Eye exams and eye health: when to consult?

Eyesight often deteriorates so gradually that we don't realize it. We attribute headaches at the end of the day to fatigue, bring the screen closer without thinking about it, avoid driving at night without really asking why. The problem with most eye diseases is that they settle in silently, sometimes for years, before triggering a signal strong enough to prompt consultation.

A regular eye examination is not just about updating an eyewear prescription. It detects conditions that, if caught early, can make all the difference to long-term visual health.

What a comprehensive eye exam can detect

A comprehensive ophthalmic or optometric examination goes far beyond a simple test of reading letters on a chart. It assesses distance and near visual acuity, color vision, peripheral vision, eye muscle coordination and the health of the eye's internal structures, including the retina, optic nerve and lens.

Many serious conditions can be detected during this examination, even before symptoms appear. Glaucoma, for example, gradually destroys the optic nerve and can lead to irreversible blindness if left untreated. It is often asymptomatic until advanced stages. Age-related macular degeneration, the leading cause of vision loss after age 50 in Canada, can be detected by fundus examination. Diabetic retinopathy, a complication of diabetes that affects the small vessels of the retina, is another condition whose early detection radically changes the prognosis.

Eye examinations can also reveal signs of systemic diseases. High blood pressure and diabetes leave visible traces in the retinal vessels even before general symptoms appear. In this sense, the eye is a window on overall health.

How often to consult according to age

For adults aged 20 to 39 with no known visual problems or risk factors, an examination every two to three years is generally sufficient. Between the ages of 40 and 64, the recommended frequency is increased to every one to two years, mainly because presbyopia sets in at this age and the risk of glaucoma increases. From the age of 65, an annual examination is recommended.

These intervals become shorter for diabetics, hypertensives, those with a family history of glaucoma or macular degeneration, and contact lens wearers. In these cases, annual or biennial follow-up is the norm from adulthood onwards (Canadian Association of Optometrists, 2023).

Symptoms that can't wait

Certain ocular signs warrant prompt consultation, without waiting for the next preventive appointment. Sudden vision loss, even partial, is a medical emergency. Flashes of light or a sudden appearance of numerous floating bodies may indicate retinal detachment, an ophthalmological emergency requiring rapid intervention to preserve vision. Intense eye pain accompanied by redness and blurred vision may signal acute angle-closure glaucoma, also an emergency.

Sudden double vision, eye deviation or drooping eyelids may indicate an underlying neurological problem that requires immediate medical evaluation.

Frequently asked questions about eye health

Is an eye exam covered by RAMQ?
In Quebec, optometric examinations are covered by the RAMQ for children under 18, people aged 65 and over, and social assistance recipients. For other adults, the examination is generally at the patient's expense, unless prescribed as part of a medical follow-up for a specific condition such as diabetes.

Should I see an ophthalmologist or an optometrist?
For routine examinations, the optometrist is the first-line professional. He can detect major eye pathologies and refer patients to an ophthalmologist if surgery or specialized medical treatment is required.

Does screen work damage the eyes?
Computer vision syndrome, characterized by dry eyes, visual fatigue and headaches, is common among intensive screen users. It does not cause permanent damage to eyesight, but it is uncomfortable and can reduce productivity. Regular breaks, appropriate lighting and adjustment of screen brightness alleviate the symptoms.

Can myopia be curbed in adults?
Progression of myopia generally stabilizes in late adolescence or early adulthood. In adults, correction remains the main approach, whether by glasses, contact lenses or refractive surgery, depending on the case.

When to consult a healthcare professional

If you haven't had an eye exam for more than two years, if you have diabetes or high blood pressure, a family history of glaucoma or macular degeneration, or if you notice a change in your vision, a consultation is essential.

A physician or specialized nurse practitioner can integrate an eye health assessment into a complete health check-up and refer you to the appropriate resources. A face-to-face consultation at one of our Omicron Clinic in Quebec, or in teleconsultation for an initial assessment, to get the ball rolling without delay.

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