Vision is one of our most valuable senses, yet we often take it for granted. Many people visit an ophthalmologist only when pain, blurred vision, or a serious problem occurs. The truth is that a large number of eye diseases develop “silently” — without symptoms, without pain, and without warning. That is precisely why a preventive eye examination is of key importance for preserving good vision and overall health, shares Dr. Metodieva for i-Health.
Why should we visit an eye doctor even when we see well, Dr. Metodieva?
This is one of the most frequently asked questions we receive as a medical services intermediary.
Dr. Metodieva:
The majority of Bulgarians still lack a culture of regular preventive eye examinations, although recently there has been a positive trend, especially among younger people who spend long hours in front of screens. Unfortunately, however, patients who seek an ophthalmologist only when pain or blurred vision in one or both eyes appears still prevail — and sometimes when it is already too late and vision in one eye has been completely lost.
The eyes have the ability to compensate and adapt. Often, a person does not notice that their vision is deteriorating or that a disease is developing. A preventive eye examination has two main purposes:
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Early detection of eye diseases that begin without symptoms and can lead to irreversible vision loss if not diagnosed in time.
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Assessment of overall health, as early signs of systemic diseases such as diabetes mellitus, arterial hypertension, vascular, and autoimmune conditions can be detected through examination of the eye fundus.
Which diseases can be detected during a preventive eye examination?
Dr. Metodieva:
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Glaucoma – the so-called “silent thief of sight,” which damages the optic nerve for years without pain or complaints.
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Diabetic retinopathy – a complication of diabetes that affects the fine blood vessels of the retina and can suddenly lead to severe vision impairment.
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Age-related macular degeneration (AMD) – affects central vision and the ability to read, recognize faces, and see details.
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Cataract – gradual clouding of the lens, leading to faded colors and reduced contrast. Today, it is fully treatable with modern, sutureless surgical techniques.
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Other conditions – inflammations, retinal tears, tumors, signs of elevated cholesterol, and autoimmune diseases.
What does a complete preventive eye examination include?
Dr. Metodieva:
During a preventive eye examination, we go through several mandatory steps:
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First, we determine visual acuity — not just whether you see, but how well and in what way you see. If necessary, glasses or contact lenses are prescribed.
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Second, we measure intraocular pressure, which is crucial for the timely diagnosis or exclusion of glaucoma.
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A mandatory part of the examination is pupil dilation. This is extremely important, and patients should take it into account when planning a preventive eye exam. Dilation can be performed with fast-acting drops (lasting up to 2–3 hours) or slow-acting ones (up to two days), depending on the specific complaints. If the pupils are not dilated, the examination is neither complete nor high-quality, but rather formal. In such cases, the patient has the right to insist on this test.
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With dilated pupils, a detailed examination of the eye fundus is performed, assessing the blood vessels, retina, and optic nerve.
It is important to know that the eye fundus is the only place in the human body where we can directly observe blood vessels without surgical intervention and without invasive, risky tests. It is precisely there that we “read” the history of your overall health.
If a condition is detected that requires more precise examinations with high-tech equipment, the patient may be referred to a specialized eye clinic. This way, all necessary tests are carried out promptly and with priority, and the patient receives an accurate diagnosis and adequate treatment without wandering from doctor to doctor or hospital to hospital.
How often should we visit an eye doctor? Are there differences in recommendations for children, young people, adults over 40, and those who wear glasses or contact lenses?
Dr. Metodieva:
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Children – first preventive examination around 6 months of age, then annually
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Young adults (20–30 years) – every 2 years in the absence of risk factors
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People over 40 years – once a year
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Patients with diabetes, hypertension, and chronic diseases – every 6 months
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People who wear glasses or contact lenses – at least once a year
It is important to emphasize that checking or prescribing glasses does not replace a full preventive eye examination.
A regular preventive eye examination is not a luxury — it is a necessity. Early diagnosis is the difference between “We can fix this” and “Why didn’t you come earlier?” I always prefer to say the first.
How do digital devices affect vision?
Prolonged work in front of a computer, phone, or tablet leads to the so-called computer vision syndrome. Symptoms include dryness, redness, fatigue, headaches, and a “gritty” sensation in the eyes. The cause is reduced blinking and increased visual strain — a problem that can be detected and alleviated with a timely eye examination, Dr. Metodieva adds.
From everything said so far, it is clear that the preventive eye examination should be our priority. But why do we so often postpone it?
Because the eyes do not “shout.” Because we think “tomorrow,” while tomorrow becomes yesterday. Because it doesn’t hurt.
But do you know what my patients say after the examination?
“I didn’t know.”
“I didn’t expect it.”
“I had no complaints until now.”
And then they realize that prevention is not for people who already have problems. It is for those who want to prevent them. Do not postpone your examination. Come now. Come while we can say “Everything is fine” or “We found it in time.” Your eyes deserve it.
And finally, what message would you give to people who postpone this important examination?
A preventive eye examination is not a luxury — it is a necessity. It is quick, painless, and can be decisive for preserving vision and quality of life. Early diagnosis makes the difference between timely treatment and irreversible consequences.
Taking care of your vision today is an investment in the future.
Do not postpone your preventive eye examination.
“Your eyes hide a story. It’s time to read it.”
Dr. Miglena Metodieva, Ophthalmologist