Selected Podcast
Ophthalmology
In this panel interview, Dr. Eric Stevens and Dr. Charlene Chang share the importance of protecting your eyes against the sun, media screens, and when you should visit an optometrist.
Featuring:
Learn more about Charlene Chang-Smith, MD
Eric Stevens, MD, PhD graduated from the University Of Minnesota Medical School in 1996. Dr. Stevens works in Oroville, CA and specializes in Ophthalmology. Dr. Stevens is affiliated with Oroville Hospital.
Learn more about Eric Stevens, MD, PhD
Charlene Chang, MD | Eric Stevens, MD, PhD
Charlene Chang-Smith, MD is an ophthalmology specialist at Oroville Hospital.Learn more about Charlene Chang-Smith, MD
Eric Stevens, MD, PhD graduated from the University Of Minnesota Medical School in 1996. Dr. Stevens works in Oroville, CA and specializes in Ophthalmology. Dr. Stevens is affiliated with Oroville Hospital.
Learn more about Eric Stevens, MD, PhD
Transcription:
Melanie Cole (Host): Welcome. Today we’re talking about the field of ophthalmology and my guests are Dr. Charlene Chang and Dr. Eric Stevens. Both ophthalmologists with Oroville Hospital. Dr. Chang, I’d like to start with you. Can you tell us the difference between an optometrist, an ophthalmologist, and an optician.
Dr. Charlene Chang (Guest): So an ophthalmologist is a physician who’s gone through medical school and internship and residency and trained in medical and surgical ophthalmology so treating medical diseases and doing surgeries on the eye. Optometrists go to school to specifically make and test for glasses and contacts and they also deal with the health of the eye, but their specialty is more in the glasses field. An optician is someone who will take the information that either the optometrist or ophthalmologist has acquired and help the patient pick out frames, make lenses with contacts, and helps with the final selection of the optical supplies.
Host: Dr. Chang, sticking with you for a second, what are some of the major causes of vision loss for individuals aged 40 years and older?
Dr. Chang: Major causes of vision loss, well I guess that’s not exactly elderly because that’s our age range, but trauma is huge for the younger people, the younger older people, as people get older, I think cataracts are a major cause of decreasing vision, macular degeneration and glaucoma are big causes of vision loss also.
Dr. Eric Stevens (Guest): The only thing I’d add to that is diabetes is obviously becoming more of an epidemic in the country and we are also seeing that effect more and more eyes – it affects the retina and decreases vision.
Host: Dr. Stevens, what are the most common eye conditions that you see?
Dr. Stevens: Well probably the most common condition that we see in just about any eye practice would be a refractive error, so a need for glasses, but shortly after that is mostly what we deal with here in town are cataracts and cataracts are where the intraocular lens that sits right behind your pupil starts to become cloudy, usually just as a result of age, but could also be for other reasons including trauma and diabetes, and as Dr. Chang had pointed out, it’s one of the more common reasons for vision issues as we age. It’s correctable with the surgery where we take that cataract out and put in a new sort of soft plastic intraocular lens, and third on that list is something that’s very common that we see are sort of what we call ocular surface issues, so dry eye, irritated eyes, conjunctivitis, is also a very common patient complaint.
Host: Dr. Stevens, what does a comprehensive eye exam include? What is it screening for?
Dr. Stevens: A comprehensive eye exam will include first a glasses check before any drops go in, and then after the glasses check we start putting in drops, the first one is a numbing drop so we can check the eye pressure as a glaucoma screen. Glaucoma is associated with high intraocular pressures and before we do anything else on the exam we check for high pressures. Other parts of the exam will include checking the pupils to make sure those are reacting normally, checking the visual fields to make sure that they’re full and that you’ve got a full peripheral field on exam, and also checking the ocular motility to make sure there aren’t any double vision type issues and that the eyes are in proper alignment. Then the second set of drops people will get are to dilate the pupil, that means to make the pupil large and we do that with two sets of drops. One actively sort of makes the muscles that open the pupil and activates those. The other one relaxes the muscles that tend to constrict the pupil, and between those two we dilate the pupil so we can get a good look in the back of the eye, and the first thing we’re looking at in that comprehensive exam is the lens because that’s the first thing we see. Well let me back up, so the first thing we’ll look at is the cornea. Again, the ocular surface looking for how the tear films and the lids interact with the eye, and then the clarity of the cornea that sort of front windshield on the eye, and then looking back through the eye, the next thing we get to as a reason for possible blurriness is the lens inside the eye and whether there’s any cataract formation on the lens, and then by dilating the pupil we also get to have a thorough examination of the retina where we look at the optic nerve and the retina proper to make sure it has the proper coloration and the proper anatomy. It’s also the one place in the body you get to just look in and see the blood vessels, or the retinal blood vessels and we look for the health of the retinal vessels. It can point to conditions like diabetes and hypertension can show up as issues with those retinal vessels that we’re looking at, and when we look at the optic nerve, we’re specifically again screening for glaucoma would be the most common problem that would be present with the optic nerve.
