Definition and Overview

A general eye follow-up is an after-care consultation with an eye specialist, who could be an ophthalmologist or optometrist after initial or comprehensive treatments have been completed. It can also be conducted in between consultations to (1) ascertain the effectiveness or progress of the previously prescribed treatment and (2) provide counseling.

Individuals who suffer from minor eye problems such as refractive errors like presbyopia, hyperopia (farsightedness), myopia (nearsightedness), or astigmatism can consult optometrists who can provide an expert advice on the most ideal device to use to improve visual clarity and acuity.

For more complex diseases, patients typically consult ophthalmologists who have additional training that allows them to perform surgeries. These eye specialists can also subspecialise in different areas including cornea and external diseases, cataract and refractive surgery, glaucoma, vitreoretinal diseases, ophthalmic plastic surgery, paediatric ophthalmology, ophthalmic pathology and neuro-ophthalmology. However, an optometrist and ophthalmologist can work together to provide the patient with the best possible eye care.

Also, some people may confuse optometrists with opticians. Although both deal with refractive errors, opticians are the ones who fill glass prescriptions.

Because the damage to the eyes can significantly reduce a person’s quality of life, a follow-up ensures conditions are controlled, treated, and managed as quickly and efficiently as possible.

Who Should Undergo and Expected Results

A general eye follow-up is necessary to:

  • Monitor complications - Various eye treatments carry a certain level of risk. Surgeries, for example, may cause damage to the nerves and cornea. There are also minor problems to watch out for such as swelling and bleeding. Some of these complications can worsen while others may develop at a later time. Regular follow-up sessions help an eye expert to ensure that such are prevented or caught and treated as early as possible.

  • Control worsening symptoms - In certain cases, treatments do not yield the expected results, or certain symptoms worsen over time. These should be monitored so appropriate adjustments can be made to make the treatments more effective.

  • Keep track of age-related eye diseases: More than 50% of diagnosed eye diseases are age-related. For this reason, regular eye screening tests with follow-up are recommended particularly to those who meet certain risk factors.

  • To provide counseling on proper eye care: Counseling patients on how to properly care for their eyes can be a preventative or management measure that can help minimise or delay damage to the eyes until such time when better technologies are available or as the person grows old. The counseling can be performed during follow-up sessions.

  • Check for recurrenceEye cancers are rare when compared to other types of cancers, but they can still be life threatening. Although they can be treated, they can recur, which a follow-up can help detect so prompt treatment can be provided.

  • Determine the effects of certain diseases to the eyes – Follow-up tests to the eyes can also be conducted if the patient has certain preexisting conditions such as a brain tumour or diabetes that can impact the eyes or some of its parts.

How Does the Procedure Work?

As part of the after-care program of the patient, the follow-up is discussed during the initial consultation to give the patient an overview of what is going to happen after the treatments are completed or while they are still in progress.

The duration of the follow-up can significantly differ. It is expected that they will be frequent at first, especially if the eye doctor is still in the process of monitoring complications, which can occur a few days or weeks after the surgery. In rare cases, these complications may appear a year after the treatment.

If the patient is progressing well, the follow-up may be scheduled at least once every three or six months. In some cases, it can be once a year.

During the follow-up, the doctor is expected to:

  • Conduct a comprehensive review of the past follow-up results - If the doctor has suggested a treatment, the follow-up will focus on assessing its effectiveness. He may also compare symptoms felt to identify if the condition has worsened or if complications have developed.

  • Request for follow-up tests - Usually, the tests obtained are the same to establish a clear baseline or a standard basis for comparison, although new exams may also be required.

  • Counsel the patient on good nutrition, eye protection, supplementation, medication and routine, among others

  • Suggest a new or another type of treatment depending on the outcomes of the exam, condition of the eyes, or treatment evaluation

Possible Risks and Complications

Some patients may not attend any of these follow-up sessions, which may happen if they believe they have already been treated and such, do not require additional appointments. However, this can be a serious problem as some eye diseases can progress even if treatments are already provided. The eye doctor must be capable of helping the patient understand the importance of these follow-up appointments and set up reliable follow-up communication methods.

References:

  • American Academy of Ophthalmology Preferred Practice Patterns Committee. Preferred Practice Pattern Guidelines. Comprehensive Adult Medical Eye Evaluation -- 2010. http://one.aao.org/preferred-practice-pattern/comprehensive-adult-medical-eye-evaluation--octobe. Accessed February 26, 2015.

  • Colenbrander A. Measuring vision and vision loss. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 5, chap 51.

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