Eye Exams Can Save Lives

Strokes, heart attacks and other potentially life-threatening illnesses can be diagnosed in advance by comprehensive, dilated eye examinations. When Lynn Nearman went in for what she thought was a routine eye exam, little did she know it could potentially save her life.

Photo by Nerissa Johnson.

Lynn Nearman  says a comprehensive exam by her eye specialist
“got the ball rolling” in helping her uncover other health challenges.

Lynn, who lives in Viera, has had diabetes for at least ten years and was careful about having her eyes examined each year. Diabetes can cause diabetic retinopathy, a disease process that results in bleeding in the retina – the back of the eye – that can cause loss of vision or blindness if not treated in an effective and timely manner. Diabetes also increases the chance of contracting other eye problems, including glaucoma and cataracts.
After experiencing blurry vision and floaters, and reporting this, Lynn sought the help of eye physician Michael N. Mandese, OD, of The Eye Institute for Medicine & Surgery. He diagnosed swelling in the back of her eyes and referred her to Retina Specialist Hetal D. Vaishnav, MD.
Dr. Vaishnav found that little blood clots, called Hollenhorst plaques, had traveled from elsewhere in Lynn’s body to the back of her eyes. After making this discovery, and understanding the potentially life-threatening consequences of their presence, Dr. Vaishnav made an immediate referral to cardiologists for a full work-up of her heart and lungs.
Doctors at the Mayo Clinic in Jacksonville subsequently located three clots, including one in her lung, “that could have killed her had they not been discovered,” according to Dr. Vaishnav.
The physicians at the Mayo Clinic discovered the underlying cause of the blood clot in her eye was due to an irregularity in Lynn’s heart rhythm.
“My heart doesn’t have a regular beat, and it’s not getting enough blood in the lower chamber,” Lynn elaborates. “If it wasn’t for Dr. Vaishnav, I wouldn’t have known about this heart problem, we wouldn’t have been monitoring it and I probably would’ve had more serious complications,” such as a heart attack.

Treating AMD

The grandmother of two from Connecticut also complained of distorted vision that made her think her eyes were “playing tricks” on her. Straight lines appeared crooked or wavy. While looking at the Atlantic Ocean one day, she thought she saw mountains and trees in the distance.
Dr. Vaishnav found “a little wrinkle on the back of her retina called a macular pucker, which is a very common problem among seniors. She also had the beginning of dry macular degeneration.”
Age-related macular degeneration, or AMD, a loss of function of the macula, the central portion of the retina, is a leading cause of blindness in people older than 50 in the United States. The macula is the part of the eye responsible for allowing a person to perceive fine details and color. AMD can leave a blind spot in the center of the visual field, which leads the brain to fill it with images from the person’s memory, Dr. Vaishnav educates.
“I have numerous patients who report seeing various types of distorted images, including mountains, trees and other anomalies,” states Dr. Vaishnav.
Lynn is presently taking vitamins recommended by Dr. Vaishnav to slow the progression of her AMD. Numerous studies suggest that AREDS formula vitamin supplements are effective at reducing the risk of AMD worsening, according to Dr. Vaishnav.
Dr. Vaishnav is also treating Lynn for swelling and bleeding in her eyes as a result of her diabetes. Over a period of time, Dr. Vaishnav has performed six injections – three in each eye – of medications designed to prevent further blood vessel growth, swelling and leakage in the back of the eyes.
While Lynn states that she had apprehension in advance of her first injection, she quickly learned that Dr. Vaishnav and his team do all that they can to numb the eye in advance of the procedure. After her first injection, Lynn reports, the apprehension disappeared.
In addition, Dr. Vaishnav is monitoring Lynn for hypertensive retinopathy, which he describes as high blood pressure-related changes in the eye.
Last spring, Lynn had her cataracts removed by The Eye Institute’s Jason K. Darlington, MD. She’s happy the surgery has improved her vision, hopefully allowing her to drive again and maintain her independence.
Despite her many health challenges, Dr. Vaishnav calls Lynn “a very lucky lady.”
“Her prognosis is excellent,” he informs, “because we know how to stop people from going blind from many of these conditions, including diabetes.”

Healthy Eye, Healthy I

Toward that end, Dr. Vaishnav created a grass-roots program called Healthy Eye, Healthy I. Through presentations to primary care doctors and community organizations, Dr. Vaishnav stresses that eyes can be a window to someone’s overall health and well-being.
“We can look inside the eye and diagnose lots of different medical problems,” he explains. “Some people think that an eye examination is just an independent test. You get an exam, you get glasses and you’re done.
“Many times, we see patients who come in with blurry vision who believe that all they need to address their concern is a new eyeglass prescription. Ultimately, we may determine that they have a tumor, or heart disease, or blood clots or vein occlusion that was caused by high blood pressure or diabetes.”

I want to get taken care of by the best, and whatever Dr. Vaishnav says, I will do.

The structures of the eye lend themselves easily to evaluation and diagnosis, Dr. Vaishnav teaches. Ocular blood vessels and nerves are directly visible to the physician. Also, the eye receives a significantly greater amount of blood flow than other organs in the body, allowing eye physicians to gauge a person’s circulatory system.
The American Academy of Ophthalmology recommends an annual, comprehensive eye exam – not just a vision screening – for anyone with a vision-threatening systemic disease or a family history, as well as for those over age 40.
Lynn says she feels “very comfortable” placing her eye health in Dr. Vaishnav’s hands. He puts her at ease by carefully explaining every procedure and outlining the expected outcome.
“I’m glad that I’m seeing the top specialist,” she enthuses. “I want to get taken care of by the best, and whatever Dr. Vaishnav says, I will do.”

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