Host: Dr. Chang, why do we start to need reading glasses? And does wearing them make it so your eyes get worse or is it good for your eyes to wear reading glasses when you need them?
Dr. Chang: Well in the majority of people needing reading glasses comes with age, and that is usually related to the lens of the eye. It’s becoming a little stiffer. As you get older, that lens gets firmer and less elastic and so the muscles that are used to change the shape of the lens to focus from far to near are not as effective, so you start needing a little help usually around 45 to 50 years old with glasses to see up close, and as you get older that amount will increase. Sometimes if you have an underlying farsightedness, that will require you to need reading glasses a little earlier in life, and likewise if you’re a little nearsighted sometimes you can put it off later. Wearing reading glasses does not make it worse. Your presbyopia is what it’s called. It will continue to worsen whether or not you wear reading glasses. So if you need it, I always tell patients just use it and make life easier.
Host: Dr. Chang, I’d like to start with you, please give us your best advice as we wrap up, what you would like listeners to know about keeping healthy eyes and the importance of preventing eye disease if possible.
Dr. Chang: Preventive care is definitely key and your basic healthy habits are going to help keep your eyes healthy also because it’s tied into the rest of your body. So using sunglasses outside, eating a good healthy diet, making sure that if you have diabetes it’s controlled, getting all your vitamins in, not smoking, all that does help your eyes. I think getting regular eye exams, even if you feel like you’re seeing find, just to make sure you’re screening for other medical eye conditions is very important also.
Host: What great information, and Dr. Stevens last word to you. What would you like the listeners to take away from this segment about the importance of visiting your ophthalmologist and getting a proper eye exam so that we can be our own best health advocate?
Dr. Stevens: Well I’d first like to second what Dr. Chang says and the more – your eye health really is related to your overall general health, so the better you eat, the more exercise you get, the healthier your eyes are going to be and smoking is really key to a lot of eye conditions and ones people don’t tend to think about, macular degeneration, is the big one that’s a lot worse in smokers, but also even in younger people, things like thyroid eye disease are made much worse by smoking. So that would be my biggest health advocacy for the eyes is if you are currently smoking to try to find a way to stop. In addition to that, I think the importance of regular eye care just gets more important the older we get and if you are someone that’s fortunate enough to not need glasses in sort of your middle years, sort of your teens to early 40s, one or two eye exams in there is probably reasonable, but once you start getting into your 40s, you really do want to start screening for things like glaucoma, and things like cataracts and macular degeneration, those are going to start showing up the older we get.
Host: Thank you both so much. It’s great information, and as you said people don’t tend to think of some of those healthy lifestyle choices as affecting our eyes but they truly do and thank you so much for joining us today. That wraps up this episode of Growing Healthy Together, a podcast by Oroville Hospital. Head on over to our website at orovillehospital.com for more information and to get connected with one of our providers. If you found this podcast as informative as I did, please share on your social media and be sure to check out all the other interesting podcasts in our library. I’m Melanie Cole.
Melanie Cole (Host): Welcome. Today we’re talking about the field of ophthalmology and my guests are Dr. Charlene Chang and Dr. Eric Stevens. Both ophthalmologists with Oroville Hospital. Dr. Chang, I’d like to start with you. Can you tell us the difference between an optometrist, an ophthalmologist, and an optician.
Dr. Charlene Chang (Guest): So an ophthalmologist is a physician who’s gone through medical school and internship and residency and trained in medical and surgical ophthalmology so treating medical diseases and doing surgeries on the eye. Optometrists go to school to specifically make and test for glasses and contacts and they also deal with the health of the eye, but their specialty is more in the glasses field. An optician is someone who will take the information that either the optometrist or ophthalmologist has acquired and help the patient pick out frames, make lenses with contacts, and helps with the final selection of the optical supplies.
Host: Dr. Chang, sticking with you for a second, what are some of the major causes of vision loss for individuals aged 40 years and older?
Dr. Chang: Major causes of vision loss, well I guess that’s not exactly elderly because that’s our age range, but trauma is huge for the younger people, the younger older people, as people get older, I think cataracts are a major cause of decreasing vision, macular degeneration and glaucoma are big causes of vision loss also.
Dr. Eric Stevens (Guest): The only thing I’d add to that is diabetes is obviously becoming more of an epidemic in the country and we are also seeing that effect more and more eyes – it affects the retina and decreases vision.
Host: Dr. Stevens, what are the most common eye conditions that you see?
Dr. Stevens: Well probably the most common condition that we see in just about any eye practice would be a refractive error, so a need for glasses, but shortly after that is mostly what we deal with here in town are cataracts and cataracts are where the intraocular lens that sits right behind your pupil starts to become cloudy, usually just as a result of age, but could also be for other reasons including trauma and diabetes, and as Dr. Chang had pointed out, it’s one of the more common reasons for vision issues as we age. It’s correctable with the surgery where we take that cataract out and put in a new sort of soft plastic intraocular lens, and third on that list is something that’s very common that we see are sort of what we call ocular surface issues, so dry eye, irritated eyes, conjunctivitis, is also a very common patient complaint.
