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Surprising things an optometrist sees during an eye exam

The eyes really are the windows to people’s health, doctors of optometry say.

American Optometric Association

The eyes are said to be windows to the soul. For doctors of optometry, they also offer an expansive look into your overall health, allowing optometrists to diagnose a wide array of common and not-so-common conditions, including diabetes, skin cancer and brain tumors.

Just ask Dr. Amber Dunn, who practices near Portland, Oregon.

In the early days of the COVID-19 pandemic, a teenage boy who was a longtime patient of Dunn’s needed contact lenses. Due to stay-at-home orders, Dunn performed an online video consultation and extended his prescription temporarily until he could come in for an in-person exam a month later.

“He said everything was fine and was having no issues at all,” Dunn said. “Once we got him into the office, I was able to do an in-person exam and take an image of the inside of his eye and found he had hemorrhaging and swelling in the back of his eye on his optic nerve. It was immediately apparent to me that he either had a mass in his brain or elevated pressure of the cerebral spinal fluid.”

After rushing to the emergency room, the boy was diagnosed with a tumor near the pineal gland in his brain and had to have an eight-hour brain surgery to remove it.

“Had I just been comfortable with that telehealth visit, I don’t know what would have happened to this young man,” Dunn said.

More than just vision tests

The episode underscores the importance of regular, in-person eye exams in preventive health care.

During the visits, doctors of optometry not only check the sharpness of your vision with those familiar eye charts, but they also examine the health of the eyes and eye tissue. Many sight-threatening diseases can be cured or slowed with early diagnosis and treatment, and many common vision problems can easily be corrected once they’re discovered.

“The eyes are not only our way of seeing the world — they also give doctors of optometry a clear view of patients’ overall health,” said Dr. William T. Reynolds, president of the American Optometric Association. “To treat patients effectively, we must have a wealth of knowledge in other areas of health care that can impact or manifest in the eyes. That’s why an in-person, comprehensive eye exam with your doctor of optometry is such an important part of preventative care.”

Optometrists can detect several non-eye related health issues.

Detectives looking for clues of disease

Like clues left behind by an intruder, diseases and other health conditions can cause telltale signs in the sensitive tissues and intricate mechanisms that make up a human eye. With their extensive training and specialized equipment, doctors of optometry can detect more than 270 serious health conditions, including diabetes, high blood pressure, autoimmune diseases and cancers.

For example, a swelling or thickening of the eyelid or the appearance of a colored mass on the eyelid can indicate skin cancer. Abnormalities in the tiny blood vessels inside the eye can reveal a wide variety of conditions, including high blood pressure or cholesterol, diabetes, and risk of stroke.

“We realize that often it’s the eye care part that is what the patient notices or that brings them into the office, only for us to discover some of these underlying medical things,” said Dr. Geoffrey Goodfellow, an associate dean with the Illinois College of Optometry in Chicago.

While telehealth played a limited but necessary role during the lockdown phase of the pandemic, the technology falls far short of what a doctor can provide in person.

“There are so many limitations to the diagnostic testing and views that we get via telehealth,” Goodfellow said. “If patients are able to get glasses or contacts online without an exam, that could be a missed opportunity to diagnose some of these vision-threatening or even life-threatening conditions that we see every day in patients who didn’t know they had them.”

To make an appointment with a doctor of optometry near you, visit the American Optometric Association’s doctor locator.

Members of the editorial and news staff of the USA TODAY Network were not involved in the creation of this content