Assessment of ocular and systemic health are important aspects of a comprehensive vision exam. Students attending Pacific University College of Optometry, are taught to integrate ocular and systemic health evaluations into a comprehensive vision examination. This requires that students have an extensive knowledge of ocular diseases in addition to an understanding of how systemic diseases can affect the eyes.
Len Hua , Ph.D, OD
Clinical Chief of Ocular
Disease and Special Testing
The topic of ocular disease covers disorders that range from infections to conditions that produce blindness. Diseases are studied during a sequence of courses that cover conditions that affect the anterior surface of the eye (such as the cornea and lids) to those that affect the posterior pole of the eye (such as the retina and optic nerve head). These courses also include systemic diseases which affect the eyes.
In addition to ocular disease, students are also taught to treat ocular emergencies such as traumas, foreign bodies and chemical exposure.
During the third year, student interns begin patient care. Clinical experience is in the Primary Care Clinic and includes comprehensive vision exams and ocular emergencies which includes treatment of red eyes. Fourth year interns complete a year of patient care including a rotation through the Ocular Disease and Special Testing Clinic. This clinic sees patients who have been referred from the Primary Care Clinics. These patients quite often have active cases of a disease requiring special treatment. Student interns perform state-of-the-art testing to further evaluate the cases and provide treatment using the latest therapy techniques. Some cases may be referred to secondary health care specialists such as neurologists and internists.
During the third year, student interns begin patient care. Clinical experience is in the Primary Care Clinic and includes comprehensive vision exams and ocular emergencies which includes treatment of red eyes. Fourth year interns complete a year of patient care including a rotation through the Ocular Disease and Medical Eye Care Clinic. This clinic sees patients who have been referred from the Primary Care Clinics or the community. These patients quite often have active cases of a disease requiring special treatment. Student interns perform state-of-the-art testing to further evaluate the cases and provide treatment using the latest therapy techniques. Some cases may be referred to secondary health care specialists such as neurologists and internists.
Cataract formation results in a decreased transparency of the lens. Cataracts can form in both the young and the old, but typically affect the elderly. A traumatic cataract results from an injury to the eye that causes the lens to become cloudy.
Age-related cataracts can form as a result of several different conditions. These include normal aging, certain medications and some systemic diseases. When vision becomes impaired, cataract removal surgery is an option that can improve sight in most cases.
Conjunctvitis (Pink Eye)
Conjunctivitis is a common childhood eye condition that can also affect adults. It can be caused by viruses, bacteria or allergy. Conjuctivitis affects the outer membrane of the eye causing redness, itching or burning with a watery or mucus discharge. Treatment of this condition can require the use of medication.
Glaucoma is a disease than produces no symptoms until late in its course when irreversible vision loss has already occured. Glaucoma is caused by a build-up of fluid pressure in the eye which can eventually damage the optic nerve. This can cause partial or total blindness. Yearly vision exams can dectect this disease in its early stages when treatment can prevent further vision loss.
Systemic disease courses are taught as part of the curriculum at Pacific University. These courses present information on diseases that affect different organ systems of the body with special emphasis on how these diseases can create ocular and vision problems.
The pharmacological agents used for treatment of systemic disorders are studied along with their side-effects on the visual system. In addition, the side-effects of medications used to treat ocular diseases on the systemic system are also considered.
Student Interns are taught the importance of taking blood pressure measurements on patients suspected of having high blood pressure. This procedure helps identify those patients at risk of a blood pressure disorder who are not currently receiving treatment.
When examining the back of the eye, a view of the internal eye structures (blood vessels, optic nerve, retina, etc.) is possible. The eye is the only place in the body where blood vessels can be directly observed without a covering of skin. Seeing these blood vessels, in addition to the other internal eye structures, can give clues to certain systemic diseases.
The following are some of the more common diseases that students are educated to diagnose and manage.
Diabetic retinopathy is a disease that can develop in people who have either Type I or Type II Diabetes. It occurs when the tiny blood vessels that nourish the retina become weak. If these blood vessels bleed or leak, they can affect vision and even cause blindness. Yearly exams with dilation of the pupils are important so that the health of the eyes can be monitored. If bleeding or leaking is noted, then the patient can be referred for laser treatment by an Retinal Specialist. Patients who have diabetic retinopathy are also encouraged to work with their physician to ensure blood sugar levels are being controlled properly.
Hypertensive retinopathy is a disease caused by systemic hypertension (or high blood pressure). If hypertension is not treated, the patient can experience serious consequences that are both vision and life threatening. When signs of hypertensive retinopathy are noted, the patient can be referred to primary care physician or a Retinal Specialist if necessary.