Early warning signs of high blood pressure, diabetes, even stroke

The eyes may be the windows to the soul, but they also are the windows to the body. Via the eyes, doctors can view internal structures, including nerves and blood vessels. What they learn can provide important clues about your whole body—and your current and future health.

Regular eye exams are obviously important for visual health. But they also can detect conditions that you might not know you have—and that your primary care doctor might have missed. Important clues…

Clue: Damaged blood vessels.

Could mean: Diabetes.

Patients with diabetes have a high risk for diabetic retinopathy, a diabetic eye disease in which blood vessels in the retina are damaged, causing vision loss and blindness. During an eye exam, your doctor will look for microaneurysms, areas where blood vessels are swollen or leaking, a sign of diabetic retinopathy. Your doctor also might notice the growth of new, abnormal blood vessels, which could indicate advanced diabetes and diabetic retinopathy.

Most diabetics get regular eye exams because they know about the risk for eye damage. But in some cases, patients who don’t know that they have diabetes—or who have it but aren’t controlling their blood sugar—first learn there’s a problem during a routine eye exam.

Clue: Thickened blood vessel walls.

Could mean: High blood pressure.

High blood pressure damages artery walls and causes them to thicken. It also promotes the accumulation of fatty buildups. Artery changes can be detected during an eye exam.

Your doctor also will look for damage to the optic nerve. This often occurs in patients with impaired circulation and poorly controlled hypertension. It can lead to hypertensive retinopathy, damage to the retina that is a common cause of vision loss.

Patients with severe hypertension can develop copper wiring and/or silver wiring, damage to the retinal arteries that gives the arteries a coppery or silvery hue.

Clue: Clots in the retinal blood vessels.

Could mean: Increased stroke risk.

Most strokes are ischemic, caused by blood clots that reduce or stop circulation to parts of the brain. As with other cardiovascular diseases, patients may not suspect that anything is wrong until it’s too late.

Your doctor might detect tiny blood clots in the arteries in the retina. Clots in these blood vessels could indicate that there is a similar problem elsewhere in the body, including in blood vessels in the head or neck. Your doctor also might see yellow flecks that indicate high cholesterol, an important stroke risk factor.

Important: See your primary care doctor immediately if you notice a sudden change in your visual field—if, for example, the right side of your field of vision is dark or blurry. Changes in the visual field could mean that you’ve already had a stroke.

Regular eye exams are critical if you have any stroke risk factors, including diabetes, hypertension, smoking or a family history of cardiovascular disease. The same strategies that can protect you from heart disease also will reduce your risk of having a stroke.

Clue: Inflammation.

Could mean: Autoimmune diseases.

Patients with an autoimmune disease don’t always know they have one because the symptoms—such as joint pain from rheumatoid arthritis or leg weakness from multiple sclerosis—might not appear until the disease progresses.

Signs of ongoing inflammation could include swollen blood vessels in the retina or blood vessels with an inflammatory coating. Other immune-related eye symptoms include blurring, dryness, itching and red, watery eyes.

A significant percentage of multiple sclerosis patients will have optic neuritis, inflammation of the optic nerve that temporarily can cause eye pain, hazy vision and sometimes blindness in one eye. Optic neuritis is an early symptom of multiple sclerosis.

Clue: Bulging eyes.

Could mean: Graves’ disease.

Having an excess of thyroid hormones, known as Graves’ disease, can cause tissues around the eyes to swell. This makes the eyes bulge outward. You can distinguish this from naturally prominent eyes by the amount of white that is visible—in patients with high thyroid levels, you will see an unnatural amount of white all around the eyes.

About half of patients with Graves’ disease will develop Graves’ ophthalmopathy. Along with bulging eyes, the symptoms may include eye irritation, immobility of the eye muscles and/or visual changes (such as light sensitivity).

Your doctor may recommend surgery and/or medications to reduce the production of thyroid hormones. You also might be given medications to reduce the effects of thyroid hormones.