5 Eye Care Misconceptions Series- Common Diseases
We all have misconceptions on a variety of topics. We don’t swallow 8 spiders when we sleep, swimming after eating is not hazardous, and all colors of fruit loops have the same flavor (wait, that’s true?!!). I plan on making a series of misconceptions on different subcategories in my specialty, Ophthalmology. We will go over things such as misconceptions on eye care insurance, what to expect during surgeries/procedures, and correct drop usage. Let’s start off with misconceptions on common eye diseases.
- “I just done told you that my eyes are tearing up, why are you saying that they are dry?!” Eye dryness is very common in my neck of the woods, West Texas. It is not only a nuisance to the patient, but can affect day and night vision. Symptoms range from irritation, burning, blurriness, redness, and yes, TEARING! Many patients are confused when I say eye dryness causes tearing, but you can think of it as a defense mechanism. The eyes are producing tears to help combat the dryness. I tell my patients not to wait until their eyes feel dry to start treating them because by that time they are screaming of dryness. You want to get ahead of the symptoms by making a daily routine out of appropriate treatment (e.g. warm compresses, artificial tears, and eyelid scrubs).
- “I am taking eye vitamins for Macula degeneration. Does that mean it won’t get worse?” Macula degeneration is deterioration of the macula, the part of the retina that is responsible for your central vision. The first, second, and third biggest risk factor for getting macula degeneration and it worsening is smoking. Taking your eye vitamins and protecting your eyes from UV sunlight are both good ways to prevent more deterioration. However, if you haven’t limited/stopped smoking then it’s like downing your Crestor cholesterol pill with a chili-cheese burger (I am sure there is someone in the world that does this). Now I know smoking is one of the hardest habits to break but that is where the greatest priority/effort should be placed.
- “I have diabetes but I see great. Do I really need to be examined yearly?” Absolutely! Patients newly diagnosed with type 2 diabetics by their primary care provider need eye exams because there is a good chance that they have harbored the disease before it was caught. Typically, it can take years for the disease to show signs of damage in the eye, called diabetic retinopathy. However, due to late diagnosis one out of five new onset type 2 diabetics will have signs of eye involvement on their very first diabetic eye exam. Now, just because ophthalmologists see diabetic retinopathy doesn’t mean we will immediately act upon the findings. We advise our patients to control their blood pressure, cholesterol, and blood sugar to prevent progression. Controlling two out of the three will still allow the disease to progress, albeit slower. If the disease continues to worsen past the stages of mild to moderate to severe then eye care providers will start taking over with treatment, mainly in forms of injection of medicine in the eye and laser. I know it sounds horrible to get injected in the eye with a needle but millions of injections occur every year in the US alone with good results and minimal discomfort. The reason for the frequent diabetic exams is so we can treat the retinopathy in that stretch where the disease is worsening but the patient hasn’t noticed visual changes yet. By the time the patient notices visual changes from diabetes it is usually way down the road.
- Two Extreme viewpoints: “I have glaucoma I heard there was no treatment for that” or “Doesn’t treatment X cure Glaucoma.” The optic nerve connects the eye to the brain, and glaucoma damages this nerve over time. Not unlike any other nerve in the body, damage to it is usually permanent. This can result in irreversible loss of peripheral vision, leaving one with tunnel vision. The only thing that consistently helps with slowing/stopping the progression of glaucoma is to lower the eye pressure. Glaucoma is a disease of age and may manifest itself after years of eye examinations. The good thing is this isn’t like your parents’ glaucoma where treatment options were limited. There is a whole new line of minimally invasive glaucoma surgeries and drops that are helping slow the disease, but unfortunately not curing it.
- “Gasp…I have cataracts, what did I do wrong!” I will tell a patient that they have cataracts and occasionally will get a reaction as if I gave them a death sentence. Disclaimer: almost everyone gets cataracts if they live long enough. Cataracts are a clouding of a once crystal clear lens that helps us focus on near and far objects. Cataract surgery is one of the most common surgeries performed in the US with usually excellent results. However, it is important to know that despite the lens being an important component of vision, there are more important structures of the eye that if not healthy will trump your recovery from cataract surgery. So for example, if you have bad macula degeneration, diabetes or glaucoma (see above) then despite having flawless cataract surgery done you still might not be able to see perfect/well, which can be disheartening to the patient. Diagnoses and treatment plans are not an all-for-one. Patients should feel comfortable relying on their doctors to give a diagnosis, treatment plan, and expected realistic results that is specific to the individual patient. Patients should be informed not to compare their results to their friend’s results. At the end of the day if that patient’s friend is seeing near 20/20 after cataract surgery they need to know why their results might differ.