ANNUAL EYE EXAMS 4 ALL AGES

Yes, eye care is an essential part of primary care; it has been named an essential benefit under recent healthcare regulations.  Here are 4 age ranges recommended for eye exams by the American Optometric Association and the reasons why…

1. Age 6 months to 1 year & 3 Years old:  At birth, a pediatrician should rule out obvious findings for eye disease in your infant, but the eye isn’t done developing at birth and an eye specialist can check for subtle signs of eye disease at appropriate intervals.  Like the milestone check-ups with your pediatrician, a specialist who performs pediatric eye exams can confirm that eye development is proceeding as it should.  Very few pediatric exams at this age result in vision correction even at age 3, but the eye health is paramount and a professional experienced in evaluating eyes knows what to look for in your baby.  If there is not eye wellness insurance and financial constraints are a concern, search the Infant See Program for doctors in your area that perform eye evaluations in the first year of life for FREE.
2. Kindergarten (Age 5) through the primary grades:  At age 5 the development of the structure is complete and vision should reach 20/20.  Entering Kindergarten in Illinois now requires an eye exam by a licensed doctor; during primary education it is critical that quality functional vision enable your child to learn.  Whether this learning happens better because of a binocular imbalance, simple myopia, or a better nights sleep because of blue-light blocking technology in their computer glasses — your doctor may have a recommendation to safeguard your child from any number of conditions.  During rapid growth, changes in eye size and shape is more likely to affect vision.  Beyond potential changes in vision, retina photos can track pigment abnormalities in the back of the eye as common as a freckle on the skin.  Yearly eye exams will monitor eye health, completing the annual physical; and vision testing performed by an eye doctor at these annual visits will detect and demonstrate vision changes.
3. Age 14 – 40 (High School to middle-age):  During the primary grades children

   Micro-Aneurysms in early Diabetic Retinopathy.

   learn to read, and during higher education they read to learn.  As growth stabilizes so should one’s glasses prescription; this is why this period is the most common time to start contact lenses; optimize visual skills for performance; and amass spare pairs, prescription sunglasses, or specific task pairs of glasses.  These are also the times when we as a society tend to stop getting annual physicals.  Wellness exams should be a greater part of our lives, and eye exams complete the annual physical because it is the only place in the body where the blood vessels can be visualized and documented.  By imaging the retinal vessels, your eye doctor can detect change over time that can identify signs of several conditions including high blood pressure, diabetes, stroke, or high cholesterol.  By measuring the macular pigment and wearing the right kind of eye protection (blue light blocking lenses, blue-violet light blocking anti-glare, sunglasses with 100% UVA and UVB coverage…) we can prevent many of the age related eye diseases that happen over 40.  It’s really up to us at this critical time in our lives to decide if we want a future of injections, pills, and possible blindness; or if we’d rather be proactive about our health and prevent blindness by electing to have the best quality eye exam we can afford once a year to detect risk factors and warning signs before vision loss happens.

4. Adults over 40 years old:  Eye health is obviously a greater concern because this
   

   Sample scan of optic nerve

   is the time frame when cataracts, glaucoma and macular degeneration are more common afflictions.  But they are more common at this time mostly because the cumulative affect of UV and high-energy blue-violet light on the eye after 40 years of exposure.  If you smoke all your life and stop at age 45 and expect that will save you from cancer because you stopped you’ve got another thing coming (but still please quit); likewise if you never wear proper eye protection from the sun or blue-violet light sources you won’t be able to stop everything from happening the day you are diagnosed with an eye disease.  Ultimately we want to prevent blindness; in nearly every case symptoms of vision loss happen after structural changes have taken place.  Measuring and imaging these structures is the most important step you can take to saving your vision.  The most common reason for a glasses prescription change in this population is called presbyopia.  Presbyopia is condition that causes use of bifocal, trifocal, and multifocal lenses.  Multifocal is often the best choice in glasses or contacts because it enables you to see at the three distances we care about in life for the rest of your life.  We don’t notice that we can see better at distance than near when we are able to change focus for near objects, but when we can’t (due to presbyopia) we soon realize that the focal distance matters.  Things are clear at a single distance only through one prescription (single vision) unless we are able to change focus for near (not presbyopic) or have a lens that makes more than one distance clear (bi- = 2, tri- = 3, multi- or progressive = multiple).  Progressive lens design has evolved and will perform better with newer technologies, so if you haven’t been successful in a multifocal lens don’t rule it out.  However, the “add” or difference in focus between the near and far increases with time and the multifocal design of any lens is easier to use when the difference is smaller (less than +1.25).  If we wait to get a progressive lens when we need it we may never adapt to the design and this leaves us with terrible choices: 1) just don’t ever read, use the computer, look at your dashboard, or care to ever see detail at arms length; 2) Lined Trifocals (ugh, very cumbersome and a technology that hasn’t gotten an update in decades); or 3) buy 3 pairs of single vision glasses every time our prescription changes significantly.