A New Timetable for Eye Examinations
Annual eye exams used to be traditional wisdom. Now, experts agree that seeing your eye doctor every year might be overkill for adults, especially if you are under 40 with no vision problems.
Adults 25 to 35 probably can get by with eye exams every two years, according to the American Optometric Assn. Annual exams are recommended for everyone else.
The American Academy of Ophthalmology also says adults under 40 without eye disease or vision problems (or who are not at risk for such problems) probably don’t need annual exams. However, from age 40 to 64, a period of two to four years between exams is advised, barring problems or injury. Beginning at 65, an exam every one or two years is recommended.
However frequent, a complete eye exam should include a number of evaluations, according to Art Corish, an Irvine optometrist and assistant professor at the Southern California College of Optometry, Fullerton, and Dr. Donald Schwartz, a Long Beach ophthalmologist and president of the California Assn. of Ophthalmology. Here are the components of a complete exam:
* A thorough medical history, including any family history of vision problems.
* Exams for visual acuity, a measurement of how well you see at near and far distances, along with evaluations of any nearsightedness, farsightedness or astigmatism.
* A test of the ability to change focus easily from far to near and near to far objects.
* Inspection of the exterior of the eye, including the lids, to detect any small growths that might be cancerous or to detect other diseases such as diabetes.
* Peripheral vision testing and depth-perception testing.
* For patients over 40, tests for presbyopia, an age-associated loss of ability to focus on near objects.
* Evaluation of eye coordination and eye muscle function to determine if the eyes are working together.
* A test of intraocular pressure to detect glaucoma.
* Inspection of the inside of the eye. Some eye doctors take a “retinal photo,” an instant snapshot of the back of the eye or other parts to evaluate ocular health, Corish says. “Ocular photography enables the doctor to monitor change over time,” he adds. Over the last few years, more general practice eye doctors have been using the snapshot evaluation. But some eye doctors, including Schwartz, believe these photos are not necessary in a routine eye exam; the same information can be obtained from a complete visual inspection.
For a complete eye exam, it may be necessary to dilate the pupils. Special drops are used to relax the muscles that cause the pupil to constrict and enlarge, allowing the eye doctor to see interior structures.
Dilated pupils usually take four or five hours to return to normal size, making reading, driving and other tasks impossible until then. Now there are drops to reverse the dilation faster.
Called Rev-Eyes, pupils are returned to normal in about 20 minutes, says a spokeswoman for Storz Ophthalmics Inc., the St. Louis-based developer of the drops. Some eye doctors say the drops are handy but not for everyone; irritation can occur.
EYEGLASSES UPDATE
Spectacles That Last Longer, Look Better
About 130 million Americans wear eyeglasses, according to estimates from the Better Vision Institute, a nonprofit organization funded by the eye care industry for public education.
Thanks to improved design, spectacles are lasting longer and looking better.
Prices are dropping slightly. The average retail price for a pair of glasses--including frames, lens and the exam--was about $132 in 1991, down slightly from 1989 ($135), according to Better Vision Institute statistics.
Other improvements:
* “High-index “ lenses can help the highly nearsighted kiss their “Coke bottle” glasses goodby. “The lens itself is made of a denser material,” says Gil Weber, a Los Angeles optician. “It bends the light more so you can make do with thinner lenses.”
* Photochromatic lenses made of plastic have improved in the past few years, Weber says. Now, most are comparable in quality to glass photochromatic lenses, but without the excess weight. “If your sole criteria is, how much do they darken, glass is still best,” Weber says. But if comfort and safety play a role, plastic is a good option.
* Eyeglass frames are holding their shape and their color better. “It’s more common to find springs on hinges, which help the frames hold their shape better,” Weber says. “Some frames have springs in the nose pads, like little shock absorbers.”
For more information: A brochure on choosing eye wear is available from the Better Vision Institute, (800) 424-8422.
