Dr. Reckell explains why it is necessary for an optometrist to closely monitor the many structures of the eye.
Well the structures of the eye are what’s going to affect the clarity of our vision, the quality of our vision. So what I am going to show you here, the different structures we analyze, the cornea, the clear coating over the front of the eye, covers our iris and the cornea has five layers to it. The cornea can cloud from various health disorders, overuse of contact lenses or not changing out contact lens properly can start to cause blood vessels growing into this structure that should be clear.
If we have had eye infections or eye allergies those can cause swelling and possible scars or disruptions in the clarity of the tissue. Also severe cases of dry eye can start to clog that or disrupt the structure.
Then we look at the iris right behind the cornea and the pupil should be round and equal in size and reactive to light, but there are different disorders that can affect that and affect our ability to change from light to dark or indoors to outdoors vision.
Then when we go inside, there’s a lens – the crystalline lens is made up of mostly water and protein and this should be clear. There are a lot of disorders that can affect that. One is cataract. Cataract is a normal process that, if we all live long enough we develop from age, but there’s a lot of environmental factors that can cloud this natural crystalline lens, use of medications and the steroid family can cloud that, overexposure to ultraviolet rays from the sun, that can also prematurely cloud our lens.
And then as we go further back, this hollow area is filled with a gel called vitreous. The vitreous should be clear, but again, trauma, environmental factors, medications, they are things that can start to cloud the vitreous and that would affect quality of vision.
And then as we go to the very back, this gold structure, that’s the retina. That’s kind of the projector screen inside the back of our eyes and the retina is very complex, several layers to that and it’s all the nerve receptors, the blood vessels, the nerve tissue that receive the vision and transmit and funnel this right to this optic nerve to our brain.
So when we look inside, we are looking at the clarity of all of these different structures, the function of all of these different structures. It’s very interesting to evaluate the retina. We use instruments that actually photograph the retina and I’m going to show a couple of pictures that help me describe what we are looking at when we look at the retina.
What I have here are a few photographs of the retina, the structure at the back of the eye, and to show what I am looking at during the course of an exam. In this eye here, the optic nerve is very normal. Where the blood vessel emerges there’s a little white spot called the optic cup. Now when we go down to this eye below, that same optic nerve has a large wide area. That area is called the optic cup and it is enlarged. When that is enlarged it is usually from elevated pressure. It’s showing us damage to the nerve tissue that’s atrophied nerve fibers and that is what it looks like when I see glaucoma.
This eye that has glaucoma actually has very healthy blood vessels. All these red lines throughout are veins and arteries, but the eye above shows some red and white blotches, looks like bruising. This bruising is the type of finding I’ll have if a person has some health problems in the circulatory system; the blood vessels, the nerve tissue. This particular case is diabetic retinopathy.
Diabetes can affect the circulation, cause the blood vessels to be damaged and leak and I will see this bruised effect. This eye below has no bruising and clear vessels.
About Dr. Susan Reckell, O.D.:
Dr. Susan L. Reckell graduated from Michigan College of Optometry at Ferris University in 1984. She holds optometry licenses in Arizona and Michigan. With more than 23 year of experience, she currently works as an optometrist at Riviera Opticare Inc.