Harvard Health Letter

Dilated eye exams are critical

Viewing the back of the eye helps catch problems earlier.

Reading an eye chart every few years isn't enough to maintain eye health and prevent complications down the road. Earlier this year, the American Academy of Ophthalmology (AAO) came out with a statement urging everyone to have regular dilated eye exams that allow physicians to see clearly into the back of the eye. "It's critical to have dilated exams," says Dr. Jeffrey Heier, director of the retina service at Ophthalmic Consultants of Boston and clinical instructor in ophthalmology at Harvard Medical School. "Once problems occur, vision loss can be irreversible. Catching problems early can help preserve vision."

Anatomy of the eye

Anatomy of the eye

Most common risks

Dr. Heier points to three main conditions that have no symptoms initially and may go undetected without a dilated exam. One is glaucoma, in which pressure is increased in the eye. "By the time you recognize that you have glaucoma, you could have lost a significant portion of your visual field and have significant damage to the optic nerve," he explains. Another disease is diabetic retinopathy, which causes damage to blood vessels in the retina. Finally, age-related macular degeneration often has no symptoms at first, but it can gradually destroy the macula, the part of the eye that provides the central vision needed for seeing objects clearly. Discovering any of these conditions early can help slow or prevent progression.

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