Why dilate?

I tend to dilate basically all patients who are new to me.

That drives some people crazy!! “Why dilate my eye when I’m just here for this bump on my eyelid?”

Here is, in my opinion, one of the fundamental truths of medicine: generally, the earlier that a disease is detected, the easier it is to fix. In many cases, if the disease is too far advanced, there is no fix available, so early detection is crucial.

How do most eye diseases that patients haven’t noticed yet get detected early? Only if the parts of the eye behind the pupil are checked, such as the optic nerve, lens, and retina. I can’t see those parts of the eye if my patient isn’t dilated, so I generally dilate. Of course, if the patient has a documented dilated eye exam with someone else within the last year, that is usually good enough.

But I’d hate to miss a little problem (that might turn into a big problem) simply because we didn’t look.