Valentine’s Day is coming up, so while you’re gazing into your partner’s beautiful eyes, remind them to schedule an eye exam. I’m not sure about the soul, but your eyes can absolutely provide a window to your overall health. The back of your eye is the only place in your entire body with an unobstructed view of your blood vessels. To view them anywhere else would require an incision or special imaging. Big deal, right? It is when the physical appearance of your blood vessels and the tissue around it can give us a picture of your systemic health– blood pressure, cholesterol levels, sugar levels if diabetic, and more. Blood vessels are essential in that they carry oxygen and nutrients to all the tissues of your body. They can dilate, constrict, leak, burst, harden, and become blocked. If the vessels in your retina appear a certain way, we can assume the other small vessels in your body appear this way too.
We first use drops to dilate or widen your pupil, which is essentially just a window that allows light into your eye. We then use a special handheld lens to look through your pupil and into the back to view and analyze your retina, optic nerve, and blood vessels. The retina is neural tissue that absorbs light, and the optic nerve takes information collected by the retina and sends it to the brain for processing. We can also use a special camera to get a photo of these structures. You may have seen these images at a previous eye exam. While the photos aren’t a replacement for dilation, they can provide a quick screening of the retina, and allow us to track the appearance over time. A photo also gives you an opportunity to see what the back of your eye looks like.
High blood pressure affects about one third of adults in the United States. Of those, only half have controlled high blood pressure. Damage to your vessels from high pressure causes hypertensive retinopathy. The vessels will appear constricted, kinked, and may even leak fluid or blood. If the leaky vessels are in the macular (central vision) region, this will significantly blur your vision and may require injections to soak up the fluid. If severe enough, uncontrolled high blood pressure can also cause your optic nerve to swell, which is an immediate referral to the ER for a full work up.
High cholesterol occurs when you ingest more cholesterol than your body can break down, so it builds up in the blood vessels. Problems with metabolizing cholesterol can also cause it to accumulate. Over time, excess cholesterol in blood vessels combines with other substances to form hard deposits, known as atherosclerosis. We see changes where hardened arteries clamp down on veins as they cross over, and vessels may have a shiny silver appearance. If there’s a blockage, we may see the blocked vessel burst (if a vein) or cut off blood supply to the eye (if an artery). This can cause irreversible vision damage and may also require injections to soak up blood or fluid. Sometimes we can even see the actual cholesterol plaque inside your vessel.
Diabetic retinopathy follows when blood sugar levels are left uncontrolled often or for long periods of time. In mild stages, the vessels may have out-pouches where the wall is weak due to extra sugar in the blood. In later stages, vessels will burst and leak blood and fluid, once again causing blurred vision and may require injections. In severe stages, tiny new blood vessels grow and may leak to later form harmful fibrous scar tissue, further retinal detachments, and possible permanent vision loss.
When your eye doctor sees these changes not only do we initiate any necessary ocular treatment, we notify your primary doctor- so they can start or adjust your blood pressure, cholesterol, and/or diabetes medications. Oftentimes your eyes will show early signs of disease before it progresses to obvious symptoms. Even if you don’t wear glasses or had previous LASIK, it’s important to have a yearly eye exam to check the health of the eye. Contact the SureVision office if you have any concerns about how these conditions may be affecting your eyes.