Benefits of a Dilated Eye Exam

Baltimore Washington Eye Center, Maryland

Thursday, July 7, 2011

Benefits of a Dilated Eye Exam

Guest Blogger:
Shari E. Strier, O.D. with the Baltimore Washington Eye Center

Recently I saw a patient for a routine eye exam. She was in her forties and reported being in good health. She had no significant complaints, she just wanted to come in for an exam because it had been a long time and her near vision was starting to become blurred. She was 20/20 at distance with no correction and was in the early stages of presbyopia. We discussed a low powered pair of reading glasses to address that issue. As part of the full exam we dilated her eyes. When I examined her retina I discovered that in one eye she had a cluster of flame-shaped hemorrhages near a blood vessel on her retina. I diagnosed a branch retinal vein occlusion.  This is a condition that occurs when an artery that has become stiff and inflexible crosses over a vein and pinches it impeding the outflow of blood through that vessel. Since the blood cannot drain it backs up on to the retina presenting as small hemorrhages.

Although the patient appeared to be in good health and had no other symptoms I asked her to see her primary care physician for a routine physical and blood work. Since the vein occlusion was not threatening her vision no treatment was required and I scheduled her to follow up in two months. When she returned for her follow up visit I asked how things and gone with her primary care. She reported that although almost all of the tests had been normal her triglyceride levels were through the roof!

Elevated triglycerides have long been associated with atherosclerosis or plaque formation in the arteries. But a recent Danish study has found a strong link between elevated triglycerides and increase risk of stroke. The study found that women with triglyceride levels of 443 mg/dL had nearly quadruple the risk of suffering a stroke, compared to women whose levels were less than 89 mg/dL. Those with levels between 89 and 177 mg/dL had a 20 percent increased risk. Men’s increased risk ranged from 20 percent to 2.3-times higher, with the risk increasing as triglyceride levels went up. With proper diet and sometimes the use of statin medications triglyceride levels can be reduced.

The only way to view someone’s blood vessels without cutting them open is with a dilated eye exam. Luckily my patient came in for her exam and we saw a sign that pointed us toward a silent underlying problem before it had caused any devastating consequences.