If you have ever noticed that you can see more looking through an open doorway than you can see looking through the door’s peephole, you will understand why we dilate pupils.
When the pupil is small, we cannot see the details of the lens and the view of the retina is compromised. When we cannot see, we cannot adequately follow the progress of conditions such as diabetes, cataracts, macular degeneration, and the risk of retinal tears and detachments in the peripheral retina and we may miss important details that could lead to loss of vision.
We also dilate to understand a potential source of error in eyeglass prescriptions. Individuals with astigmatism or who are far-sighted tend to overfocus. When we dilate the pupil, we can relax that tendency and get a more accurate and comfortable prescription for eyeglasses.
We do not have anything to replace pupil dilation completely, but we have a partial substitute with the OPTOMAP — photography that gives a 210-degree view of the inside of the eye or 80% of the retina. This allows us to see somethings in better detail than a dilated exam, but there is still 20% we cannot see. At least every other year, we still need to dilate to look at the details of the lens that the OPTOMAP cannot see.
It should be noted that OPTOMAP, when used to avoid dilation, is not covered by insurance and you may pay out of pocket for the convenience of no dilation. In summary, though it may be inconvenient and a bit uncomfortable, dilation allows us to take better care of your eyes.