Your eyes may reveal a window to your heart as they can provide insight to potential hypertension and high cholesterol levels.

According to the Centers for Disease Control, 68 million Americans live with hypertension. Less than half of those diagnosed have their blood pressure under control; many other people don’t even know they have hypertension or display any noticeable symptoms.

Did you know that the eye can sometimes present the very first signs of systemic disease, whether it is heart disease, diabetes or another health condition? Getting a comprehensive eye exam each year can help identify undetected systemic conditions such as hypertension in patients. Here are a few ways a trip to your eye doctor can help gauge your overall cardiovascular health.


Your optometrist can detect systemic high cholesterol when corneal arcus is seen. Arcus is a white ring of cholesterol metabolites that accumulate over time behind the cornea the clear, round tissue in the front of the eye and its colored iris. While this sign remains even after high cholesterol is controlled, it can help initially bring cardiovascular health to a patients attention.

Moving inward, we have the retina, the tissue in the back of the eye that receives the focused light and brings that signal through the optic nerve to the brain. This tissue features blood vessels that are actually visible through your eye by your optometrists equipment. It is one of the few places we can observe functioning blood vessels in the body. Your optometrist is able to detect changes to the shape, size and overall appearance of the blood vessels, which can indicate cardiovascular problems. With hypertensive retinopathy, we can see leaking blood vessels or even a swollen macula, both of which can impair central vision. After discussing these findings, a patient can initiate management with their primary care physician to treat the high blood pressure.

With heart disease, atherosclerosis is a thickening of the artery wall caused by chronic inflammation associated with LDL cholesterol. A buildup of plaque can occur in the major arteries; this buildup commonly occurs in the carotid artery. If a plaque is dislodged from the carotid, it can travel to the eye and can cause an intermittent or even permanent loss of vision. If seen during an eye exam, referral for diagnosis and treatment of carotid artery disease is recommended whether the patients vision is symptomatic or not. Management of carotid artery disease is extremely important, as dislodged plaque could travel to the brain and cause a stroke or heart attack.

Hypertension can be worse for patients with diabetes as it can cause blood vessels to leak inside the body and the eye. If you have hypertension, those leaky vessels have more pressure flowing through them and can bring about even more severe leaks.

Maintaining your heart health is important, and the eyes are one area that can be used to detect poor cardiovascular health in patients. Annual comprehensive eye exams can help detect undiagnosed systemic diseases as well as monitor for complications associated with a diagnosed systemic health conditions. The earlier the detection and treatment, the better the outcome will be moving forward.

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