You are here:

Dilated eye exams are critical

Viewing the back of the eye helps catch problems earlier.

Reading an eye chart every few years isn’t enough to maintain eye health and prevent complications down the road. Earlier this year, the American Academy of Ophthalmology (AAO) came out with a statement urging everyone to have regular dilated eye exams that allow physicians to see clearly into the back of the eye. “It’s critical to have dilated exams,” says Dr. Jeffrey Heier, director of the retina service at Ophthalmic Consultants of Boston and clinical instructor in ophthalmology at Harvard Medical School. “Once problems occur, vision loss can be irreversible. Catching problems early can help preserve vision.”

Anatomy of the eye

Anatomy of the eye

Most common risks

Dr. Heier points to three main conditions that have no symptoms initially and may go undetected without a dilated exam. One is glaucoma, in which pressure is increased in the eye. “By the time you recognize that you have glaucoma, you could have lost a significant portion of your visual field and have significant damage to the optic nerve,” he explains. Another disease is diabetic retinopathy, which causes damage to blood vessels in the retina. Finally, age-related macular degeneration often has no symptoms at first, but it can gradually destroy the macula, the part of the eye that provides the central vision needed for seeing objects clearly. Discovering any of these conditions early can help slow or prevent progression.

Catching problems early

Dilated exams are painless but can be time-consuming, which may be why some people put them off. After an initial vision check using eye charts and a device to measure the intraocular pressure in your eye, a technician will place drops in your eyes that enlarge the pupils. They’ll stay enlarged for several hours, which may require that you have someone drive you home. Light will appear brighter with your pupils dilated, so keep sunglasses handy.

Dilated pupils enable the doctor to look into the back of the eye for signs of disease. Sometimes doctors find more than just eye conditions. Dr. Heier says the eye is really an extension of the brain, so you can see signs of vascular disease, which may warn of impending stroke or heart attack. “A few times a year I see evidence of plaques in the eye that tell us the patient is at risk of systemic disease, and it turns out they have plaques or blockages in the arteries supplying blood to the brain or heart,” he says.


With so much at stake, the AAO recommends that by age 65 you have a dilated eye exam every one to two years, or as directed by a doctor. You can also protect your eye health by taking care of your overall health. That means eating a well-balanced diet and watching your cholesterol and blood sugar. “Taking care of those things that help you systemically also take care of your eyes,” says Dr. Heier. Research shows that vitamin supplementation with antioxidants, as well as leafy green vegetables such as spinach, can help people with intermediate macular degeneration. And as we reported in the August 2012 Harvard Health Letter, omega-3 fatty acids found in fish, flaxseed, and supplements may also help protect your vision.

Posted by: Dr.Health

Back to Top