You have your annual eye exam coming up. Sounds simple enough, right? Usually it is. Until the day your doctor detects a serious health condition just by looking into your eyes.
Not only do your eyes provide all kinds of information about your sight, they can also show signs of a host of other medical conditions that have nothing to do with vision.
From diabetes, heart disease and thyroid problems to arthritis, lupus and even certain cancers, your eyes can say so much about your underlying health.
Even scarier? If your eye doctor is the first to detect some of these more serious non-eye-related conditions, it’s pretty late in the game, says Dr. Douglas Rhee, chairman of the Department of Ophthalmology and Visual Sciences at University Hospitals Case Medical Center in Cleveland.
“With all of these, it’s generally late stage,” Rhee tells SheKnows. “Most likely, your primary care physician will catch these things before we do.”
That said, here are nine diseases and other health problems that can be seen by your ophthalmologist in a routine eye checkup.
1. Diabetes
Undiagnosed diabetes can show up in an eye exam as blood and other yellow-tinged fluid trickling out of microscopic, delicate vessels in the retina. Called diabetic retinopathy, it often leads to a total loss of eyesight. “People with diabetes are told that if they don’t treat it, they’re going to have amputations and go blind,” says Rhee. “By the time that happens, hopefully they’ve picked it up already.” But, he added, if blood sugars are really high and uncontrolled, patients will see fluctuating vision.
2. Thyroid disease
This is one of the conditions that can manifest itself in the eyes early on, according to Rhee. Patients with thyroid problems might have bulging eyes or protruding eyeballs, particularly if they’re dealing with the hyperactive thyroid illness known as Graves’ disease.
3. High blood pressure
Though it’s fairly rare that your eye checkup would catch hypertension before another exam would, if it’s left untreated, high blood pressure can be seen in the eyes in the form of bleeding new blood vessels and nicks in those leading to the retina or total retinal detachment. But, generally, according to Rhee, eye doctors “are not going to see anything until it’s way too late.”
4. Heart disease
Some eye tests — including a high-tech, 30-second retina scan — can pick up abnormalities in the blood vessels in the eye that could be a sign of heart disease. If your ophthalmologist sees changes in the widths of the vessels or an out-of-the-ordinary branching formation, it might indicate risk of heart attack.
“Sometimes we can see plaques inside the eye — arterial plaques,” says Rhee, referring to one of the symptoms of cardiovascular disease. “Sometimes, an embolism, instead of going into the brain, will go into the eye. Then, it’s a warning sign. It will destroy part of the vision. It’s an indication that there’s plaque somewhere in the system releasing emboli.”
5. Autoimmune disorders
This includes lupus, rheumatoid arthritis, multiple sclerosis, sarcoid and others, can be detected in a regular eye exam. Inflammation of the retina might be a sign of lupus and other autoimmune diseases, for example. And the swelling of the optic nerve and blurred or blotchy vision can be a sign of multiple sclerosis, according to Rhee.
6. HIV
Very late-stage HIV that’s left untreated (without drugs) can sometimes be detected in an eye exam, Rhee says. But, with advanced HIV medications on the market and people living longer and longer with the disease today, it’s rare that it would be left undiagnosed that way.
7. Cancer and tumors
Growths in the eye, droopy or sagging eyelids, changes in the structure of the eye and pupils that are different sizes could all be signs of cancer or tumors — either in the eyes or elsewhere in the body — according to doctors. But it’s not common for those to first show up at the ophthalmologist’s office, says Rhee.
“Lots of cancers can go either in the eye or around the eye,” he says. “Every so often, we find the metastasis of some of the cancers, and that’s sometimes the first presentation.”
8. High cholesterol
Though a yellowish ring around the cornea and yellowish plaque building on the blood vessels in the eye can both signal high cholesterol, Rhee says that levels would have to be off the charts to show up that way in an eye appointment. “You’re talking ultra-high cholesterol,” he tells us.
9. Stroke
Certain types of stroke, particularly those in the very back of the brain, are accompanied only by a loss of vision and no other symptoms, according to Rhee. “You won’t get a weak arm or leg,” he says.
Bottom line
Get regular medical checkups annually, including eye exams. And watch for general changes in your eyes, including redness, inflammation, light sensitivity and blurred vision — all of which could be signs of something more serious, whether it’s vision-related or not.
“Lots of diseases in late stages can cause damage to the eyes,” Rhee says. “A good message is for people to get regular health care, and eye exams are part of that.”
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