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Heartfelt Vision: What Your Eyes Reveal About Your Heart Health

by | Mar 1, 2025 | Manuscripts | 0 comments

Sneha Baidya, M.Optom

Consultant Optometrist, Sudarshan Eye Hospital, Gaur, Nepal

 

More than half a billion people worldwide are still affected by cardiovascular diseases, which caused 20.5 million deaths in 2021—nearly a third of all global deaths. This represents an increase from the estimated 121 million cardiovascular disease deaths. As much as 80% of premature heart attacks and strokes are preventable. (1)

Changes both in and around your eyes, some detectable only through specialised tests, can be early indicators of heart disease.

The eye is the only part of the body where an eye care practitioner can directly observe the activity of blood vessels, nerves, and connective tissue without invasive procedures. This unique feature often allows eye care practitioners to be the first to detect health conditions such as high blood pressure, high cholesterol, stroke, and more.

Pupillary reaction and aortic regurgitation: Landolfi’s sign, characterised by alternating systolic constriction and diastolic dilation of the pupils, is a clinical indicator of aortic regurgitation. It is believed to result from an intensified physiological circulatory hippus in the iris vessels, caused by a wide pulse pressure due to severe aortic valve incompetence. (2)

Xanthelasma and CVD: The yellowish plaques over your eyelids, formed by lipid deposits, can be a subtle yet telling indicator of cardiovascular diseases. A study found that xanthelasma can independently predict the risk of myocardial infarction, ischemic heart disease, severe atherosclerosis, and death in the general population, regardless of established cardiovascular risk factors. (3)

Retinal vessel structure and CVD risk: The structure and diameter of retinal vessels are crucial biomarkers for assessing cardiovascular disease (CVD) risk. (4)

  1. Arteriolar Narrowing: Linked to hypertension, this condition indicates increased vascular resistance and reduced blood flow, mirroring changes in coronary and cerebral arteries, thereby heightening the risk of heart attacks and strokes.
  2. Venular Widening: Associated with systemic inflammation and endothelial dysfunction, wider retinal venules indicate higher risks of ischemic heart disease, elevated blood pressure, and metabolic conditions.
  3. Arteriovenous Ratio (AVR): The AVR, calculated by comparing arteriolar to venular diameters, serves as a comprehensive indicator. A lower AVR predicts hypertension and is linked to increased risks of coronary artery disease and stroke.
  4. Structural Changes: Abnormalities such as vessel tortuosity, microaneurysms, and haemorrhages may indicate chronic hypertension, diabetes, and atherosclerosis, contributing to cardiovascular morbidity and mortality.

Tips for Maintaining Heart Health Through Eye Care

  1. Schedule Regular Eye Exams: These exams can help detect early signs of cardiovascular issues, as the eyes can reveal underlying health problems such as high blood pressure and diabetes.
  2. Monitor Vision Changes: Pay close attention to any changes in your vision, such as blurriness, difficulty seeing at night, or sudden loss of vision. These changes can be warning signs of heart health issues or other systemic conditions.
  3. Make Healthy Lifestyle Choices: Prioritise a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Incorporate foods high in omega-3 fatty acids, such as fish, which can benefit both heart and eye health.
  4. Control Blood Pressure and Cholesterol Levels: Monitor your blood pressure and cholesterol regularly. High levels can increase the risk of heart disease as well as negatively impact your vision.
  5. Manage Stress Effectively: Find stress-reducing practices that work for you, such as mindfulness, yoga, or engaging in hobbies that bring you joy. Regular physical activity can also help manage stress levels.
  6. Be Aware of Your Family History: Understanding your family’s medical history can provide valuable insights into your own risk for heart disease and vision-related issues.

Think of your eyes as secret agents, always collecting information about your cardiovascular system. They can uncover hidden hints about your heart’s condition before you even notice any symptoms. So, the next time you visit the optometrist, remember: those eyes might just save your heart!

 

References:

  1. Di Cesare, M., Bixby, H., Gaziano, T., Hadeed, L., Kabudula, C., McGhie, D. V., … & Pinto, F. (2023). World heart report 2023: Confronting the world’s number one killer. World Heart Federation: Geneva, Switzerland.
  2. Ghosh, R., Sengupta, S., Siraj, S. K., & Benito-León, J. (2020). Landolfi’s Sign: A Riddle for Primary Care Physicians. Journal of Primary Care Specialties, 1(1), 13-14..
  3. Christoffersen, M., Frikke-Schmidt, R., Schnohr, P., Jensen, G. B., Nordestgaard, B. G., & Tybjærg-Hansen, A. (2011). Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study. Bmj, 343.
  4. Flammer, J., Konieczka, K., Bruno, R. M., Virdis, A., Flammer, A. J., & Taddei, S. (2013). The eye and the heart. European heart journal, 34(17), 1270-1278.

 

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