Eyes are windows to good health

An eye test can do more than spot fading sight – it can actually save your life, as Danny Buckland reports

When Amber Carter walked into an optician’s, her main fear was that she might have to wear glasses.

But the routine test led to the alarming discovery of a brain tumour, the size of an orange, and she underwent nine hours of life-saving surgery the next day.

The 23 year old’s optometrist, Anna Lewin, of Haine & Smith, in Chippenham, Wiltshire, had spotted swollen optic nerves and referred her to hospital. Surgeons at Bristol’s Frenchay Hospital excised the benign growth in an emergency operation.

Ms Lewin says: “I could see her optic nerves were swollen in both eyes and that can indicate the presence of a tumour. Amber was completely shocked.”

Modern eye tests have become powerful health screening interventions that can help to pick up early signs of diabetes, high blood pressure, raised cholesterol levels, as well as brain tumours.

The procedures that determine strength of vision and potential eye defects also have far-reaching capabilities to provide early warnings for a range of conditions in patients who may not be displaying obvious symptoms.

“The eyes are one of the few parts of the body where we have clear visibility of the microvascular network,” says Vicky O’Connor, optometrist for Boots. “This, alongside the range of visual and eye-health checks, can help us detect many systemic general health conditions.

“We are familiar with the cliché that the eyes are the windows to the soul, but it is realistic to suggest they are also windows to many medical conditions.”

A key factor in eye tests is the digital retinal photograph taken of a patient’s eye, which provides valuable eye and general health indicators

Optometrists are skilled at recognising and addressing eye complaints, but they are also trained to help sleuth out potentially serious conditions from the bank of checks completed as part of every correct eye test.

“A patient may come in for a routine eye check and will feel completely fine, yet the eye examination may reveal suspicious changes in the characteristics at the back of the eye and that could point towards diabetes,” she adds. “We may be able to refer the patient to their GP before any other symptoms are displayed.”

A key factor in eye tests is the digital retinal photograph taken of a patient’s eye, which provides valuable eye and general health indicators.

The optic nerve, the part of the eye that sends messages to and from the brain, appears as a round, pale area slightly off-centre. Its qualities are unique to the individual, rather like a fingerprint, but observation of nuances of shape, colour and size can reveal evidence of glaucoma and brain tumours.

The macula, a tiny area at the back of the eye, which generates the greatest detail of our vision, is prone to subtle but impactful changes caused by ageing, smoking and UV exposure, which signpost the potential for age-related macular degeneration (AMD), the leading cause of blindness in the UK.

The rest of the examination, which covers the mid-peripheral and peripheral retina, considers arteries, veins and blood vessels that show up as lines tracking across the retina. They change in shape and overall appearance when high blood pressure, raised cholesterol and diabetes are present in the body.

“Some patients may present with no symptoms and are very surprised when other conditions are spotted. It can be a huge relief that they can begin to address these conditions so early on,” says Ms O’Connor. “Eye checks are important for those who have experienced symptoms because, although they won’t always be caused by something as significant as a brain tumour, they can be investigated further and next steps decided.

“Cases like Amber’s are rare, but do happen, so an eye test does provide a measure of medical reassurance as well as making sure your eyes are healthy.”

Amber concludes: “If I hadn’t gone to the optician, I probably wouldn’t be here now so I’m really grateful. Things are really good and I’m now back at work.”

CASE STUDIES

LUCKY TEST ON DAY OFF

A chance visit to an optician saved psychology graduate Rhiannon Campbell from a life-changing neurological disorder.

Staff spotted swelling and haemorrhages at the back the 23 year old’s eyes and referred her to hospital for tests, which subsequently diagnosed idiopathic intracranial hypertension that can lead to serious neurological complications.

“I only went in because my mum was picking up her glasses and I happened to have a day off,” says Rhiannon, from Coatbridge, near Glasgow. “They certainly saved my sight and, as far as I’m concerned, they saved my life.”

Rhiannon, who in May 2011 was completing her third-year exams at Strathclyde University when she had the test at James Hughes Opticians in Coatbridge, had no obvious symptoms and associated a downturn in health with stress.

“I would have kept going and put any headaches, which may have suggested a problem, down to the exams,” she adds. “I shudder to think what might have happened had I not gone in that day.”

CT scans showed no signs of a brain tumour, but a lumbar puncture recorded a spinal fluid pressure more than four times normal which manifested behind her eyes. Fluid was drained to relieve the pressure and Rhiannon, a volunteer counsellor and part-time supermarket employee, now takes daily medication to control the condition.

“I hadn’t been to the optician for four years so it shows how important it is to have regular checks,” she says. “I was very lucky.”

REAL-LIFE HOSPITAL DRAMA

Sarah Atkinson had to swap a trip to the cinema for a dash to hospital after a routine eye test uncovered evidence of a cyst.

The 29-year-old deputy restaurant manager had brain surgery at Nottingham’s Queen’s Medical Centre to remove the golf-ball-sized tumour five days after the visit to her optometrist in Derby.

The cyst, which had been blocking fluid circulating around her body, had caused headaches and blurred vision, which were diagnosed at a previous hospital visit as a viral infection, and she was discharged.

But a week later the growing problem was spotted by Vision Express optometrist Philippa Myers, who says: “Her retinal scan showed something quite unusual – a swelling of the optic nerve – and it worried me greatly, which is why I wanted her seen straight away. I am glad I spotted it.”

Sarah, from Heanor, adds: “My boyfriend was waiting outside the shop as we were going to the cinema afterwards, but he ended up driving me to hospital.

“Before the operation, I was warned I might lose my speech and ability to write. I might even have a stroke or a seizure, or die on the operating table. But thankfully it was spotted early and I’m so thankful to Philippa for saving my life.”