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Systemic Health Conditions and Your Eyes

You can see my what?? I'm just here for new glasses....

It is almost every day when I find myself talking to patients about not only their new glasses or contact lenses, or even the health of their eyes, but how their eye health can be a snapshot of their total systemic health. There are many common findings during a routine eye exam that can be an early sign of significant systemic health concerns. When caught early, many of these conditions can more easily be managed. A few common systemic health conditions that will be discussed are diabetes, high blood pressure and various autoimmune diseases.

Diabetes

One of the most important and common general health conditions that can be evaluated with an eye exam is diabetes. Diabetes is a disease that causes damage to the fine blood vessels in the body. The eye just so happens to be the only place in the body where the blood vessels can be directly and noninvasively viewed. During every comprehensive eye examination, a detailed and careful view of the internal ocular blood vessels is performed. During this exam, any subtle change to the vascular structure can be observed. Diabetes causes the blood vessels within the body to become fragile and leak. This can cause hemorrhaging within the retina, and if left untreated, can cause significant vision loss. When these early signs of diabetes are noted in a patient who is not currently diagnosed with diabetes, a more thorough evaluation is ordered to perform the necessary lab tests to either confirm or rule out the condition. If a patient is already diagnosed with diabetes, a yearly eye examination is a crucial step in the overall evaluation of diabetic control. I always tell diabetic patients that if there are changes in the blood vessels of the eyes, there are also potentially changes in the rest of the body. Diabetes can cause serious health complications, but early detection can allow someone to know the appropriates steps necessary in order to properly control this lifelong condition.

Hypertension

Hypertension is a chronic condition that can not only cause damage directly to the eyes, but it can also cause potentially life threatening damage to the rest of the body. Like diabetes, this can be undiagnosed for years until there are serious complications. Also like diabetes, hypertension causes damage to the blood vessels of the eyes. When these blood vessels are observed with the classic symptoms of hypertension, a complete medical workup is often warranted to begin the process of managing this condition. It is very important for all patients managing hypertension to continue to be vigilant in the long term control of the condition. A person can have absolutely no symptoms of even significant hypertension, and during this time the risk of systemic health issues such as heart attack and stroke is still present. By recognizing these early blood vessel changes from a simple eye exam, a patient can be directed for additional tests in order to properly diagnose and begin treatment.

Autoimmune Conditions

The human immune system is an amazingly efficient system that can recognize, eliminate and correct many conditions. There are certain instances where this system can incorrectly identify normal body tissues as potentially dangerous. These conditions are collected under the name of autoimmune disease. There are many individual conditions in this group such as rheumatoid arthritis, lupus and sjogrens. Interestingly, many autoimmune disease have certain eye related symptoms that can often be the first sign of the disease. Inflammation within the eye called uveitis, certain forms of corneal ulcers and dry eye can all be related to autoimmune disease.  When these symptoms do not follow a typical course, a diagnosis of an autoimmune disease is often suspected. In these cases, specific lab tests may be ordered that can test for specific genes or antibodies that are related to these conditions. When an autoimmune diagnosis is made, a patient can begin treatment and monitoring to help manage these symptoms. It is very important for these patients to be vigilant in the management of these conditions because they can remain asymptomatic for long periods before flaring up. A prompt diagnosis is therefore critical in addressing both the short term and long term complications of these conditions.

I always think of patients not just as a pair of eyeballs, but as an entire person whose eye may just show the tip of the iceberg with regards to their overall health. An ocular issue can often be the symptom of a systemic disease, and it can also be the first sign of a much more serious problem. Patients are often surprised when I talk with them about their overall health and not just their eyes, but in my opinion it is a necessary part of the exam. It is not surprising for us to recommend further testing or additional appointments with specialists to address the findings of the eye exam. If you are already managing one of these conditions, or you want to ensure that you have no early eye related signs, please come see the doctors at Optique in order to put your mind at ease.

-Dr. Z

10 January, 2019