Early Signs of Heart Disease Can Be Detected Through Eye Exam

Close up of the eye under medial lights, detecting early signs of heart disease

“In your eyes, I see there’s something burning inside you,” says American singer and songwriter The Weeknd; and although he may not be singing about early signs of heart disease, he is right – we can actually see if something strange is happening inside our bodies right through our eyes. How is that possible? 

The retina vasculature, which consists of blood vessels in the back of the eye, is directly related to cardiovascular function. The difficulties we detect visually may even indicate issues in the cardiovascular system and the blood vessels.

A blockage in an eye blood vessel can cause sudden visual abnormalities like blurriness, dark spots, or shadows, which can be a precursor to a more severe stroke in the brain. Also, there is mounting proof that even minor, early injury to the small blood vessels in the eyes might serve as a warning sign for us. 

Detecting Early Signs of Heart Disease 

Aside from the eye, no other body part allows a doctor to observe the proper functioning of blood vessels, nerves, and connective tissue without intrusive surgery. That’s why even a routine visit to the ophthalmologist can detect some of the early indications of different cardiovascular diseases. 

For example, using an ophthalmoscope, the retina, pupil reflexes, and optic nerve can be examined, allowing professionals to inspect the functionality of the eyes. A more comprehensive exam includes an optical coherence tomography (OCT) that looks closely at the retina, marking evidence of potential eye stroke. 

Eye strokes occur when the eye loses blood supply and oxygen, leading cells to die over time. This results in a mark known as a retinal ischemic perivascular lesion.

That’s why eye doctors are frequently the first medical professionals to identify serious health issues, including high blood pressure, cholesterol, and stroke.

High Blood Pressure

High blood pressure is one of the most overlooked early signs of heart disease. Without using a blood pressure cuff, an ophthalmologist may tell if you have high blood pressure only by looking at the blood vessels in your eye.

Retinal arteries and veins should be around twice as wide as each other. Therefore, high blood pressure or cardiovascular risk factors may be present if the vein is noticeably wider and dilated than the artery, or vice versa.

Retinopathy, or damage to the retina’s primary blood supply, is one complication of excessive blood pressure in the eye. There is a risk of retinal hemorrhage, stroke, nerve damage, and eventual stroke in the retina, leading to blindness.  

High Cholesterol

Soft, yellowish lumps may appear on or near the eyelids of middle-aged and older individuals, typically in the area close to the nose. 

These benign growths, known as xanthelasmas, often cause little discomfort and have no effect on eyesight. However, they may indicate an excess of blood lipids such as cholesterol or triglycerides.  

Cholesterol tests, also known as lipid tests or lipid profiles, should be routinely performed on those who suffer from xanthelasmas.

Half of those who have xanthelasmas have regular lipid levels, making the growth purely aesthetic. People who have a history of cardiovascular disease in their family at a young age, however, should discuss this risk factor with their doctor.


Even though diabetes comes up slowly, people tend to miss the most obvious signs of it happening right inside their eyes. Eye issues might occur when blood sugar levels are too high. This puts the patient at risk for developing diabetic retinopathy, which can cause blindness and other serious health problems if left untreated.

But developing cardiac issues or even developing diabetes-caused blindness shouldn’t happen that easily. A routine eye checkup can help patients go under proper treatment on time, saving them from the worst-case scenario. 

Blocked Arteries

Arteries can constrict, harden, and become clogged with deposits known as “plaque” due to age and other risk factors such as high blood pressure and high cholesterol. 

This is known as atherosclerosis, and the retinal and optic nerve blood supply arteries may be damaged by it. If plaque pieces enter the brain, they can cause a stroke. 

When plaque deposits are discovered during a routine exam, your ophthalmologist may refer you to your primary care physician or an eye specialist.

How Is Technology Helping Indicate Early Signs of Heart Disease

Utilizing artificial intelligence or virtual reality in healthcare is nothing new. Google’s health technology division – Verily – conducted a study in 2018 that demonstrated how an algorithm could utilize an individual’s retinal scans (both current and historical) to forecast their risk of cardiovascular disease.

Built upon 300,000 different images of different eyes, scientists built this AI system to detect which patients may suffer from a cardiac incident in the next five years. The accuracy rate was 70%, which is comparable to the existing blood tests. 

The advantage is that this risk assessment can be completed during a doctor’s session rather than waiting for blood lab results.

Although it cannot diagnose heart failure, it can identify those at risk for developing the condition. Ophthalmologists’ diagnostic abilities, algorithm development, and patient care can all benefit greatly from the availability of big data, but this is especially true in underserved areas with limited access to eye experts.


To look is only part of what the eyes accomplish. An eye doctor may detect early signs of heart disease before any other symptoms appear. 

Comprehensive dilated eye exams are essential for preserving both eye and heart health. An in-depth eye exam might reveal potentially fatal heart disease risk factors and spark a vital conversation about cardiovascular health. 

So don’t postpone your regular eye exams – they might be of greater importance than you may think.