Are your eyes comfortable and your vision clear? Regular visits to an eye care professional can help prevent vision problems, often before the symptoms become noticeable. The eye care team at Malcolm Grow Medical Clinics and Surgery Center works with patients to provide preventative care such as annual and flight qualification physicals, correct vision problems, treat infections of the eye and surrounding tissue and even help diagnose health issues that are not limited to the eye, such as high blood pressure or diabetes.
Maj. Michael Sapp said that he and his team of four providers see approximately 650-800 patients each month. Their focus is on active duty service members, but they will also see TRICARE Prime-covered dependents and retirees as appointment availability permits. Patients who do not have TRICARE Prime coverage are seen by eye care professionals at Joint Base Anacostia-Bolling, instead of here at Malcolm Grow.
Most patients with a vision problem seek help because of nearsightedness, farsightedness or blurry vision at any distance, also known as astigmatism. Those eye problems are known as “refractive errors,” because they are caused by abnormalities in the way the eye redirects light into the eye to be processed by the brain as visual images. Often, prescription eyeglasses or contact lenses are enough to correct poor vision so that it does not impact daily life.
Though most of the care provided at MGMC&SC is routine and preventative, doctors there also treat red eyes, infections and mild traumas to the eye. Contact lens wearers are also frequent visitors to the eye care clinic, often because of discomfort and other problems caused by contact lens misuse.
“People sleep in their contact lenses, wear them too long, don’t replace them when they should, or use the wrong disinfecting solution. All of those can lead to an eye infection, which then becomes our problem to treat,” Sapp said.
Most eye injuries are preventable, Sapp said, and since the Air Force began in 2005 requiring deployed service members to wear ballistic eyewear protection, a lot of potential battlefield injuries have been prevented. Over the past decade, BEP has been improved to make the safety goggles more comfortable, with a more modern appearance, making that mandatory gear a little easier to accept.
“They are like an Oakley (sunglasses frame), with an outsert for everyone to protect from small particles, and an insert for those who require a vision correcting prescription,” Sapp explained.
Because of the nature of improvised explosive devices, many of which explode into many small particles, shielding the eyes from tiny projectiles is more important than ever before for service members on deployment. Once back home, however, the average service member is less likely to have eye problems than other people.
“Ages 18 to 35 is the prime population for injuries to the eye, and three fourths of those patients are male,” Sapp said, “but our pool of people (within military service) is generally healthier than the general population.”
About half of all eye injuries happen at home, due to chemical splashes or contact with flying particles. The first and most natural reaction to those injuries, rubbing the eye, is often just a cause of additional discomfort and vision problems.
“Rubbing the eye releases histamine, which causes more itching,” Sapp said. “It’s better to apply a cool compress to the eye, than to rub it. If your itchy eyes are caused by allergies, you can treat them with allergy medicines,” available either over-the-counter or at the allergy clinic.
Sometimes, changes in vision or in the eye itself are not directly due to an obvious injury. During an exam, eye doctors look for changes in the eye which can indicate larger health problems such as diabetes, hypertension, high cholesterol and certain genetic disorders.
Some eye problems, such as cataracts, are almost a symptom of good health and longevity.
“A heart attack will kill you; a cataract will not. If you live long enough, you will get one,” said Sapp. “It’s just a matter of time, but it is treatable.”
Getting enough sleep, eating a healthy diet and wearing sunglasses to protect from harmful rays can help prevent or slow the development of cataracts, although the location and type of a cataract determines how quickly it will develop. Once a cataract adversely affects vision, doctors can remove it.
Macular degeneration also appears mainly in older patients, especially people of northern European ancestry, smokers, women and people who regularly get less than six hours of sleep per night. Age-related eye degeneration supplements, known as AREDS, can help reduce the rate of macular degeneration in older people when it is already present, but does not prevent the disease. Treatments include eye drops and painless but unnerving injections into the eye.
Sometimes changes in vision do not indicate any serious disorder. “Floaters,” or black specks that move around the field of vision, are just shadows thrown by naturally forming debris in the liquid part of the eye. Unless they are accompanied by flashes of light or a sudden change from a few floaters to many in one day, they probably are not worth concern--and can’t be treated, anyway.
Other changes are a normal, common part of aging. Many people develop farsightedness between the ages of 40 and 45. The simplest solution? Pick up a few pair of reading glasses at a grocery or drug store, for just a few dollars a pair, without an eye appointment.
Most eye diseases, such as glaucoma, do not have many visual symptoms until the disease is advanced. If your vision seems as if you are looking through a veil, cloud or curtain, however, that could indicate a retinal detachment. This is an emergency requiring immediate medical care, and possibly surgery.
Eye strain and fatigue, common among those who spend most of their time working at screens, reading and otherwise focusing on things very close to the eye, can cause dry, uncomfortable eyes in the short term, but no real lasting damage, no matter what your mother said about sitting too close to the television. If work or play keeps you focused on something nearby, Sapp suggests the “rule of 20--for every 20 minutes of near-focused work, take a break to look at something 20 feet away.”