The dilated eye allows almost the entire lens to be viewed and is one of the few places in the body we can see the blood vessels, nerves, connecting tissue in action – without surgery. During dilation, doctors may discover patients with poorly controlled high blood pressure, diabetes, and those at risk for strokes.
A good view of the nerve lets us diagnose high pressure around the brain and inflammations of the nerve, such as multiple sclerosis. Presence and extent of cataracts can also be documented. Pseudoexfoliation, a “dandruff-like” appearance on the lens surface associated with glaucoma, is another example of lens pathology more easily discovered with dilated pupils.
The central and back portions of the eye require dilation to be fully seen. Retinal tears and detachments often occur in the retinal periphery. Indirect ophthalmoscopy, or other means of observing the peripheral retina, is essential when a patient experiences flashes and floaters. Evaluating the optic nerve to help diagnose and treat glaucoma is more easily accomplished with dilation. Macular degeneration and diabetic retinopathy are other common retinal problems. A larger pupil facilitates the search for complications that can be corrected by medication or laser treatment.
Regular eye appointments are recommended and should be part of living a healthy lifestyle. Genevieve, a 38-year old mom of two boys would tell you she didn’t schedule regular checkups for herself. But her son was already seeing a pediatric doctor at Eye Surgeons when she developed a blind spot in the center of vision in her left eye. Her son’s good relationship with Dr. Frederick incented her to make an appointment for herself with Eye Surgeons.
Having specialists within Eye Surgeons gave Genevieve access to a whole team of experts who worked in collaboration to diagnose her. Dr. Hansel performed a dilated exam discovering hemorrhaging in the retina and suggested that she may have diabetes. He ordered lab work and made a note for them to check her white blood cell count in addition to blood sugars. Her labs came back with normal blood sugar levels but her white blood cell count was extremely high. It was the night before Thanksgiving. Dr Hansel consulted Dr Wagle. He took a look at her. Dr. Wagle was worried that her white count was so high that she was at risk for having a stroke, that he drove her to the hospital emergency room himself. It was there Genevieve was diagnosed with CML or chronic myeloid leukemia. She was transferred to University of Iowa hospitals to be treated by doctors familiar with her urgent circumstances.
It’s been about a year now since her diagnosis, and Genevieve treats her leukemia with oral chemo and is managing her condition well. “I’m so grateful to Dr. Hansel for being so smart. It was at his suggestion on the lab work to check the white count in addition to the blood sugars. That one notation made such a difference in how quickly my condition was discovered and then was able to be treated,” Genevieve says. She has maintained regular eye appointments and can now continue checkups on a yearly basis.
Dilation has its purposes. In spite of the temporary discomforts, it is indispensable for the diagnosis and treatment of various ocular conditions, helping us to prevent vision loss and occasionally catching other health conditions, hopefully early, when treatment is most effective.
BIO’s : Dr. Hansel is an optometrist with Eye Surgeons Associates. He is currently the co-president of the Mississippi Valley Optometric Society and practices at Eye Surgeons Associates Bettendorf, IA office.
Nikhil Wagle, M.D., with Eye Surgeons Associates, is board certified with a fellowship in Glaucoma. He sees patients in our Silvis, Rock Island, Muscatine and Bettendorf offices.
The material contained in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider.