The Big Picture

As health care professionals, optometrists have the responsibility always to be at their best and serving the needs of their patients. Occasionally, that means having to play detective when something just doesn’t seem quite right. If you rush through an examination or ignore a nagging sign or symptom, you could miss a serious diagnosis. Take, for example, retinal disorders. Each has its own unique clinical presentation. They can present in an emergent walk-in patient or be diagnosed during a comprehensive eye examination. Management options are not all standardized, and complex presentations can challenge even the most experienced among us.

This issue of Modern Optometry takes an in-depth look at retinal disorders. Our contributors serve up tips on how to efficiently and accurately diagnose and manage a variety of conditions. We all know that age-related macular degeneration (AMD) is increasing as the population ages, but challenges remain for clinicians regarding the best ways to make a timely diagnosis and to manage the various presentations of AMD. In this issue, Damon Dierker, OD, FAAO, guides you through the ins and outs of this well-known condition, with pearls on making an accurate diagnosis of AMD and managing these challenging patients.

Retinal detachments can be visually devastating, even when they present subtly. Patients may not even be aware that anything is wrong. That’s why it’s important to be familiar with the variety of their clinical presentations. Christopher Lopez, BS, OD, provides an overview, with a discussion of technology that can aid in diagnosis and best management strategies for these potentially sight-threatening disorders.

We’ve all heard the saying that the eyes are windows to the soul, but for eye care providers the eyes are also windows to systemic health. Many times, signs in the retina can provide clues to optometrists that there are issues elsewhere in the body. Retinal vein occlusions and infectious retinal diseases are great examples. Not only can they affect the vision of our patients, but they are also potential warning signs of something more serious occurring systemically. Jennifer Gould, OD, MS, FAAO, Dipl ABO, and Joseph J. Allen, OD, FAAO, discuss clinical signs and symptoms of these conditions and provide blueprints of what happens after the diagnosis has been made.

Other articles in this issue explore systemic diseases that have connections with the eye. Successful management of thyroid eye disease involves communication among eye care, primary care, and endocrinology practitioners, for example. Many times in such diseases, the eyes and the body must be treated simultaneously by different specialties. Click here to learn about ocular manifestations of an important systemic disease in the pediatric population: juvenile idiopathic arthritis. Kathryn Andrews,OD, FAAO, explains the importance of identifying and appropriately managing this autoimmune disease in a timely fashion.

Enjoy the issue! We hope that you gain valuable insights into managing retinal disorders, and remember that the eyes are windows to our health. Similarly, our email is a direct portal to us, so send your questions, comments, or best practices to modernOD@bmctoday.com. We’d love to hear from you.