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Posted on 08-09-2016

I recently examined a very bright high school student who asked me a question that was both interesting and thought provoking; it was even kind-a funny.  His question was, "Don't you get tired of saying, 'Which is better, one or two' all day?"  

He made me smile because I almost replied, "yes!"  But, he genuinely seemed interested, so I took a few minutes to share some of the following with him.  Who knows, maybe I lit a spark in him to consider optometry as a career choice?

This article is also being written for those of you who are equally curious.  Some will find the following to be "TMI" (too much information).  However, I often find that some people really WANT TO KNOW about many different things, but they may be a bit intimated or just too shy to ask.  I hope you find the following interesting.

We optometrists actually do a lot more than simply ask, "Which is better, one or two."  When your eye doctor exams the outside of your eyes (lids, lashes, cornea, iris, conjunctiva and sclera), as well as the inside of your eyes (anterior chamber, lens, posterior chamber, vitreous, optic nerve, macula, retina, choroid, blood vessels, and more), he or she is looking for any anomalies that are outside normal limits.  Some abnormalities may be exclusive to the eye, but there can be findings that are associated with diseases affecting or emanating from other parts of the body.

For example, did you know that the following may be detected or diagnosed during a thorough eye exam - hypertension, arteriosclerosis, atherosclerosis, high cholesterol, diabetes, early stroke, an embolus in a blood vessel that can be considered a "stroke about to happen," space occupying brain mass, cancer (primary to the eye or metastatic, originating from another area of the body), inflammatory disease related to lupus... arthritis... back pain, and a host of other diseases.

Here are a few other systemic diseases that can either be diagnosed via an eye exam, or result in eye findings helpful in making a diagnosis: acute leukemia, liver disease, colon cancer, inherited adenomatous polyposis (FAP) syndrome, Fabry's disease, medication toxicity (Chlorquine, Plaquenil, Amiodaron, Temoxifen... ), pseudo-tumor cerebri, rheumatoid arthritis, systemic lupus erythematosus, diphtheria, onchocerciasis, adnovirus, varicella zoster, tuberculosis, syphilis, sjogren's syndrome... and the list goes on.

Take-Home Message:

It is important to keep in mind that many systemic diseases have ocular manifestations. Armed with this knowledge, pediatricians and primary care physicians often refer to optometrists and ophthalmologists for careful ocular examinations which can reveal subtle diagnostic clues. These clues may be the first sign of a serious systemic and potentially life-threatening condition.

Although many retinal, corneal, posterior and anterior segment findings are not specific to a particular systemic disease process, when they are associated with systemic symptoms, these findings may provide practitioners with valuable information.  For example, they may enable the practitioner to determine which additional tests to order, facilitating accurate and early diagnosis and treatment.  When systemic diseases are identified early, morbidity and mortality are minimized and the patient's quality of life is improved.  It would be highly beneficial if YOU TOO were an advocate for your own health care, and/or the care of your children.  You may also advocate on behalf of your elderly parents or other family members.  Just like the referring physicians, you too need to be armed with this knowledge and be proactive in seeking appropriate health care.

Please allow me to repeat something I wrote in my previous blog article.  Now that I am new to Facebook, I am discovering quite a number of friends/patients/family and community members who enjoy sharing using the FB format.  If you have questions about anything eye related - or you simply want to share your child's first steps - please post.  Having been in Anaheim Hills since 1977, I continue to enjoy learning new things about my extended family (all of my patients and the Anaheim Hills community)... and I love to write!

As usual, I am interested in your comments.  Please write to me at info@drcharm.com.  If you'd prefer, I wouldn't mind learning how to become more proficient using Facebook and/or the Anaheim Hills Buzz.  We could give those a try too.

Be well,
Dr. Harry J. Charm, Optometrist

Anaheim Hills Family Optometry
6200 E. Canyon Rim. Rd., Suite 101
Anaheim Hills, CA 92807
(714) 998-2020

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