An eye examination, commonly known as an eye test, is a series of tests performed to assess vision and ability to focus on both far and near and discern objects. It also includes other tests and examinations of the eyes. Many eye conditions are associated with systemic health, and many diseases can have manifestations in the eye. Certain systematic medications can cause ocular side effects and warrant routine eye exams.

Hypertension

Longstanding hypertension can contribute to microvascular damage of the blood vessels in the retina, leading to hypertensive retinopathy.

Malignant hypertension can lead to papilledema, which is the swelling of the optic nerve. This is a medical emergency and can lead to blindness.

Autoimmune disorders

Autoimmune disorders can affect the eyes in different ways. Sjogren's disease manifest as dry eye.

Medication use

Hydroxychloroquine

Hydroxychloroquine, also known as Plaquenil, is an antimalaria medication commonly used to treat lupus and rheumatoid arthritis. Individuals who are on long-term hydroxychloroquine for more than 5 years are recommended to have a comprehensive eye exam annually. Patients usually receive a baseline exam before starting the medication to document their baseline eye condition as well.

Corticosteroids

Corticoteroids can have ocular side effects. It can increase the intraocular pressure, which can lead to glaucoma. The position of the eyelids are checked for abnormalities such as ptosis which is an asymmetry between eyelid positions. Any asymmetry, discharge, pus, changes in color and structure around the eyelid will be noted. Often, children who are suspected of having amblyopia are too young to be able to verbally recognize letters on the Snellen chart, making the eye examination challenging.

It is critical to identify eye conditions early in children, as early detection and intervention can save vision and lives. Retinoblastoma is a rare but life-threatening eye cancer that primarily affects children under the age of 5. Amblyopia, often also called lazy eye, is a common condition in children where the neurological connection between the eye and brain fails to fully establish, resulting the brain's inability to process the visual information from the eye, despite normal structure and function of the eye. The treatment of amblyopia usually involves patching of the good eye. However, this intervention needs to happen in a critical period of time, usually before the age of 12, ideally before the age of 7 or 8, in order for affected children to achieve full visual potential in adulthood. Screening of ROP is often initiated promptly while the infants are still in the hospital, and they are often followed up closely in the first few weeks to months of life to monitor the normal development of blood vessels in the premature retina. Accommodation is the ability of eyes to adjust to various different distances of focus.

  • Medscape article on Neuro-ophthalmic examination