Eye Care Specialist SC

The following article has appeared in a number of southeastern Wisconsin publications, including 50-Plus, Boomers, and Modern Health & Living (MHL).

A visit to an eye care specialist may save more than your sight:

Eye MDs’ detective skills can uncover diabetes, tumors and blocked arteries

By Cheryl L. Dejewski

"I consider myself an ophthalmic 'detective,'" says Mark Freedman, MD, of Eye Care Specialists, one of Wisconsin's leading ophthalmology practices. He explains, "The eye is the only part of the body that gives us the unique opportunity to look in and actually see certain diseases and conditions, rather than just infer their presence from signs and symptoms. The eye is like a looking glass into the vascular, neural and connective tissues of the body. As a result, a visit to an eye MD can not only lead to the detection of ocular diseases, it may also turn up clues of serious non-eye-related conditions affecting the rest of your body which present clues of their existence through minor changes in the appearance of the inside of the eye."

For example, a visit to an eye care specialist may uncover carotid artery blockage. How? Artery blockage in the neck can break into small pieces that travel through the bloodstream and appear as yellow fatty deposits in the arteries in the back of the eye. These are a warning sign to the eye examiner that the patient may need a carotid artery and heart evaluation.

"Although such findings are not good news, they give patients the opportunity to start medical treatment before they would have even noticed anything was wrong," explains Brett Rhode, MD, Head of Ophthalmology at a Milwaukee-area hospital. "If a tumor, clogged arteries or diabetes are caught early enough, less invasive and less costly procedures may be able to be used to not only prevent the spread of the problem, but to even save a person's life." Eye Care Specialists’ team presents continuing education lectures on eye exam disease detection to physicians and nursing staffs. "It’s important for all health care professionals to know the signs of eye conditions, such as cataracts and glaucoma, as well as non-eye-related conditions, such as blocked arteries or tumors, that may appear in the eyes," says eye surgeon Daniel Ferguson, MD.

An area of special interest to Eye Care Specialists' team is detection and treatment of a condition that can affect both the body and the eyes--diabetes. Ferguson explains, "As the life span of diabetics has increased, so has the incidence of related circulatory problems which can develop over time. The most common eye-related complication is ‘diabetic retinopathy’--a deterioration of the small blood vessels that nourish the retina in the back of the eye. Sometimes an eye exam reveals tell-tale signs of weakened vessels leaking blood or fluid before a patient is even aware that they have diabetes. Fortunately, if the diabetes is caught early enough, we can treat it to stop or slow vision loss, and the patient can be put on an appropriate diet and/or medication to control or prevent other diabetes-related problems."

Although discovering underlying diseases is fascinating work, most of an eye specialist’s day is filled with performing eye exams and surgery.

"As with any detective, you begin by interviewing the people involved. You have to listen to patients and pick up on clues when they explain their health and vision history. What’s the real cause behind a person no longer driving, having difficulty ‘hearing’ the TV, suffering frequent falls, or not doing well in school? Are these clues pointing to the need to test for cataracts, macular degeneration, dyslexia or other conditions?" asks Daniel Paskowitz, MD, PhD, an ophthalmologist with credentials from both Harvard and Johns Hopkins.

A thorough exam of the parts and workings of the eye includes evaluating: the external surface (for infections and inflammations); the internal pressure, lens, optic nerve and retina (for diseases like cataracts, diabetes, glaucoma, macular degeneration, etc.); accommodation capability (ability to switch focus between near and far); pupil reflexes (ability to adjust from light to dark); muscle motility (ability to look to the sides and keep the eyes in alignment); visual acuity (ability to see objects clearly near and far); and visual field (ability to see objects off to the side).

One specialized tool in Eye Care Specialists’ detective arsenal is an Optical Coherence Tomographer (OCT machine). "This fast, accurate, non-invasive and painless device uses laser scanning technology to create a CT-like image that enables us to detect microscopic signs of glaucoma, macular degeneration, diabetes, and other sight-threatening conditions before they could be noticed through visual inspection, retinal photography or visual field tests. Armed with this insight, we can prevent future loss of vision by promptly starting or adjusting medications or performing laser, medication injection, or surgical treatment," explains Michael Raciti, MD, an ophthalmologist who has extensively researched debilitating eye diseases, such as macular degeneration.

How do the "detectives" feel about their role? David Scheidt, OD, past president of the Milwaukee Optometric Society, comments, "Patients come with questions, and we like to have them leave with answers. We strive to provide the most thorough examination possible to detect and treat eye conditions. To achieve that goal, however, patients must remember that it’s their responsibility to provide information, ask questions, and follow treatment suggestions. That way, we can work as partners mapping out the best possible vision for your future."