posted by Elizabeth Klunk, SVP, Medical Management, Versant Health
on August 1, 2019
Heart disease accounts for nearly 800,000 American deaths per year, according to the Centers for Disease Control (CDC). Many of these deaths would be preventable with early detection – and one rarely discussed early detection test is an eye examination.
An eye examination is the only non-invasive means by which a physician can see the blood vessels. A cardiologist, neurologist, or kidney specialist can go through their entire career and never actually see the blood vessels of the heart, brain, or kidney that factor so prominently in the diseases they treat.
Yet an eye exam provides a direct view of the blood vessels, and can tell a physician volumes about the health of the cardiovascular system without making a single incision or drawing one drop of blood.
Untreated hypertension has often been described as a “ticking bomb,” given its lack of symptoms. In fact, quite often, elevated blood pressure first declares itself in the form of a catastrophic heart attack or stroke. Given this, it’s no surprise that uncontrolled high blood pressure (hypertension) is a leading risk factor for heart disease and stroke. Yet, 1 in 5 people with the condition are not even aware that they have it.
An eye exam can change all of that.
Chronically high blood pressure changes the appearance of the retinal blood vessels in characteristic ways. These changes are apparent during an eye examination. In fact, research shows that many people first learn of their risk for hypertension, not from their cardiologist, but from their eye doctor.
One study from 2015 found that, in one optometric practice alone, 21% of patients tested were found to have high blood pressure. Of these, 66.7% had no idea they had elevated levels.
Given the connection between hypertension and 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. Researchers looked at more than 3,000 patients who were followed for an average of 4.4 years. Of the nearly 2% who had a stroke event, researchers found that diseases that affect the retina and larger retinal blood vessels were associated with stroke risk. In fact, they found that retinal imaging (as that done during an eye exam) improved the detection and classification of stroke risk beyond the known and established risk factors.
Similarly, an eye exam can also detect elevated cholesterol levels. High cholesterol is a leading cause of hardened 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. When retinal vein occlusion occurs, it can impede blood flow from the eye to the brain and back, resulting in sudden, yet painless, vision loss.
Fortunately, this doesn’t have to be the case. A simple eye exam can predict heart risk long before traditional symptoms occur. And as the research tells us, routine vision exams equal better health outcomes. And with better health comes greater savings on medical costs.
It’s a win-win all the way around.