Eye care and prevention: why it is important to have an eye examination
Already in the early years of life it is recommended to have an eye examination. As time goes by, this becomes even more important, as diseases such as cataracts, glaucoma and diabetic retinopathy may occur due to old age, other diseases and family history
WHEN TO HAVE THE FIRST EYE EXAMINATION?
All children should have their first eye examination together with an orthoptic test at around 4 years of age and repeat the examination once a year, or as indicated by the treating ophthalmologist.
This allows the functional state of the eye to be assessed and any refractive defects such as myopia, hypermetropia, astigmatism and amblyopia (lazy eye) to be discovered so that they can be corrected with glasses, contact lenses or possible occlusion.
Even in adulthood it is important to have eye examinations, especially from the age of 40, the age at which the risks of serious diseases increase and one begins to have small problems in near vision (presbyopia) that can be corrected with glasses.
EYE EXAMINATION – WHAT IS IT FOR?
It is important to have an eye examination to assess the cornea, crystalline lens, intraocular pressure, retina and optic nerve.
The crystalline lens tends to lose its transparency over time, developing what is called a cataract.
This, when it limits the patient’s quality of life, requires surgery.
The pressure of the eye normally ranges between 10 and 22 millimetres of mercury.
Increased intraocular pressure associated with optic nerve damage is called glaucoma.
Glaucoma is a subtle disease because it is asymptomatic, but if left undiagnosed and untreated, it leads to a reduction in the visual field (perceived space around the eye).
An eye examination also allows the state of the arteries, veins and retina to be assessed
The vessels of the eye are among the smallest in the body.
When the patient has diseases such as hypertension and diabetes, the first changes can be detected precisely at the level of the retinal microcirculation.
It is therefore important to examine the fundus of the eye in order to provide the internist or cardiologist with indications for further investigations.
Studying the fundus of the eye also includes assessment of the macula (small retinal area that allows distinct vision).
Maculopathy is one of the most frequent causes of visual impairment after the age of 70.
In order to diagnose and treat it, it is important to assess the macula and possibly perform diagnostic tests such as OCT (Optical Coherence Tomography), Angio-OCT, fluorangiography and indocyanine green angiography.
GLAUCOMA
Glaucoma is a subtle and unrecognised disease.
It is a disease of the optic nerve that involves a characteristic loss of fibres and a reduction in the visual field.
It is essential, if there is a family history or a doubt about increased eye pressure, to carry out specific investigations such as
- corneal pachymetry; assesses the thickness of the cornea (which remains constant throughout life);
- tonometric curve; measurement of eye pressure during the course of the day (should be performed at 7.30am, 12 noon, 4pm and 7pm). Eye pressure varies throughout the day and a single extemporaneous measurement does not allow for a correct assessment. This test can be performed 2 or 3 times a year and is closely linked to the pathology, the therapy and the specialist who will perform it;
- visual field; it is performed with computerised instruments, which present standardised light stimuli. The patient fixes a central aim and is asked to press a button every time he sees a light stimulus, even if it is of mild intensity, in the space in front of him;
- hrt; a test that studies the fibres that make up the optic nerve.
These tests are non-invasive, painless and can limit glaucoma-induced damage.
DIABETIC RETINOPATHY
Diabetic retinopathy is an ocular complication of diabetes.
It is due to damage to the retinal blood vessels.
It can develop in anyone with type 1 and type 2 diabetes.
The risk of developing diabetic retinopathy is associated with the age of onset of diabetes and blood glucose control.
The test that has always been used to study diabetic retinopathy is fluorangiography.
This is performed by injecting fluorescein intravenously; this dye is evenly distributed in the veins and arteries and makes it possible to pick up the changes that diabetes produces.
Today, fluorangiography is increasingly being replaced by oct and angio oct, non-invasive tests that can study the microcirculation and provide the diabetologist with precise indications on the need to change medical, dietary or insulin therapy.
CATARACTS
Cataract is a very common pathology that is part of the normal ageing process.
Cataracts consist of the opacification of the crystalline lens and, depending on the type, can lead to difficulties in night vision, blurred or hazy vision, photosensitivity, glare, perception of halos around lights and double vision.
SURGERY
Cataract surgery is among the most frequently performed operations in the world.
It is a procedure that is recommended as soon as the transparency of the crystalline lens interferes with the quality of life, as the patient with suboptimal vision tends to withdraw into himself and limit his usual activities.
It is generally performed without hospitalisation with only a few drops of eye drops as local anaesthesia.
The patient remains awake during the procedure but feels no pain.
The technique used is phacoemulsification, which can now guarantee immediate visual recovery and a considerable reduction in complications.
The procedure generally takes about 15 to 30 minutes depending on the procedure used, and the patient can return home after a few hours.
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