If you’re like most people, you treat your eye doctor like a fixer. 

Street signs blurry? You have your prescription checked. Eyeglass frames loose? You stop by for a quick adjustment. Eyes itchy? You pick up some drops. 

But don’t overlook the many benefits of an annual eye exam. 

“We do more than check your vision,” says Cynthia Collins, O.D., an optometrist with America’s Best Contacts & Eyeglasses in North Myrtle Beach, North Carolina. 

“We screen for glaucoma and cataracts, retinal detachments, and even high blood pressure and diabetes,” she continues. “Some cancers can even appear in the eyes, because the tumor metastasizes there.”

But to get the most from your routine eye exam, you need to be completely honest, says Dr. Collins. Here are some of the most important things to share with your eye doctor at your next exam.

Confession #1: I Sleep in My Contacts (and That’s Not All)

Six in seven people who wear contacts don’t practice proper lens care, according to a report from the Centers for Disease Control and Prevention (CDC). One of the study’s most common bad behaviors? Sleeping or napping in their lenses.

Similarly, says Dr. Collins, many people overwear their contacts. For example, they try to stretch a pair of lenses past the 30-day expiration mark, or wear their dailies a couple of days, or simply leave them in past the recommended 10 to 12 hours. 

Problem is, leaving your contacts in for too long (whether you wear them overnight or for too long during the day) can starve the eye’s cornea of its much-needed supply of oxygen. And that, in turn, can cause dry eye and infections like corneal ulcers, which are open sores that are caused when bacteria starts to eat away at the front surface of the eye.

“I want your honest-to-goodness history on your contact hygiene,” says Dr. Collins. 

For example, if you’re someone who tends to fall asleep in their contacts—or wears them for close to 18 hours a day—your doctor might be able to prescribe you a specific type of extended-wear lens that is approved by the Food and Drug Administration for overnight wear.

Even if you do make the switch, however, Dr. Collins still recommends taking out these contact lenses at least once a week to give your eyes a rest.  

“I see more problems with patients sleeping in their contacts than any other time,” she says, “and it only takes one of those bad infections right in the center of your vision for you to have a problem that’s never going away.”

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Confession #2: I Haven’t Stopped Smoking

Cigarette smoking is on the decline, but 14% of adults in the United States still light up regularly, according to the CDC. And cigarette smoke doesn’t just damage your lungs—it can cause vision problems, too. 

Cigarette smoke can increase a person’s risk of dry eye, a condition that develops when your body isn’t able to properly make tears that lubricate the eye, says Dr. Collins. 

Quitting is a must, and your eye doctor or family doctor can recommend some good strategies for quitting. (The website Smokefree.gov also has great free tools and tips.) In the meantime, using artificial tears daily as needed might help alleviate some of the discomfort.

Smokers are also more likely to develop macular degeneration—the leading cause of severe vision loss in people over the age of 50—than nonsmokers, she says.  

“I definitely look at my smoking patients’ retinas more closely for signs of macular degeneration,” says Dr. Collins. That’s because, for this disease, early detection is key. While there may be ways to slow future vision loss, any eyesight that has already been lost to macular degeneration can’t be restored, according to the American Optometric Association (AOA). 

Confession #3: My Eyes Sometimes Feel Dry

There are many possible causes of dry eye, says Dr. Collins. Some are environmental (for example, maybe you’re allergic to pollen or pet dander); another is poor contact lens hygiene (if you’re not cleaning your lenses every night, they could be harboring harmful bacteria).

Dry eye can also be a result of aging. As we get older, our body naturally produces fewer tears (or less oil in the tears), which keep our eyes lubricated and itch-free, says Dr. Collins. And for women, the hormonal changes that take place during menopause can also play a role in triggering dry eye. 

“There are a lot of different things that can cause that itchiness,” she says. 

You don’t have to tough it out. If it’s bothering you, she says, tell your doctor. He or she can recommend a brand of artificial tears, refer you to an allergist, or offer up another solution based on the root cause of your symptoms.

Confession #4: I Stare at a Screen All Day

Working at a computer or spending hours on your smartphone or tablet can set you up for problems like headaches and dry eye, which can also cause eye fatigue.

That’s because when we stare at a computer, says Dr. Collins, we don’t blink nearly as often as we should. Blinking is important for our health because it delivers those lubricating tears to our eyes.

Another reason: “Holding a screen too close to your eyes overstimulates your focusing system, which causes your eyes to feel strained or tired,” she says.

The bottom line: “If your eyes feel tired when you’re using the screen, tell your doctor,” says Dr. Collins. To combat eyestrain, the AOA recommends the 20/20/20 rule: Every 20 minutes, look at something 20 feet away for 20 seconds. 

Confession #5: I Recently Had a Concussion

Whether you were recently in a car accident or simply collided with your colleague on the softball field, you should tell your eye doctor about any head injuries that you might have had since your last eye exam. 

According to the AOA, about 90% of people who have a traumatic brain injury will also experience eye problems like double vision, difficulty focusing, eyestrain, fatigue, and more.  

Plus, a comprehensive eye exam can even uncover symptoms of concussions if the injury itself has gone undiagnosed, according to the AOA. (Let’s be honest, many of us don’t think to call any doctor after every bump or head bang.) Your eye doctor can also help refer you to a concussion specialist, if needed.

Confession #6: I’ve Been Diagnosed with a Chronic Illness

Dr. Collins likes to be informed of her patients’ new medical diagnoses, especially high blood pressure and diabetes. People with these conditions are at risk for diabetic retinopathy, where damage to the blood vessels in the eye can lead to blurry vision or a loss of eyesight, according to the American Heart Association. 

Similarly, always tell your eye doctor if you’ve been diagnosed with cancer or have started chemotherapy, says Dr. Collins. Some cancer treatments can cause eye problems like dryness, pain, or blurry vision. 

Before your eye exam is over, give your optometrist the contact information of all your other doctors, including your primary care physician, cardiologist, or oncologist. 

“It’s a good to keep everyone in the loop,” she says. “We like to talk to each other to coordinate treatment plans, as well to know what’s going on in your medical history.”