When Joseph Walters, 72, experienced occasional darkening in his left eye, he was concerned. “One time, when I was lying down in bed and looking at my iPhone, the vision in my left eye blanked out. It was white in the center and black around the perimeter. That’s when I knew it was time to make an appointment with the eye doctor.” He didn’t expect anything out of the ordinary when he saw Robert Feinfield, M.D., an ophthalmologist at Providence Saint Joseph Medical Center.
Dr. Feinfield examined Walters' eyes and asked him about the episodes he was eperiencing. “He told me there was nothing wrong with my eyes, but the darkening vision in the eye can indicate a blockage in the carotid artery,” says Walters. Carotid arteries are located on either side of the neck and carry blood to the brain.
"Dr. Feinfield advised that I see my primary care physician, Eric Feit, M.D., as soon as possible to arrange for an ultrasound of my carotid arteries,” says Walters, who was in good shape and always very active with his wife of 49 years, Cathe. It was good advice. Dr. Feit arranged a diagnostic ultrasound the following day and recommended that Walters see vascular surgeon Sasan Najibi, M.D., who ordered a CT scan.
The test confirmed that both of Walters's carotid arteries were severely blocked. Dr. Najibi explained that the episodes of darkening vision were actually considered to be TIAs (transient ischemic attacks), commonly known as mini-strokes. This terrified Walters, whose mother had died of a stroke. Dr. Najibi tried to ease his fears, reassuring him that surgery would open the arteries and reduce the chance of a stroke. Walters underwent two surgeries—one on each artery—which successfully cleared the blockages, and today he continues to be amazed that the diagnosis began with an eye exam.
EYE EXAMS, AN IMPORTANT TOOL IN PREVENTIVE CARE
"Many people who come to us have something they're experiencing or a family history of an eye disease,” says Dr. Feinfield. “The eyes are the windows to the soul—and to our physiology as well,” he adds. “We have the ability to pick up some systemic diseases by examining the eyes.”
Diabetes, for instance, affects the smallest blood vessels in the eyes, damaging the walls of those blood vessels and causing them to become leaky, creating micro-aneurysms. “The eye is the only place where you can examine the vascular strength of the body and see the earliest changes in diabetes,” the ophthalmologist says. Lupus and thyroid conditions can also be detected in an eye exam.
“Primarily, we look at visual acuity and how it can best be corrected," says Dr. Feinfield. "We also screen for glaucoma, cataracts and macular degeneration.” Eyes change with age, so he looks for such changes and ways to treat them. “In a person’s early 40s, sometimes the lens isn’t able to change its shape, forcing that person to hold things farther away to see them clearly. This often plateaus in later middle age, requiring corrective glasses or contact lenses.” He also looks for pterygia, small bumps on the eyes that are common in people who live in Southern California and are exposed to a lot of sun.
As we age, the lenses can become cloudy, a characteristic of cataracts. This condition can easily be treated through laser-assisted cataract surgery. Dr. Feinfield specializes in the procedure, in which he removes the cloudy portions and implants a new lens.
Some other common complaints include floaters, or “little flashes of light” in the field of vision. This could result from a torn retina. “Macular de-generation, which used to be untreatable, is also a common finding,” says Dr. Feinfield. “We are happy medicine has progressed in this area, allowing us to offer a set of medications and certain vitamin supplements to reduce its progression.”
All these conditions—including the one that Joseph Walters experienced—demonstrate why getting an eye exam every year or two is so important.
Walters will be the first to agree, and is grateful he scheduled his exam. ”The insightful diagnosis may well have saved me from a debilitating stroke that could have taken my mobility, my ability to speak or my vision, or possibly worse,” he says. Today Walters enjoys a healthy life with his wife and new granddaughter and is grateful for the team of “absolutely top-shelf physicians” who worked so quickly and efficiently to help save his life. “There is not a day that goes by that I am not thankful for the insight that Dr. Feinfield had with me,” says Walters. “If he had not picked up that problem, I would not have found my way to Dr. Najibi and my life would very likely be much different today.”
