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Not Just For Eyes: Other Health Issues Eye Exams Can Detect

January 25, 2021 | By Dr. Katherine Harkins
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If you don’t wear glasses or believe you have perfect vision, you may think to opt-out of vision benefits or to skip your routine eye exam that is included in your medical insurance. But did you know an annual eye exam provides insight into your health more broadly than just your ocular health? 

They say the eyes are the windows to the soul, but our eyes can also tell a great deal about our systemic health. Sometimes patients look at us funny when we want to discuss a thorough review of their health history and medications. It is not intuitive that your eyes can be impacted by health conditions affecting other parts of your body, and patients are often surprised to hear that even the most common medications can occasionally affect ocular health. 

Below are other health problems an annual eye exam can detect — it may make you reconsider deferring your vision and ocular health assessment. 

Cardiovascular health problems

Your heart and your eyes may be more in sync than you thought! At your routine eye exam, your doctor may be able to discover common heart health problems that your primary care provider typically diagnoses. 

If your optometrist notices unusual kinks or bleeding from blood vessels in the back of your eye, that can indicate high blood pressure. High blood pressure, which affects over 100 million Americans, is a known risk factor in the onset and/or progression of glaucoma, diabetic retinopathy, macular degeneration and other diseases. 

Additionally, if your eyes have a yellow or blue ring around the cornea, that may be a signal of high cholesterol, which can be a precursor to a life-threatening stroke. An eye exam can also detect an increased risk of stroke; if your blood vessels in your retina contain clots, it can cause sudden blind spots and reduced vision. 

Nearly half of American adults suffer from cardiovascular disease. A routine eye exam can help at-risk patients stay on top of their health and get back on the right path. 

Detecting cardiovascular issues: A true story 

The most common complaint in an eye exam is blurry vision. Usually, a new pair of glasses solves the problem, but there are occasional cases when the blurry vision is caused by a much more concerning problem. I can recall a patient in his early 40s who came in with the usual concerns of blurry vision. While taking a look inside his eyes, I observed swollen optic nerves, retinal hemorrhages, and changes to the retinal vasculature. We immediately paused the “routine” exam and checked his blood pressure, which turned out to be 218/185 (normal is 120/80). 

After that reading, he was rushed to the emergency room where they started efforts to lower his blood pressure to prevent a cardiovascular event. Vision problems due to this cause will often resolve over time, but sometimes the visual effects can be long-lasting. 

What was important in this patient’s case was that he got the treatment he needed to prevent a life-threatening event. It was very rewarding to follow up with the patient and learn that this experience had motivated him to begin living a healthier lifestyle with good eating habits and daily exercise. 

Other serious diseases

Although we never want it to happen, an optometrist can also detect other serious illnesses like cancer, diabetes, and multiple sclerosis during an annual eye exam. 

Signs of diabetes can be visible in eye tissue even before a person has been diagnosed. For example, small blood vessels in the retina can leak fluids, which can be an early sign of diabetic retinopathy. Detecting this disease early can help people avoid serious vision problems or vision loss. 

Surprisingly, many types of cancers can also be detected during an eye exam including skin cancer, leukemia, lymphoma, and even breast cancer. Certain skin cancers can affect the eyelids and outer surfaces of the eyes. Eye exams done by an ophthalmologist or optometrist are sometimes the first step in diagnosing melanoma of the eye, where he or she will look for abnormal growths or irregular blood vessels indicating a possible tumor. 

Separately, cancerous tumors from other parts of the body can affect the eye, which can be detected during eye exams. Ocular metastasis, or secondary growths in the eye, are most commonly caused by breast cancer in women or lung cancer in men. Because metastasis can go undetected, a routine eye exam can help diagnose serious illnesses before it’s too late. 

Lastly, an inflamed optic nerve can be an indication of multiple sclerosis, a debilitating disease of the nervous system. If you have severely blurry vision and painful eye movement, your optometrist may be able to help diagnose this disease and recommend the next steps, like going to the emergency room or seeing a specialist.  

Detecting multiple sclerosis: A true story 

I saw a young woman in her 20s who came to me with concerns of very blurry vision in one eye only. It was a new problem for her in the previous weeks, but she wasn’t exactly sure when it started because she had been busy studying for her college final exams. We went through all of the normal tests in an eye exam, and most things were looking pretty normal. In fact, even when I looked inside her eyes, I could not see a reason for her worsened vision, and I could not improve the vision with glasses. Based on her age, gender, complaints, recent stressors, and ocular findings (or lack thereof), I sent her to the emergency room for an MRI, which confirmed my suspected diagnosis of multiple sclerosis. Although this was a shocking and upsetting outcome, the patient was able to get the treatment she needed to improve her vision and control her newly diagnosed condition. 

Eye exams aren’t just for your eyes. 

These are just a couple of examples of the many systemic health conditions we can uncover during an eye exam. As an optometrist, our focus is taking care of your eyes, but our number one priority is to take care of the patient as a whole. It is difficult to deliver bad news, but it is rewarding to know that these patients will live a longer, healthier life because they had their eye exam.

Stay on top of your health — check out our Mobile Vision Clinics’ neighborhood schedule and book your annual eye exam with us.


About Dr. Harkins 

Dr. Katherine Harkins grew up in a small town in Wisconsin and attended college at the University of Wisconsin-Madison, where she earned her BS in Biology. She was drawn to the East Coast to attend optometry school at The New England College of Optometry in Boston and fell in love with the city. After earning her Doctorate in Optometry, she spent the next several years in private practice where she enjoyed caring for patients of all ages, providing comprehensive eye care in both English and Spanish. Dr. Harkins likes to travel, try new foods, and meet new people. She also loves her sports teams and luckily rarely has to choose between cheering for her Wisconsin and New England teams!


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