Eye Health Exams
"The eyes are windows to the soul" is a phrase we have all heard. It is a true phrase in that examination of the eyes can give clues to many health conditions. For instance, problems with the liver, kidneys and heart will also have manifestations within the eyes.
The eye is a complex optical system - very similar to a camera. Vision begins when light enters the eye through the cornea, a powerful focusing surface. From there, it travels through clear aqueous fluid, and passes through a small aperture called the pupil. As muscles in the iris relax or constrict, the pupil changes size to adjust the amount of light entering the eye. Light rays are focused through the lens, and proceed through a clear jelly-like substance in the center of the eye called the vitreous, which gives it form and shape. When light rays finally land on the retina, the part of the eye similar to film in a camera, they form an upside-down image. The retina converts the image into an electrical impulse that travels along the optic nerve to the brain, where it is interpreted as an upright image.
Examination of eye health begins with the intake questionnaire and family history. This can give us clues as to potential problems. For example, the patient with glaucoma in the family has a much higher chance of developing glaucoma.
The anterior segment is usually checked first. Gross observation of the lids and lashes for any growths, discolorations or other abnormalities (such as no eyelashes) is carried out. The cornea, sclera, conjunctiva, iris/pupils and lens are next examined, usually with the biomicroscope. Diseases such as Cataracts, Dry Eye, Glaucoma and various Refractive Problems are common findings.
The posterior segment is examined last. This includes the vitreous, ciliary body/zonules, choroid, macula, optic nerve and retina. The indirect ophthalmoscope is the primary instrument used.
Additional
Links:
Optometric Clinical Practice Guideline for the Comprehensive Adult Eye and
Vision Examination
Optometric Clinical Practice
Guideline for the Comprehensive Pediatric Eye and Vision Examination
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