What Is That Puff of Air During My Eye Exam?

My eye doctor tells me to sit still and don’t blink and then “poof” a puff of air hits my eyeball. This has happened enough times that I’ve started kind of wincing in anticipation and sometimes the doctor has to repeat the test because, that’s right, I blinked. While it is just part of the many tests one goes through when you see your ophthalmologist, it is very important, especially for us older citizens.

A hint as to what this test does might come from the revelation that January is National Glaucoma Awareness Month. Obviously, this month of awareness revolves around the health of our eyes which sometimes get overlooked (pun intended). I’ve talked a lot in my blogs about how to stay healthy, whether it’s an awareness about a certain type of illness, or ways to eat healthy and to exercise, or actions we can take to prevent sickness, like getting vaccinated. While getting older often robs us of some of our physical and mental health we can do things to slow down this process and maintain our quality of life. When I sit back and think about my eyesight, I realize that losing my eyesight would have a huge impact on my quality of life. While my ability to see the golf ball has shrunk from 250 yards to 200 yards, I can still play and enjoy the game. It is also helpful that the distance I drive the golf ball has also shrunk. I do notice I must play closer attention when I’m driving the car at night. These small inconveniences would become huge if I had a big reduction in my ability to see.

Back to the eye test. I can’t remember how I found out, whether I asked the doctor or read about it, but the puff of air on the eye test is to measure the pressure inside your eyeball. This pressure, called intraocular pressure or IOP, has a direct correlation to the disease of glaucoma. The puff of air makes a very small indentation in your eyeball and by measuring the amount it indents and rebounds the test, called a Tonometry, can determine the pressure inside your eyeball. The higher the pressure the higher the risk of glaucoma. The higher eyeball pressure is caused by the lack of exit circulation of the liquids inside the eyeball. It’s like the drain is plugged so the pressure builds up. It is important to catch this increased pressure as soon as possible so that steps can be taken to stop the damage from progressing.

Glaucoma is one of the leading causes of blindness. There is no cure, but there are steps that can be taken to stop further loss of vision. Unfortunately, the onset of glaucoma can go unnoticed since it starts affecting the peripheral vision first. It is estimated that over 3 million Americans have glaucoma but only half of those know they have it. A fact that I found astounding is that blindness from glaucoma is 6 to 8 times more common in African Americans than Caucasians. This is a problem that needs to be addressed. The only way to detect glaucoma early is through testing. We need to ensure that our healthcare system reduces any access barriers that might exist so that everyone can easily get tested for glaucoma.

Another reg flag to be aware of is the propensity for glaucoma to run in your family. I’ve talked in an earlier blog about my early detection of a detached retina because both my brother and sister had experienced the problem and made me aware of the problem and symptoms. My mother had macular degeneration. Knowing what kind of problems run in our family gives us information on where we need to be vigilant. Glaucoma tends to be more prevalent in different families. If you have members of your family who have been diagnosed with glaucoma should be all the encouragement you need to get regular eye tests.

The Glaucoma Research Foundation identifies five tests that can be performed to detect glaucoma. You can click on the test names to find out more about each test. While it isn’t necessary to get all of the tests every time, they can all be used to refine a diagnosis. Regular glaucoma check-ups should include two routine eye tests: tonometry and ophthalmoscopy.

Examining...	Name of Test
The inner eye pressure	Tonometry
The shape and color of the optic nerve	Ophthalmoscopy (dilated eye exam)
The complete field of vision	Perimetry (visual field test)
The angle in the eye where the iris meets the cornea	Gonioscopy
Thickness of the cornea	Pachymetry

I realize that the COVID-19 pandemic may have made us hesitant to schedule preventive appointments with our healthcare providers. If you haven’t seen an ophthalmologist in the last year, I encourage you to schedule an appointment now. Before you go, find out if you have a history of glaucoma or other eye problems in your family and then talk to your doctor about it. The puff of air on your eye is nothing to blink at; it’s a great step toward keeping your eyes healthy.

Best, Thair