As it turns out, your eyes are the windows into a lot more than just your soul.
“They are the windows into the rest of your body in many ways,” said Dr. Thomas Steinemann, a Cleveland-based ophthalmologist and surgeon with the MetroHealth Medical System.
In addition to identifying the early stages of vision-stealing conditions like glaucoma and cataracts, eye exams can spot signs of life-threatening health conditions such as diabetes, heart disease, tumors and neurological disorders, according to Steinemann. Exams can often identify warning signs before outward symptoms are present because the back of the eye is the only place in the body where blood vessels can be viewed directly. The circulation there says a lot about patient’s general health status.
“If there’s a problem happening, your eye doctor is sometimes the first to detect that change,” Steinemann said. “This is why it’s so important you make sure to get your annual eye exam.”
Steinemann added that researchers are learning more and more about the connection between ocular wellness and overall health.
“In my opinion, and obviously I carry some bias, but I think the eye is the most important square inch of your body,” he said.
Diabetes and high blood pressure are among the most common hidden health issues detected through eye exams. Steinemann said diabetes is of particular concern due to the escalating number of victims and the potential for significant vision loss and other serious complications.
Of the estimated 29.1 million people in the U.S. with diabetes, 27.8 percent are undiagnosed, according to the Centers for Disease Control. Another 86 million Americans have prediabetes, which can be reversed with early intervention.
“Some of them may come to us with blurry vision; other times there are no symptoms at all. But we can see those tale-tell changes in the eye,” Steinemann said.
If left unmanaged, the high blood glucose levels associated with diabetes can damage the blood vessels in the eye and lead to vision impairment and even blindness. Diabetes wreaks havoc on other organs as well, putting diabetics at much greater risk for cardiovascular and kidney diseases and premature death.
Meanwhile, the CDC estimates that one in three U.S. adults with high blood pressure – aka hypertension – don’t know they have it. Uncontrolled high blood pressure raises the risk for heart disease, stroke and dementia. Like with diabetes and prediabetes, knowing you are in the grips of hypertension – often called the “silent killer – is the first step in fighting its progression. An eye exam can reveal undiagnosed hypertension by identifying a thickening of the blood vessels there, along with other signs of damage.
Steinemann anticipates vision screenings will become ever more critical as we uncover links between ocular health and overall wellness – some of which are already coming to light.
A substantial 2021 study, for example, found that people who suffer from two or more systemic diseases (such as diabetes, cardiovascular disease and/or depression) in addition to an ophthalmic condition (macular degeneration, cataracts and/or diabetes-related eye disease) were at a greater risk for dementia. The increased risk was most pronounced in participants with diabetes-related eye disease, whose risk of dementia was 61% higher than participants who did not have an ophthalmic condition.
“We are also learning that cataract surgery may stave off dementia,” Steinemann said. “A very exciting study just published last month that took place at the University of Washington and followed over 3,000 patients for eight years found that patients who had cataract surgery had a reduction in the risk of dementia by 30%.”
Steinemann said ophthalmologic professionals recommend for everyone to get an eye exam every year. The annual screenings are most essential for people with conditions like diabetes and high blood pressure that can impact vision and for those who have been diagnosed with glaucoma or another eye disease.
Because many eye disorders – and health problems in general – increase with age, the older you are, the greater significance you should place on seeing a vision professional each year. Steinemann said people should make it an “absolute priority” by the mid-40s, if not earlier. He also noted the importance for people of color to get routine screenings due to a higher incidence rate of diabetes, hypertension and other chronic diseases.
Ophthalmologic appointments, Steinemann added, have been skipped or postponed more than any other type of health care intervention during the pandemic, which is especially troubling since many of the regular patients are older adults at risk for eye diseases and vision loss.
“Now’s the time for people to return,” he said. “We have the protocols in place, and we are ready and able to see patients safely.”
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