Welcome back to the “Optometrist Explains” series with Dr. Ansel Johnson, Clinical Director of Vision Salon Eye Care Associates. In this second video, Dr. Johnson clarifies the differences between optometrists and ophthalmologists, highlighting their distinct roles in eye care. He also explores how systemic health conditions, like high blood pressure and diabetes, can impact eye health, how myopia management can protect children’s future vision, and the importance of preventative measures for maintaining good vision.
One of the key topics Dr. Johnson discusses is eye stress and dry eyes in adulthood. With increasing demands from screen time, online learning, and virtual meetings, many adults are experiencing more eye strain and dryness than ever before. Dr. Johnson explains how regular eye exams and subtle adjustments to your prescription can significantly improve your comfort and eye health.
Watch the full video or read the complete transcript below.
Video transcription
Many times, people do not understand the difference between an optometrist and an ophthalmologist because we are the only two professions that really look at the eyes in depth.
Ophthalmology vs. optometry
What is an opthalmologist?
“Ophthalmologists are eye doctors who perform medical and surgical procedures for eye conditions.”
An ophthalmologist is a medical doctor or doctor of osteopathic medicine, an MD or DO who has gone through four years of medical school. And then they do a one-year internship, usually at a hospital where they’re working under another doctor that’s practicing even though they have their MD degree. And then they take their surgical specialty residency to be board-certified as an ophthalmologist. That is three years.
Most ophthalmologists have a subspecialty that could be in glaucoma, that can be in retina, that can be in cornea, that can be handling the eyelids, surgery of the eyelids or the eye, and that can be an additional one to two years. So your ophthalmologists are basically your surgical eye specialists.
What is an optometrist?
“Optometrists are licensed healthcare professionals who specialize in primary eye care.”
And a lot of what we do overlaps with what ophthalmologists do. We’re more of your general eye care providers, just like you have your internal medicine and family practitioner, where we do most everything that ophthalmologists can do, short of surgery. We’re kind of like the gatekeepers of eye care.
The impact of systemic health on eye care
The connections between various systemic problems and your eye health greatly impact communities of color, specifically the black community. One of the things that I do every day when we examine a person’s eyes is look at the blood vessels and the blood flow and the conditions of the back of the eyes, and we connect that with their overall health.
A lot of times, people don’t think about high blood pressure affecting the eyes, but hypertension can cause narrowing of the blood vessels in the back of the eyes, just like high cholesterol can and prediabetes. So, a lot of patients have been told that they were borderline pre-diabetic, and it wasn’t a point of emphasis.
The cutting-edge technology that we have allows us to look at the nerve impulses and how the nerve fibers are transmitting the electrical signals in the back of the eyes. This allows us to see early changes in the back of the eyes well before it’s an issue. And I tell my patients, look, it’s important to get these baselines so that over the years, we can monitor these subtle changes and talk to you, talk to your physician, your caregivers, about how you’re handling your overall health and prevent vision impairment by ten years down the road. Those are some exciting things that are becoming more of the standard of care in eye care.
Preventative measures to maintain good eye health
- Adhering to your medications
- Adhering to your diet
- Adhering to your overall lifestyle
The importance of preventative measures, such as adhering to your medications, adhering to your diet, adhering to your overall lifestyle, is so critical. These are points of education that we need to share with our patients, and patients need to take just baby steps.
Lifestyle tips for long-term vision care
My own personal health journey is that I’m living with type two diabetes, and I did not adhere to early changes when I was pre-diabetic. I kept kind of getting ready to and I’m going to get to it, I’m going to get to it until you have that diagnosis. So, I’m walking that journey with my own patients and tell them how I do not want them to have that same journey that I did. But those preventative measures, lifestyle and diet, adhering to your medication, making your doctor visits are very critical even when you’re feeling perfectly healthy. Regular eye exams and monitoring are so very important because they allow us to put the patient in a position where we can detect these conditions early. It places you in a position where things don’t sneak up on you. You’re less likely for a sudden onset of vision loss.
Myopia management for children
As an optometrist, I like to see my children every year because they’re growing. There are many tools that we have to prevent children from becoming more and more nearsighted every year. The specialty is called myopia management. So before, we did not know how to keep kids from getting their prescriptions stronger and stronger and stronger every year. And there’s some serious risk in adulthood when you have a very, very strong nearsighted prescription. So now we have technologies to deal with that.
Eye stress and dry eyes in adulthood
Moving on through college and your early working years, there are so many more demands put upon us with computers and with online learning and with various online platforms that we have meetings on all the time, and people are experiencing more eye stress, more dry eyes from that. So, I prefer to see people every year because very subtle changes in the prescription, your eyeglass prescription or contact lens prescription, can make a very big difference in terms of how comfortable you’re seeing.
Let’s move into the 40s when people start having more issues focusing up close, a normal aging change in which your eyes kind of lose their focus, and you might notice more difficulty seeing small print. We like to know how you are using your eyes day to day. All those demands are different depending on how you use your eyes. So, we’re able to prescribe special lenses for those different situations. We connect the dots between how well and how comfortably someone sees with their overall health.
Dry eyes and autoimmune diseases
What most people don’t think about is that dry eyes can often be one of the very first symptoms of autoimmune diseases, autoimmune diseases like lupus, sarcoidosis, rheumatoid arthritis. And these are things that can have eye effects, cause eye pain, sensitivity to light, and dryness. Sometimes those eye signs can be your very first symptoms that we have to send people and put them back in the direction of maybe getting some blood work from their primary care physician or rheumatologist.
Monitoring BMI and its impact on eye health
When we’re connecting the dots between your overall health and eye health, a lot of patients say well, what can I do? Our epidemic with diabetes has been following our whole nation’s trend in obesity. So we also track the patient’s BMI, the ratio between their overall weight and their height because BMI is also a risk indicator for heart attack, stroke, which people don’t think about, as well as diabetes.
Body mass index (BMI) is not a perfect measure of health, and other factors can also play a role in these conditions. However, maintaining a healthy weight can help reduce your risk of developing these and other chronic diseases.
So we monitor that and we help the patient track that just like their primary care physician. A lot of times, we see blood vessel changes in the back of the eye in patients who are living with obesity. So we try to let them know of that connection. And whether they have diabetes or not, whether they have pre-diabetes or not, they can still be living with obesity, and we connect the dots and help them try to steer the ship, looking at how their overall life and their vision are going to be 5-10 years down the road.
