The intricate mechanics of the eye

If something goes wrong with people’s vision, the first thought is to go to the emergency room. Optometrists want to change that thinking

  • Jun. 4, 2015 9:00 a.m.
Dr. Mark Langer is an optometrist at Iris in Cranbrook.

Dr. Mark Langer is an optometrist at Iris in Cranbrook.

From eye infections to eye injury, eye emergencies can come in many different forms and, without proper treatment, can have damaging and lasting effects on your vision.

A recent nationwide survey reveals that when faced with an eye emergency, Canadians are most likely to visit the Emergency Room or their family doctor. Yet, few people are aware that they can access to prompt, specialized emergency eye care by visiting an optometrist.

The survey was conducted by the Mustel Group on behalf of Doctors of Optometry Canada, collected responses from 2,500 people across Canada. And the optometrists want to make Canadians aware that optometrists do a lot more than determine your glasses prescription.

“If your tooth hurts you go to the dentist, but if you have a problem with your eye, for some reason people tend to go to the Emergency Room,” said Dr. Mark Langer, an optometrist with Iris in Cranbrook. “The ER wait times are averaging four hours across the country, so patients are spending a significant amount of time waiting for care that can be more promptly delivered by visiting their optometrist.”

Optometrists are trained to provide preventative vision care and treat acute and chronic eye conditions,”  Dr. Langer says that Whether for an eye exam or an eye emergency, your doctor of optometry would provide an essential role in protecting eye health and treating urgent problems as they arise.

“The idea is still out there that optometrists are who you go to for your glasses prescription,” Dr. Langer said. “That’s important, but it’s only a very small part of our education. We went to school for eight years  — four just dedicated to the eyes alone, and a lot of that is dealing with systemic health and ocular health, and all the diseases and conditions and treatments that can go along with that.

“And the wait times are significantly shorter. If someone has a problem, I’m getting them in the same day, I’m fitting them in between patients, or seeing them early the next day if they can wait a day. And we’ll be able to be able to deliver what I would consider better care. We’ve got all the technology, tools and knowledge at our disposal to focus on eyes and eye conditions.”

The eye is a fascinating organ, Dr. Langer said.

“It’s so intricate — everything from the front of the eye all the way to the back of the eye. But also, what people don’t realize is that out of the 12 inter-cranial nerves, there’s a huge percentage of them that are dedicated either solely to the eyes or somewhat to the eyes. The visual system goes from the eyes to the back of the brain, at the occipital lobe, where the impulses are then processed as vision.

Anything going on in the brain can affect your vision as well, depending on what part of the visual pathway is affected. There is just so much brain power dedicated to vision.

“It’s fascinating how vision works, but that also sets the stage for a lot of things that can go wrong.”

Some of the conditions optometrists deal with are ones specific to the eye — like severe eye pain, corneal scratches or foreign bodies in the eye, chemical exposures, or blunt injuries to the eyes or eyelids. People can also experience flashes of light, or floaters, or changes to their vision, which could be indicative of things like retinal tears or detachment.

“There are a lot of conditions that are just based on the eye alone,” Dr. Langer said, “but then there are a lot of conditions that present in the eye that are actually from systemic conditions. Optometrists are often the first ones to see signs of diabetes, or any rheumatoid arthritis, or even multiple sclerosis — because it typically affects the optic nerve before anything else. So it’s not just eye conditions per se.

“There’s a long list of systemic conditions that first present in the eyes, and optometrist is going to be very adept and capable at figuring out and diagnosing some of these other conditions, and then getting you on to the proper specialist after that.”

Of the senses five, few would argue that vision is most important.

“Vision is so critically important to everyday life,” Dr. Langer said. “You’re processing so much information from the outside world through your eyes. The vast majority of us take it for granted, but there’s so much going on, so much processing involved.”

Optometrists recommend eye exams every year for people up to 19 years old (BC medical plan covers the cost of the eye exam for those years). “After that, in an otherwise healthy individual, we recommend eye exams every two years,” Dr. Langer said. “There’s just so much stuff that goes on in the eyes that you can not be aware of. If you go regularly, the preventative aspect becomes much more important.

If something goes wrong, and the patient comes in 10 years later, it might be too late for us to intervene, than if we’d caught the condition 10 years earlier.”

For more information, to schedule an appointment, or in case of emergency, contact your local optometrist. “I would say all of us here are doing an excellent job, and we’re always happy to see people on an urgent care basis,” Dr. Langer said.