Alyssa Westrate, O.D.: Why Year-End Vision Screenings Are Essential for Eye Health

In an interview with The Educated Patient, Alyssa Westrate, O.D., an assistant O.D. at Walmart Store 5386 in Grand Haven, Michigan, discusses how regular vision screenings are crucial for maintaining eye health, can detect conditions like glaucoma and macular degeneration early, and can reveal signs of underlying health conditions, such as diabetes and high blood pressure.

Why is it important to get a vision screening before the end of the year?

Alyssa Westrate, O.D.: Patients should schedule their eye exams before the year's end to make the most of their insurance benefits. Many vision insurance plans reset at the start of the new year, allowing patients to minimize out-of-pocket costs and fully utilize their annual coverage. Additionally, patients who don't have vision insurance might have healthcare accounts, like Flexible Spending Accounts (FSAs), which often don't roll over year to year. While some Health Savings Accounts (HSAs) do allow rollover, FSAs usually do not, so it's a good opportunity to use those funds on glasses and contacts before they expire.

What are some common vision problems screenings can detect early, and why does early detection matter?

AW: Screenings can catch diseases like glaucoma and macular degeneration early, allowing for treatments that can significantly improve outcomes. Many patients with early-stage glaucoma have no symptoms until the disease is in an advanced stage. Through regular eye exams, we can intervene with treatments like surgery or medication to lower eye pressure and prevent vision loss, especially peripheral (side) vision. Similarly, early detection of macular degeneration — particularly the more treatable "wet" form — can lead to better management through treatments like injections. For the "dry" form, we often recommend antioxidants like zeaxanthin and lutein to slow disease progression.

How do vision screenings help detect underlying health conditions like diabetes or high blood pressure?

AW: Eye exams can reveal signs of high blood pressure and diabetes. During a dilated retinal exam, we can identify changes like retinal hemorrhages or leakage at the back of the eye, which might indicate undiagnosed diabetes or poorly controlled blood pressure. These findings can prompt referrals for further testing or inform the patient's primary care doctor. In severe cases, additional eye treatments like injections may be necessary, and we may need to monitor the patient more frequently to track any progression.

What are the risks of not getting regular vision screenings, especially for older adults and those with a family history of eye diseases?

AW: The primary risk of skipping regular vision screenings is untreated vision loss. Many eye conditions can progress silently without noticeable symptoms until significant vision damage has occurred. Even in individuals with eye diseases, regular screenings can adjust prescriptions for glasses or contacts to help maintain optimal vision and quality of life.

How do vision screenings vary for different age groups?

AW: Children's eye exams focus heavily on visual development and eye alignment, screening for conditions like amblyopia (lazy eye) and strabismus (eye misalignment). Early detection is crucial; for example, if strabismus is caught early, children have a better chance of achieving 20/20 vision. For younger children who can't yet communicate clearly, we use techniques like retinoscopy to evaluate their refractive status without requiring verbal feedback.

In contrast, eye exams for older adults are more focused on age-related conditions like macular degeneration or cataracts. These screenings help monitor retinal health and address issues typical in older populations.

There are several steps patients can take to maintain eye health between exams:

• Wear sunglasses: Use sunglasses with ultraviolet (UV) and UVA protection, even on cloudy days, to shield the eyes from harmful rays.
• Wear safety glasses: Use protective eyewear during high-risk activities like woodworking, high-impact sports or even mowing the lawn to prevent injuries.
• Practice good contact lens hygiene: Follow recommendations for contact lens use, including proper cleaning, regular replacement and avoiding overnight wear.
• Manage chronic conditions: Keeping chronic health conditions like diabetes and high blood pressure under control can reduce their impact on vision.
• Maintain a healthy diet and lifestyle: A balanced diet rich in fruits, vegetables and omega-3 fatty acids supports eye health, potentially preventing conditions like dry eye disease. Regular exercise is also beneficial for overall eye health.

These preventive measures can help preserve vision and reduce the risk of eye-related complications.

This transcript was edited for clarity.