Host: Dr. Stevens, what does a comprehensive eye exam include? What is it screening for?
Dr. Stevens: A comprehensive eye exam will include first a glasses check before any drops go in, and then after the glasses check we start putting in drops, the first one is a numbing drop so we can check the eye pressure as a glaucoma screen. Glaucoma is associated with high intraocular pressures and before we do anything else on the exam we check for high pressures. Other parts of the exam will include checking the pupils to make sure those are reacting normally, checking the visual fields to make sure that they’re full and that you’ve got a full peripheral field on exam, and also checking the ocular motility to make sure there aren’t any double vision type issues and that the eyes are in proper alignment. Then the second set of drops people will get are to dilate the pupil, that means to make the pupil large and we do that with two sets of drops. One actively sort of makes the muscles that open the pupil and activates those. The other one relaxes the muscles that tend to constrict the pupil, and between those two we dilate the pupil so we can get a good look in the back of the eye, and the first thing we’re looking at in that comprehensive exam is the lens because that’s the first thing we see. Well let me back up, so the first thing we’ll look at is the cornea. Again, the ocular surface looking for how the tear films and the lids interact with the eye, and then the clarity of the cornea that sort of front windshield on the eye, and then looking back through the eye, the next thing we get to as a reason for possible blurriness is the lens inside the eye and whether there’s any cataract formation on the lens, and then by dilating the pupil we also get to have a thorough examination of the retina where we look at the optic nerve and the retina proper to make sure it has the proper coloration and the proper anatomy. It’s also the one place in the body you get to just look in and see the blood vessels, or the retinal blood vessels and we look for the health of the retinal vessels. It can point to conditions like diabetes and hypertension can show up as issues with those retinal vessels that we’re looking at, and when we look at the optic nerve, we’re specifically again screening for glaucoma would be the most common problem that would be present with the optic nerve.
Host: Dr. Chang, why do we start to need reading glasses? And does wearing them make it so your eyes get worse or is it good for your eyes to wear reading glasses when you need them?
Dr. Chang: Well in the majority of people needing reading glasses comes with age, and that is usually related to the lens of the eye. It’s becoming a little stiffer. As you get older, that lens gets firmer and less elastic and so the muscles that are used to change the shape of the lens to focus from far to near are not as effective, so you start needing a little help usually around 45 to 50 years old with glasses to see up close, and as you get older that amount will increase. Sometimes if you have an underlying farsightedness, that will require you to need reading glasses a little earlier in life, and likewise if you’re a little nearsighted sometimes you can put it off later. Wearing reading glasses does not make it worse. Your presbyopia is what it’s called. It will continue to worsen whether or not you wear reading glasses. So if you need it, I always tell patients just use it and make life easier.
Host: Dr. Chang, I’d like to start with you, please give us your best advice as we wrap up, what you would like listeners to know about keeping healthy eyes and the importance of preventing eye disease if possible.
Dr. Chang: Preventive care is definitely key and your basic healthy habits are going to help keep your eyes healthy also because it’s tied into the rest of your body. So using sunglasses outside, eating a good healthy diet, making sure that if you have diabetes it’s controlled, getting all your vitamins in, not smoking, all that does help your eyes. I think getting regular eye exams, even if you feel like you’re seeing find, just to make sure you’re screening for other medical eye conditions is very important also.
Host: What great information, and Dr. Stevens last word to you. What would you like the listeners to take away from this segment about the importance of visiting your ophthalmologist and getting a proper eye exam so that we can be our own best health advocate?
Dr. Stevens: Well I’d first like to second what Dr. Chang says and the more – your eye health really is related to your overall general health, so the better you eat, the more exercise you get, the healthier your eyes are going to be and smoking is really key to a lot of eye conditions and ones people don’t tend to think about, macular degeneration, is the big one that’s a lot worse in smokers, but also even in younger people, things like thyroid eye disease are made much worse by smoking. So that would be my biggest health advocacy for the eyes is if you are currently smoking to try to find a way to stop. In addition to that, I think the importance of regular eye care just gets more important the older we get and if you are someone that’s fortunate enough to not need glasses in sort of your middle years, sort of your teens to early 40s, one or two eye exams in there is probably reasonable, but once you start getting into your 40s, you really do want to start screening for things like glaucoma, and things like cataracts and macular degeneration, those are going to start showing up the older we get.
Host: Thank you both so much. It’s great information, and as you said people don’t tend to think of some of those healthy lifestyle choices as affecting our eyes but they truly do and thank you so much for joining us today. That wraps up this episode of Growing Healthy Together, a podcast by Oroville Hospital. Head on over to our website at orovillehospital.com for more information and to get connected with one of our providers. If you found this podcast as informative as I did, please share on your social media and be sure to check out all the other interesting podcasts in our library. I’m Melanie Cole.