Dr. David Kisling is a VSP doctor practicing in Fort Collins, CO.
Dr. David Kisling, a VSP network doctor, returns for his second guest blog. Today’s post addresses one of the most challenging portions of an eye exam—dilation of your eyes.
Does an hour appointment with your optometrist turn into a full day of discomfort due to the pupil dilation? Have you wondered why you have to endure this glaring assault on your eyes? If you have ever tried looking through a peephole in your front door to see if it is a friend or foe knocking on the door, you have some idea of the difficulty of looking inside an eye. You have to get very close to the tiny peephole, squeeze one eye shut, and even then you have a very limited view. Think how much easier it the would be if there were holes for both eyes the size of a silver dollar! When examining the retina, the tissue lining the back of your eye, having the equivalent of a silver dollar size opening allows a much more thorough check of your eye health.
An ophthalmoscope is the instrument used to view the inside of the eye, specifically the retinal tissue lining the back of the eye that contains the cone and rod cells with which we see. The ophthalmoscope was invented in 1828 by Charles Babbage, who also invented the first computer. The ophthalmoscope was not used by eye doctors until a new design was introduced by Hermann von Helmholtz in 1853. His original ophthalmoscope was dependent on a candle for illumination to view the inside of the eye, and he could only view with one eye. This type of ophthalmoscope is referred to as a direct ophthalmoscope and does not require dilation. It magnifies the inside of the eye about 15 times but has a very small field of view. It was a tremendous advancement at the time but only allowed viewing a very small area inside the eye.
Binocular indirect ophthalmoscope.
The binocular indirect ophthalmoscope looks like a miner’s light the optometrist wears on top of his head. Kids used to recall the movie “Honey I Shrunk the Kids” when seeing it. Today they think it’s a virtual reality gizmo. It was invented in 1946 by Dr. Charles Schepens who utilized it to develop the treatment for tears and detachments of the retina. With proper technique, the binocular indirect ophthalmoscope takes advantage of the dilated pupil size to provide a view of the entire retina. The indirect ophthalmoscope utilizes mirrors and prisms, providing an image of your eye that is seen from slightly different perspectives in the right and left eye of the examining eye doctor. This allows the retina to be seen with stereoscopic vision, the 3-D type of vision enjoying a recent resurgence of popularity in the movie theaters today, due to new technology.
More important to you, stereopsis allows very fine discrimination of alterations in elevation or depression in the retinal tissue. These elevations in the peripheral retina can be places where the retina has separated from the underlying tissue, or where melanomas develop. Other special lenses create 3-D vision and are used to evaluate the optic nerve for the diagnosis of glaucoma. Because the eye has transparent, clear tissues and fluids, it is one of the few places we have a good glimpse, not only of the inside of the eye, but also into the inner health of the whole person. Arteries and veins can be viewed and any abnormalities that show up in the blood such as diabetes and high blood pressure will show up in the eye at some point. As we age, the pupil becomes smaller, making dilation even more essential.
Many times people feel like they can’t see after dilation and are concerned about driving. While distance vision may be affected in select cases, normally only your near vision is reduced. If you have concerns, you can always arrange for a ride in advance. More importantly, don’t leave the office without the temporary sunglasses to protect your eyes from ultraviolet radiation. Ultraviolet radiation contributes to the formation of cataracts and damage to the retina. A helpful hint—keep those in your glove compartment and with camping gear in case you ever get caught on a really bright day when you forgot your sun wear.
David H. Kisling, O.D., A.B.D.A.
http://drkisling.com/
Harmony Eyecare
Fort Collins, CO. 80525
[...] He isn’t afraid to get his eyes dilated (a key step in making sure your eyes are [...]
Oh! I forgot to add, Jessica, that my better half and I have already scheduled eye exams for next month thanks to the Dr.’s post. We’re both getting our eyes dilated on the 15th at 9:00 and 9:15 AM. I’m doing it because I’m worried about what is in there while he’s doing it for the cool glasses. Either way, it’s getting done, thanks!
I read this entire post. Who knew looking into pupils was so involved ( Well, other than eye doctors, i mean.) I have only had my eyes dilated once in my life; maybe my Dr. just can’t be bothered to employ stereopsis! On a more serious note, did you ever look into a cat’s pupils? It’s pretty amazing, and you can see the veins and everything even without dilating. Probably because cat eyes light up in this green-yellow color, not unlike my old watch did. Fascinating, and thanks for teaching me a new word: stereopsis.
Studdavich, I challenge you to use “stereopsis” in your everyday conversation… should be a head-turner! And ask your eye doc about dilation… if it’s a VSP network doctor, a dilated eye exam is part of your annual WellVision Exam.
Pssh, I already have used it in casual conversation. Observe: “Hey honey, what did you do today?” “I went to work, learned a few neat facts from vsp blog, vandalized the wikipedia page for stereopsis and walked the dog when I got home.”
Hehe, just kidding. (I really said that but I did not really vandalize the wikipedia page.) Now I’ll have to find new ways of working it into my everyday vocabulary.