The Eyes Have It

Daily Health Solutions, Featured Article, Healthy Aging, Healthy Living, Multiple Sclerosis
on October 11, 2011
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The eyes may be the window to the soul, but “they are also the windows to your health,” says New Orleans ophthalmologist Dr. Monica L. Monica, a spokesperson for the American Academy of Ophthalmology. Though it’s a tiny organ, the eye is often the first place many diseases make themselves known. That’s a pretty good reason why you need a baseline eye screening at age 40 with follow-up exams as recommended by your ophthalmologist. Here, a rundown of some common conditions your eyes may reveal.

Raised yellow patches on your eyelids
Could mean: An increased risk for a heart attack or heart disease.
The scoop: Though you may beg your dermatologist to remove these unsightly blemishes, called xanthelasma, you may need a cardiac work-up instead. The reason: Those raised patches of skin are actually cholesterol deposits. In a study published in the British Medical Journal this fall, Danish researchers reported that the risk of having a heart attack, developing heart disease or dying over the next 10 years increased in people who had xanthelasma. The older you are, the higher the risk. Men ages 70 to 79 with the patches had a 53 percent increased risk of developing heart disease compared to a 41 percent risk for men without them. Women in their 70s had a 35 percent increased risk versus a 27 percent risk for women without the patches.

Bulging eyes
Could mean: You have hyperthyroidism, also known as Graves disease. An autoimmune disorder, hyperthyroidism is caused by an overactive thyroid gland.
The scoop: In people with Graves disease, the upper and lower eyelids retract, exposing much of the whites of the eyes. The result: “The biggest wide-eyed stare you’ve ever seen,” explains Monica. The bulging can also cause dry eye. Other symptoms include nervousness, irritability, weight loss, fatigue, intolerance to heat, difficulty sleeping and a rapid, irregular heartbeat.  Graves disease is treated with radioiodine therapy or antithyroid medicine to try to normalize thyroid production, and sometimes thyroid surgery. Unfortunately, the bulging doesn’t always resolve. Dry eyes are typically treated with drops. To allow eyes to return to their original positions, surgery may be performed.

Chronic, red, irritated eyes
Could mean: Sjorgen’s Syndrome.
The scoop: Common in women–and recently diagnosed in tennis great Venus Williams—this autoimmune disorder occurs when white blood cells attack moisture-producing glands, including the salivary and tear glands. The syndrome causes dry eyes and dry mouth and can affect organs throughout the body. Half of people with the syndrome also develop other autoimmune conditions, namely, rheumatoid arthritis, lupus or scleroderma. “If I have a patient with red eyes, especially if the eyes hurt in the late afternoon, I look for Sjorgen’s Syndrome,” Monica says. Dry eyes and mouth are treated with over-the-counter and prescription remedies. Other therapies such as immunosuppressive medications are recommended as needed.

Grey or white circles around your cornea
Could mean: High cholesterol
The scoop: Called arcus corneae, these circles are tiny cholesterol deposits. Though your ophthalmologist usually spots them during the slit-lamp eye exam, if you get close enough to someone you can actually see them. The good news: “Just because you have them doesn’t mean you have high cholesterol,” says Monica. In people 60 and older, the circles are typically a sign of aging. If you’re under 40, they could be a red flag for high cholesterol, which puts you at increased risk for early coronary artery disease or heart attack.

Blood spots on the retina
Could mean:
High blood pressure or Type 2 diabetes
The scoop: Tiny hemorrhages on the retina are a sign of blood vessel damage caused by these conditions. In the case of diabetes, “usually we see this if someone has diabetic retinopathy, which occurs over time,” says Monica. “But it can happen at any time if a person hasn’t controlled their diabetes.” An ophthalmologist may also see yellow spots in the retina of people with diabetes.

A shiny plaque in an artery of the retina
Could mean: A blockage there or in the carotid artery
The scoop: Known as a Hollenhorst plaque, this is detected when the doctor uses a handheld direct ophthalmoscope to peer deep into your eyes. If she finds one, you’ll need a work-up by a cardiologist. “If something is blocking the small vessels of the eyes, you could have hardening of the arteries elsewhere,” says Monica. If your doctor detects a blockage in your central retinal artery, you’ll need immediate treatment.

A pale optic nerve
Could mean: Multiple sclerosis or an inflamed nerve
The scoop: In young adults, “the eye may be the initial point of onset for MS,” says Monica. Usually pink, the optic nerve pales when the wrapping around it—myelin—is damaged. (In MS, the immune system attacks myelin throughout the body.)  In 50-somethings and older, a pale optic nerve could signal ischemic optic neuropathy. One type is characterized by inflammation of the arteries in the head; another occurs when not enough blood reaches the optic nerve.

Yellowing of the whites of your eyes
Could mean: Liver damage, or jaundice
The scoop: Jaundice occurs when your liver doesn’t process bilirubin, a yellowish pigment produced by the breakdown of red blood cells. (You get rid of it in stool.)  As a result, bilirubin levels build up in your blood, turning the whites of your eyes—and your skin—yellow. Possible causes include hepatitis, cancer and cirrhosis of the liver.