Throughout our vast network, our Optometrists receive a lot of questions from their patients. There is a lot of information circulating on the web and on social media from sources that are not always very reliable, so the professionals within our large network always make it their duty to keep their patients informed. We asked Dr. Sophie Morissette, Optometrist at IRIS Saint-Bruno, Québec, to answer the questions that are most frequently asked in her office.

Dr Sophie Morissette, IRIS Saint-Bruno

Is it true that through our eyes, the Optometrist can see if we are healthy?
Indeed, I sometimes tell my patients that they cannot hide anything from me when they allow me to look deep into their eyes ...

First of all, it’s important to specify that an eye exam will never replace a doctor’s medical exam. However, looking at the retina, among other things, will often give us clues to the general health of our patients.

Small retinal hemorrhages may be an indication of the onset of diabetes. The presence of edema (swelling) in the macula (center of the retina) is also a sign. Uncontrolled or undiagnosed diabetes can also cause significant vision fluctuations within the same day.

There may also be signs of high blood pressure with changes in the appearance of the retina. It is even possible to find small plaques of cholesterol in the blood vessels of the latter.

Some patients may come to our offices with signs and symptoms of major glare and eye pain. If the final diagnosis is uveitis, we refer the patient to their doctor, especially if they are suffering from it for the first time. Uveitis can be a side effect of an autoimmune disease (e.g. our antibodies fight our own antibodies). An example of a well-known autoimmune disease is arthritis.

Dry eye usually means ageing of the eyes, but it isn’t always necessarily the case. A disruption in the functioning of the thyroid gland, a hormonal change or the fact the patient is taking certain medications may be responsible for symptoms of dry eye.

I usually end my explanations with my patients by telling them that it is not all that simple. The patient may have an undiagnosed systemic disease while having perfectly healthy eyes. The eye exam is used to detect eye pathologies first! The doctor is the only one who can make diagnoses concerning general health.

My vision worsened the moment I started to wear my reading glasses. Is this true? 
Well no. You really have to take the time to demystify how the eye works to understand what happens when our eyes are around 40 years old.

First of all, we have to understand that inside our eyes, we have a lens that is similar to the one on a camera. This lens contracts and relaxes depending on the distance from which the focus is placed. The lens is therefore motile, it has a certain flexibility. The more we have to look at an object that is close to our eyes, the more the lens has to contract (in our lingo, we say that it has to accommodate). The problem is that from our birth, this ability to accommodate decreases.

A person with a normal far vision will see well up close during their lifetime. Between the ages of 40 and 50, he or she will start to have trouble seeing small printing and will pull his or her arm further to see the same thing they once saw closer to their eyes. This phenomenon is called presbyopia.

The first pair of reading glasses will be necessary to avoid unnecessarily straining the eyes. At the start of presbyopia, the lens is still active, but slower and less flexible. This means that between the ages of 40 and 55, patients will need to adjust their glasses to their prescription, which will become stronger over time. The phenomenon of vision loss is therefore not linked to the fact that the patient has started to wear glasses but rather linked to the fact that the lens will slowly lose its flexibility so that at a given moment, it can no longer function at all. It is at that moment that presbyopia is at its worse. In our genetic code, it is written that sooner or later, our eyes will all be affected by presbyopia.

Of course, we will always hear about a grandfather or a grandmother that passed away at 94 years of age without ever having worn glasses. There are several reasons why this is possible. For example, if the patient is slightly short-sighted (nearsightedness = blurred far vision), he or she may be able to read without his glasses, even at the age when presbyopia should start affecting them. This does not mean that he or she does not have presbyopia but rather that one of the main vision problems of this individual is myopia which compensates for their presbyopia.

We have just lost a few readers here! However, let's remember that losing near vision acuity as you age is a normal phenomenon that is linked to age and not from wearing reading glasses.

Do not hesitate to wear glasses. These will help relieve the visual effort made from reading or from computer screens. Optometrists only want the best for their patients!