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The Eyes Really Are the Windows to the Heart

There’s no question annual eye exams are critical for vision and eye health, but their benefits go well beyond ocular health. A routine exam is not only an “early detection” strategy for eye health, but heart health as well.

Research shows that a regular eye exam can identify a number of cardiovascular conditions, often before the patient even knows they have an issue. In fact, one study found that a routine eye exam detected risk factors for heart disease long before any other health professional had noted the condition.1 Specifically, they found signs of high cholesterol 65 percent of the time, high blood pressure 30 percent of the time, and diabetes 20 percent of the time.1

In other words, one can learn a lot about your heart health from a routine eye exam BEFORE there are symptoms of bodily damage. Talk about preventative care.

The secret lies in the exam itself. When an eye doctor performs an exam, they not only test visual acuity, eye movement, and side vision, but they also check eye pressure, the topography of the eye, and your retina and optic nerve. In doing so, an ophthalmologist or optometrist can see characteristic changes of damage to the retinal blood vessels that reflect system-wide abnormalities affecting the heart.

In fact, an eye examination is the only non-invasive means by which a physician can actually see your blood vessels. This is key when it comes to high blood pressure in particular.

Often called “the silent killer”, high blood pressure often has no symptoms in its early stages. That’s why untreated hypertension has been explained to patients as a “ticking bomb” to their health, often first declaring itself with a catastrophic heart attack or stroke.

Sadly, one in five people with high blood pressure are not even aware that they have it.2 In fact, research shows that many people first learn of their risk for hypertension, not from their cardiologist, but from their eye doctor.

According to a study from 2015, in one optometric practice alone, 21 percent of patients tested were found to have high blood pressure.3 Of these, 66.7 percent had no idea they had elevated levels.

Given the connection between hypertension and both heart attack and stroke, this is early detection at its best. And speaking of stroke…

A study from Singapore found that retinal microvascular measurements can predict risk of stroke.4 Researchers looked at 3,189 patients who were followed for an average of 4.4 years. Of the nearly two percent who had a stroke event, researchers found that they retinopathy and larger retinal venular size was associated with stroke risk. In fact, they found that retinal imaging (as that done during an eye exam) improved the “discrimination and stratification” of stroke risk beyond the known and established risk factors.

Lastly, an eye exam can also detect elevated cholesterol levels. Elevated cholesterol is one of the leading causes of hardening of the arteries and coronary artery disease.

The hallmark of high cholesterol in the eyes is a retinal vein occlusion. In the same way elevated cholesterol can cause plaque to form in the arteries, it can also narrow the central retina artery, the main connection between the optic nerve and the brain.5 When this retinal vein occlusion occurs, it can impede blood flow from the eye to the brain and back, resulting in sudden, yet painless, vision loss.

As you can see, routine eye exams not only protect you from devastating eye diseases like glaucoma and macular degeneration, but can also detect heart disease and stroke risk years before symptoms even occur.

Give this, there’s little doubt that everyone age 50 and older should be making routine eye exams a part of their routine, preventative, screening checkups


  1. Schaneman J, et al. The role of comprehensive eye exams in the early detection of diabets and other chronic diseases in an employed population. Popul Health Manag. 2010 Aug;13(4):195-9.
  2. Mozzafarian D, et al. Heart Disease and Stroke Statistics-2015 Update: a report from the American Heart Association. Circulation. 2015;e29-322.
  3. AlAnazi SA, et al. Effectiveness of in-office blood pressure measurement by eye care practitioners in early detection and managemetn of hypertension. Int J Ophthalmol. 2015;8(3):612-21.
  4. Cheung CY, et al. Retinal microvascular changes and risk of stroke. Stroke. 2013;44:2402-8.
  5. O’Mahoney PR, et al. Retinal vein occlusion and traditional risk factors for atherosclerosis. Arch Ophthalmol. 2008 May;126(5):692-9.
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