By now, I hope that the general public knows that diabetes, high blood pressure and high cholesterol can be seen in the eye on a routine eye exam. If you do not know that by now, then we as eye care providers are not doing a good enough job educating you. However, I wanted to talk about other bodily diseases that many are not aware can also be found in the eye, and if not treated early, can lead to severe health issues later.
Syphilis, a sexually transmitted disease, can occur in many forms in the eye, but the most common is a condition called uveitis. This will cause eye pain, redness, blurry vision and sensitivity to sunlight. In 2015, there was a rise in the number of ocular syphilis in the west coast with no accompanying genital symptoms. It is important to be honest with your eye care provider and inform them if you have had a change in sexual partners or are HIV positive, in order to receive the correct treatment promptly. For more information, go here.
Brain Tumors cause an increase in intracranial pressure. With the eye being so close to the brain, a mass in the brain that causes an increase in intracranial pressure may also cause swelling of the optic nerve. The photos below do not show the swelling adequately, but I would describe it as though there are two torpedoes pointing toward you. Many patients will often have no symptoms, therefore, it is important to have a full ocular health exam to rule out any abnormalities.
Fabry’s Disease is an inherited disorder which in its severe form, can cause organ system damage later in life. More than 90 percent of patients with Fabry’s Disease will have this spoke-like whorl opacity on the cornea, and many are young individuals with no symptoms.
Myasthenia Gravis is an autoimmune neuromuscular disease that causes muscle weakness and fatigue, often worse at the end of the day. More than half of patients with this disease will have a droopy eyelid and possible double vision. An easy test is to put an ice pack on the eye for 2 minutes. If the droopy lid is less droopy after applying ice, it’s likely that it’s caused by Myasthenia Gravis.
FAP (Familial Adenonomatous Polyposis) – a form of hereditary colon polyps which if not treated and removed early will lead to a 100 percent diagnosis of colon cancer by age 40. Ninety percent of these patients will also have pigmented areas on the retina called CHRPE (congenital hypertrophy of the retinal pigmented epithelium). Again, early diagnosis is key, and your optometrist may be the first one to diagnose this.
Above is just a handful of hundreds of bodily diseases that can be detected in the eye. If you think about it, the eye has an intricate network of nerves and blood vessels that is intimately connected to the brain and blood supply. So what affects your body will likely affect your eyes. An eye exam is not just about whether you can see 20/20, it’s about what your optometrist sees in your eyes. Regardless of age, get them checked yearly.
~Cindy P. Wang, OD, FAAO
California Optometric Association