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Your eyes are windows to your overall health: schedule regular eye exams to identify ocular disorders and potential signs of medical conditions elsewhere in your body.

It's been said that the eyes are the "windows to the soul."

Less poetically, those "windows" may allow for a glimpse of your overall health. Since your eyes offer an unobstructed view of your blood vessels, any problems found during an eye exam may provide doctors and patients with the first clues about a body-wide, or systemic, medical condition, such as diabetes, cardiovascular disease, several autoimmune diseases, and even certain cancers.

"Some of the earliest signs of these diseases occur in the eyes," says Rishi Singh, MD, with Cleveland Clinic's Cole Eye Institute. "For example, we commonly have found patients who have a retinal hemorrhage or some other finding, and that problem has been the first sign of a systemic disease, like diabetes. The biggest issue is that these eye findings may be silent, and the patient doesn't notice any early vision changes."

So, Dr. Singh stresses the importance of scheduling regular eye exams, paying attention to any ocular alerts that may herald a systemic disease, and managing any chronic medical conditions that can affect your vision.

PORTALS TO YOUR HEART

Diabetes is a risk factor for cardiovascular disease and stroke. Just as it restricts blood flow in other blood vessels throughout the body, diabetes can damage the capillaries that supply the retina with nourishing blood. In response, your eyes may form abnormal vessels, which may hemorrhage, form scar tissue, and lead to severe vision loss.

The same diabetic circulatory problems in the retina also occur in smaller blood vessels elsewhere. Consequently, diabetic eye disease may coincide with kidney disease (nephropathy), erectile dysfunction and nerve damage (neuropathy), and may foreshadow a cardiovascular event.

"We can see retinal hemorrhages where a patient has never known he has diabetes," Dr. Singh says. "We know that in patients with end-organ disease from diabetes, such as blood vessel leakage and changes in their retina, or blood vessel formation in the front of the eye, that would definitely predict cardiovascular morbidity, mortality, and even stroke."

An eye exam also may uncover undetected high blood pressure, or hypertension, another "silent" disorder with ocular manifestations. Long-term hypertension can lead to hypertensive retinopathy (damage to blood vessels in the retina), as well as fluid buildup under the retina (choroidopathy) and optic nerve damage--all of which may cause vision impairment.

Researchers have identified an association between cardiovascular disease and another common eye disorder, age-related macular degeneration (AMD). Both diseases share risk factors, most notably high blood pressure, smoking, and inflammation.

One study found that the risk of death from a heart attack or stroke over a 10-year period was twice as high among those with early-stage AMD and five times greater among people with late-stage AMD.

"We know that the mechanisms that cause cardiovascular disease are probably the same ones that cause macular degeneration," Dr. Singh says. "But no true cause and effect has been established. We just know they're associated with each other and there are common pathways."

OTHER ASSOCIATIONS

Several other systemic diseases may manifest in the eyes. In some patients, symptoms such as a retinal hemorrhage may lead to a diagnosis of certain types of leukemia or lymphoma.

"We see patients with changes in the eye that correspond with leukemia or lymphoma and are the first signs of those cancers," Dr. Singh says. "We definitely see it enough to speak about it, but it's not necessarily a commonplace scenario."

Symptoms such as dry or watery eyes, swelling around the eyes, bulging eyes, or vision problems may be the first signs of a thyroid disorder. Other autoimmune diseases, such as vasculitis, multiple sclerosis and rheumatoid arthritis, may cause vision and other problems in the eye, as well. "They can be a first manifestation of these diseases," Dr. Singh adds.

ON THE LOOKOUT

All adults over age 60 should undergo a baseline eye screening to check for any ocular problems and, potentially, identify any early signs of systemic diseases, Dr. Singh says. Based on the findings of that examination, patients should return every year for follow-up exams or every other year if they have no significant risk factors, he adds.

"Routine eye screening is something that's not done frequently enough," Dr. Singh says. "If it's done right, you can really pick up on a lot of diseases."

He adds that patients diagnosed with AMD or retinopathy should be more vigilant about their cardiovascular health and, if they haven't already, ask their doctors about a cardiac risk assessment. "And, I would caution patients with diabetic retinopathy to get other areas of their health, such as their kidneys, checked to determine what other complications they might have lurking," Dr. Singh says. "Patients need to get those evaluations."

WHAT YOU CAN DO

* Schedule a baseline eye examination and then follow-up exams every year or two (or more frequently if your doctor recommends).

* Follow-up with your medical doctor if your eye exam uncovers ocular manifestations of diabetes, hypertension, or other systemic diseases.

* Work with your physician to control your blood pressure, blood sugar, and other cardiovascular risk factors that might contribute to eye diseases.

* If you smoke, talk to your doctor about ways to quit. Smoking is a leading risk factor for several eye diseases, including age-related macular degeneration and cataracts.
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Title Annotation:Vision
Publication:Men's Health Advisor
Date:Jan 1, 2016
Words:869
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