By Deb Risden
William Shakespeare wrote that the eyes are the window to the soul. They are also a window to overall health, according to Amanda Walls, owner and optometrist at Falcon Family Eye Care.
“Your eye doctor should be part of your primary care team, and that should include an annual checkup,” said Walls, who earned her doctorate in optometry in 2010 from the Southern College of Optometry in Memphis, Tennessee. Before opening Falcon Family Eye Care in 2013, she worked as a pediatric optometrist in Colorado Springs.
Walls reports an increase in several eye conditions affecting both children and adults, along with advances in treatment options.
Increasing myopia in children
Walls said more children are developing myopia, or nearsightedness, at an early age. “Reports are telling us that by next year, 50% of kids will be struggling to see far away,” she said, attributing the trend largely to increased use of digital devices.
“The more you use digital devices and cellphones, the faster myopia develops,” Walls said. “I tell parents it’s normal and it gets worse every day. We don’t know how to stop it.”
There are two standard treatment options: myopia-management contact lenses and prescription eye drops. Walls said she prescribes the daily disposable contact lenses for children as young as 6. When worn consistently from about age 6 to 15, the lenses can slow progression of the condition.
“As myopia progresses, the eye stretches,” Walls said. “That can lead to more serious health issues inside the eye and can be debilitating to the point where someone may not qualify for a driver’s license.”
A prescription eye drop is also available and can slow progression.
Walls said insurance does not yet cover the cost of myopia-management contacts, which run about $1,500 a year, including follow-up visits. She expects coverage to improve within five years as demand increases.
Signs of myopia include squinting to see distant objects or difficulty reading a classroom board. “That’s when it’s time for a complete eye exam,” Walls said.
Adult eye health
Macular degeneration, glaucoma and cataracts remain the most common eye conditions affecting adults.
Macular degeneration: The macula, part of the retina, provides central vision. With macular degeneration, the retinal layers begin to change and separate, sometimes allowing fluid to accumulate.
“There are dry and wet forms,” Walls said. “We don’t have treatments to cure the dry form, but studies show a vitamin called AREDS can slow progression.”
She said genetics play a role, and she recommends the vitamin for patients with a family history beginning around age 55.
The wet form is more aggressive and is treated with eye injections by a retinal specialist. Smoking, high blood pressure and high cholesterol are linked to worsening of the disease.
Symptoms include central vision loss or distortion, such as straight lines appearing wavy. Walls recommends annual retinal exams using imaging or dilation.
Glaucoma: Glaucoma affects peripheral vision and often progresses unnoticed. “It’s a silent disease that you can have for 10 or 20 years and not know it,” Walls said.
Early detection is critical. Treatment in the U.S. usually begins with daily prescription eye drops. If drops fail, surgery may be required. In Europe, surgery is often the first-line of treatment.
“A lot of times people forget to use the drops or refill prescriptions, and the disease progresses,” Walls said.
Diagnosis includes eye pressure checks and imaging of the retina and optic nerve.
Cataracts: Cataracts develop as the eye’s natural lens becomes cloudy with age. “Cataracts are a normal age progression,” Walls said. “About 95% of people will have cataract surgery at some point.”
Glasses or contacts cannot correct cataracts. Surgery, typically covered by insurance, takes about 10 to 15 minutes and replaces the cloudy lens with a clear artificial one, often correcting distance vision as well.
Walls said cataracts usually begin developing around age 55, with surgery commonly occurring between ages 70 and 80. “Cataracts are not a disease,” she said. “Everybody gets them.”
More than vision
Walls emphasized that eye exams can reveal more than vision problems.
“We can see signs of high blood pressure, diabetes, lupus, AIDS, multiple sclerosis, brain tumors and cancers,” she said. “There have been multiple times when I’ve seen something serious that the patient didn’t know was there.”
Falcon Family Eye Care provides most eye care services except surgery, including treatment for infections and removal of foreign objects. Walls recommended seeing a local optometrist for eye emergencies before visiting urgent care.
“Often we can see patients the same day, and we’re more specialized in eye-specific emergencies,” she said.
