( People will often question just why it is that they should have their eyes checked when they seem completely fine.  A person would surely know if something is wrong.  Right?  If there was a problem there would be pain or blurred vision or both.  The eyes are surely sensitive enough.  Just getting a fleck of dust or a little soap in one’s eyes is intensely unpleasant.  Certainly the interior of the eyes is just if not more sensitive than the exterior of the eyes.  After all, the retina is a lot of nerve endings and nervous tissue.  

It is true that the retina has an enormous number of nerve endings, nerve cells and nerve fibers. Probably as high of a concentration of nerve tissue as in the brain itself.  The important distinction inside the eye is that the nervous tissue of the retina is strictly involved with detecting light.  The retina has no ability to feel pain.  Just as the retina cannot detect sounds, odors, or flavors.  All the pain sensors of the eyes are on the outside.   Any swelling, traction, or pressure on the retina is surprisingly and completely painless.    

You say, okay, fine.  So the retina cannot feel pain.  Certainly one would know if they were losing vision or developing an empty area in their field of view.  You’re a sensitive person.  You’re paying attention.  It’s not as if you take days off from using your eyes.  Again, not so.  Glaucoma decreases a person’s vision gradually.  There is no sudden change from one day to the next.  Contributing to this effect is that one eye will typically be affected sooner than the other.  The field of vision of the better eye will hide or obscure the damage that is occurring in the worse eye.  It’s only when both eyes have experienced damage in the same field of view that a person may realize that they have lost their vision.

Elevated pressure within an eye, or Glaucoma, is a fairly common problem.  The high pressure in the eye crushes the individual fibers that comprise the Optic nerve.  This prevents the information from the retina from getting to the brain where we interpret the information.  Unfortunately, nerve damage is permanent.  We cannot reverse the damage that is done.  There are no surgical treatments to repair or reverse the vision loss that Glaucoma causes.  

Checking the pressure in a person’s eyes is painless and easy to do.  This is why checking eye pressures is always a part of a complete eye examination.  In our office, we’ve even replaced the ‘puff of air’ test that was so unpopular with a great new test that is virtually without sensation.  If we find a patient with Glaucoma, it is fairly easy to control their eye pressures with eye drops.  At times, surgery is required to attain safe eye pressures.  The key is an annual eye examination to check for Glaucoma as well as other painless eye problems that can develop.   Even if your eyes seem completely fine.


Richard Butzeye, examsComment