The result of a Snellen acuity-based refraction represents an important dimension of the individual’s ability to see, their Quantity of Vision. However, quantity of vision does not necessarily equate with visual function and visual satisfaction. Snellen acuity is an artificial construct, a doctor’s office or refraction lane type of vision, determined under controlled conditions of light and contrast that simply do not exist consistently in the real visual world. Quality of vision is more akin to real-world vision and is generally the most important arbiter of visual function and visual satisfaction for the individual. The real visual world is a place of light and dark, contrast and glare, color and shades of gray—more than simple black and white. The customized eyeglass prescription addresses these quality of vision concerns, taking the eyeglass prescription beyond the numbers that define quantity of vision and recommending eyeglass lens enhancements that serve to improve quality of vision.
Beyond Refraction
While refraction, even with the customized eyeglass prescription, is the first step in vision and eye care, with Healthy Sight Counseling it is simply the beginning of the process. A complete ophthalmic examination to determine the health of the eye is next, including an assessment of the external eye (lids, lacrimal apparatus, conjunctiva and cornea), slit lamp biomicroscopy, tonometry, and dilated ophthalmoscopy.
Because of the important relationship between ocular health and systemic health, features of medical examination are incorporated into the ophthalmic examination including a thorough ocular and directed medical history, review of recent or current topical and systemic medications in use (including prescription and non-prescription agents), allergies and sensitivities, family ocular history, assessment of risk factors (smoking, alcohol consumption, obesity), and lifestyle and visual lifestyle issues (occupational, recreational and sports, and environmental).
Healthy Sight, Ocular Health, and Overall Health
Healthy Sight Counseling is based on the premise that healthy sight is something that can be achieved through a combination of customized vision correction, maintenance and preventive vision care, and increased awareness of the importance of healthy sight and how to achieve it. Healthy sight implies good sight; good sight depends on ocular health.
Ocular health and overall health are inextricably linked. In some ways, the eyes may be considered a barometer of the patient’s general medical status. Disease in other organs and systems often has an effect on the eyes. Conversely, abnormalities in the eyes may suggest disease elsewhere in the body. This is true with a number of serious and potentially life-threatening conditions including diabetes, hypertension, atherosclerotic cardiovascular disease, thyroid dysfunction, and cancer.
In addition, various hereditary, social, environmental, nutritional, recreational, and occupational considerations that may affect general health may also affect the eyes and carry the potential to impair healthy sight.
When vision care is viewed as a component of medical/primary care, it assumes a much broader scope. It takes into account the need for regular maintenance and preventive vision care and encourages those components of a healthy lifestyle that can impact both on general and on ocular health, such as a well-balanced diet, vitamin (particularly A, C, and E) and nutritional supplements, a program of regular exercise, and the avoidance of recognized health risks such as smoking, obesity, and excessive ultraviolet light exposure. Vision wear, with its many available specialized lens designs and enhancements, plays an important role in overall vision care, impacting on both immediate and long-term ocular health.
As the individual on the front line for vision care, the vision care professional is in the unique position to provide vision correction and to counsel patients on how best to optimize that vision and protect and preserve it for a lifetime of healthy sight.