Field of Ophthalmology: Ensuring a Clear Future
“Going to the eye doctor” can mean a variety of things. Will you see an optometrist, an ophthalmologist, or an optician? Or, all three?
According to Dr. Charlene Chang, ophthalmologist with Oroville Hospital, each has a very specific job in regards to eye health. “An ophthalmologist is a physician who’s gone through medical school, internship, and residency and is trained in medical and surgical ophthalmology—so treating medical diseases and doing surgeries on the eye,” she explains. “Optometrists are trained to specifically make and test for glasses and contacts, and they also deal with the health of the eye, but their specialty is more in the glasses field.”
An optician is someone who takes the information that either the optometrist or ophthalmologist has acquired and helps the patient pick out frames, makes lenses with contacts, and assists with the final selection of optical supplies.
Vision Loss and Other Complaints
Major causes of vision loss for individuals aged 40 and older include cataracts, macular degeneration, glaucoma, and complications from diabetes. For younger individuals, trauma is typically the number-one reason for dramatic vision loss.
“We also see patients who are experiencing ocular surface issues like dry eye, irritated eyes, and conjunctivitis,” notes Dr. Eric Stevens, also an ophthalmologist with Oroville Hospital.
The Eye Exam
A comprehensive eye exam begins with a glasses check, prior to any drops being administered. The first drops act as a numbing agent, so eye pressure can be screened for signs of glaucoma. “We scan the pupils to make sure they’re reacting normally, checking the visual fields to ensure they’re full and the patient has a full peripheral field, and we also check the ocular motility to confirm there aren’t any double vision issues and that the eyes are in proper alignment,” states Dr. Stevens.
The second set of drops dilate the pupil. One activates the muscles that open the pupil and the other one relaxes the muscles that tend to constrict the pupil. “Between those two, we dilate the pupil so we can get a good look in the back of the eye,” adds Dr. Stevens.
By dilating the pupil, it allows a thorough examination of the optic nerve and retina to ensure it has proper coloration and anatomy. The eyes are also the one place in the body where blood vessels are clearly visible from the exterior. Poor retinal health can point to conditions like diabetes and hypertension.
Time for Reading Glasses?
It’s common for individuals to require reading glasses as they age, typically around the age of 45, even if they’ve never experienced prior eye issues. “As you get older, your lens becomes firmer and less elastic, so the muscles that are used to change the shape of the lens to focus from far to near are not as effective,” shares Dr. Chang. “If you have underlying farsightedness, that may require reading glasses a little earlier in life. Likewise, if you’re nearsighted, sometimes you can put it off. Wearing reading glasses does not make it worse. I always tell patients, just use them and make life easier.”
Eye health is related to overall general health, so per Drs. Chang and Stevens, the better you eat, the more exercise you get, and the less you smoke, the healthier your eyes are going to be. “Using sunglasses outside, eating a healthy diet, making sure that if you have diabetes it’s controlled, getting all your vitamins in, not smoking—all that does really help your eyes,” states Dr. Chang. “And, getting regular eye exams is also important, even if you feel like you’re seeing fine, just to make sure you’re screening for other medical eye conditions.”
Dr. Stevens concurs, and specifically stresses the damage smoking can have on eye health. “Smoking is really key to a lot of eye conditions—ones people don’t tend to think about. Macular degeneration is worse in smokers, but even in younger people things like thyroid eye disease are made much worse by smoking. My biggest health advocacy for the eyes is if you are currently smoking, try to find a way to stop.”