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Getting your eyes dilated is no fun. It distorts your close vision and makes bright light painful for several hours after your appointment.
But optometrists and ophthalmologists say the short-term inconvenience is worth it.
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The special drops that your eye doctor uses for dilation allow your doctor to see all the different parts of your eye and spot early signs of problems that could threaten your eyesight and your overall health. In fact, a dilated eye exam can detect more than 270 diseases and abnormalities, according to the American Optometry Association.
Looking into an undilated eye compared to one that’s been dilated is “like the difference between looking through peephole or opening up the door and seeing all the way into the room,” explains Ethan Greenberg, M.D., assistant professor at the University of Minnesota Medical School and an ophthalmologist with M Health Fairview.
Unfortunately, many Americans who should have annual dilated eye exams aren’t getting them. Fewer than 60 percent of the 93 million adults in the United States at high risk for vision loss received a dilated eye exam in the preceding year, according to a 2017 survey.
Annual exams are especially important for older adults, who are at higher risk of developing eye problems such as cataracts, glaucoma and macular degeneration.
Is it really necessary to have your eyes dilated?
Some optometrists have started offering “no-dilation” exams. As an alternative to dilation, they use retinal imaging devices to look at the inside of the eye, which can sometimes cost the patient extra.
However, dilation is still the gold standard, Greenberg says.
“Nothing fully replaces a dilated exam,” he says. “You’re going to miss some things sometimes without a dilated exam.”
A 2017 study published in Seminars in Ophthalmology compared the use of Optomap, a common retinal imaging device, to a traditional dilated eye exam for evaluating patients with a history of retinal detachment. The device’s ability to detect retinal holes, tears and scarring was “poor” compared to a dilated eye exam, the study found.
The American Optometric Association’s evidence-based clinical practice guidelines note that dilation is required for a thorough evaluation of ocular structures. The organization recommends that patients ages 65 and older have an annual eye exam with dilation at least once a year.
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