William Kegerize, O.D.
We’ve all heard the expression “the eyes are the window to the soul.” They can
also be windows on your health. A visit to our optometrist may turn up more than a new prescription for eyeglasses; it could
help spot and treat conditions such as hypertension, high cholesterol, and diabetes. "Most people are completely caught off guard when we find these
conditions in a routine eye exam,” said Dr. Kegerize. “We catch many of these before
they become symptomatic.” During
a routine eye exam, the doctor typically will dilate your pupils in order to check the retina, optic nerve, and blood vessels
in the back of the eye. Glaucoma, a condition in which the optic nerve is damaged due to increased eye pressure, is often
diagnosed this way. The following are examples of other diseases that can be picked up during an eye exam.
Narrow or enlarged blood vessels and tiny “flame-shaped” hemorrhages can be an
indicator for hypertension. There are both arteries and veins
behind the eye that cross over each other. In a person with normal blood pressure, the arteries and veins occupy the space without issue; but in a person with hypertension,
the higher pressure will cause the arteries to push down on the veins, cutting off some of the circulation.
High cholesterol, which can lead to heart disease
and diabetes, may be noticeable during an eye exam. Cholesterol that has built up in the carotid artery can break off.
Blood from the carotid is constantly flowing to the eye, and sometimes they can lodge there. This is called a Hollenhorst
plaque. Large broken-off pieces can be dangerous — if it goes to the eye and blocks off a major vessel, a person can
have an ocular stroke and go blind. Cholesterol
can build up in the eye as a person ages and cause macular degeneration, a breakdown of the layer of tissue on the inside
back wall of the eye which leads to vision loss in the center of the field of vision.
Many times, we are often the first person to spot diabetes
in a patient. The patient will come in and think they just need their glasses changed but consistently
elevated blood sugar will cause swelling in the lens. This swelling causes the vision problems. The changes are
not the same kind associated with aging, it’s a bigger change. Diabetics will have damaged blood vessels in the retina, which can cause
blood and plasma to seep out into the eye and trigger vision changes. Vision change happens over time. If a person has high blood sugar one day, they won’t
notice any difference. But if their blood sugar is significantly higher than 100 for 10 days or more (a normal fasting blood
sugar range is between 70 and 130), that’s when the damage starts to be noticeable.
inflamed optic nerve may signal multiple sclerosis, a degenerative disease in
which the immune system attacks the protective coating on the nerves. In about one-third of multiple sclerosis cases, inflammation of the optic nerve is
one of the first signs. This inflammation, called optic neuritis, causes blurred vision. The National Multiple Sclerosis Society estimates that 66 percent
of people with the disease will have at least one episode of optic neuritis. The instances of blurred vision are often temporary
and cannot be treated with prescription glasses. Steroids may be used to reduce the inflammation, but the episodes can recur.
Keeping track of thinning
retinas can help predict multiple sclerosis relapses, in which symptoms recur as isolated flare-ups.
are many things we can diagnose by examining the eye that you, the patient, cannot necessarily determine by how you see,”
said Dr Kegerize. “Typically, you are not going to pick up on these diseases based on how well you see.”