glasses or contacts," says Steven A. Loomis, O.D., AOA president. "Our tests are specialized for the needs of each individual and allow us to check the overall health of our patients. By analyzing images of the back of the eye, for example, we can see how a patient's blood vessels are functioning, which can signify serious conditions such as hypertension that often go undetected. The eyes are the window to your well-being, and their care cannot be left to a computer and a smartphone."

Read how one state's legislators recently took a stand for in-person, comprehensive eye care.

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