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Ocular Health: A Window Into the Heart

Ocular Health: A Window Into the Heart

CU ophthalmologist Niranjan Manoharan, MD, explains the connection ocular and cardiovascular systems often share, revealing important clues that can lead to proper diagnosis and treatment.

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Written by Kara Mason on February 6, 2024

What’s good for the heart is generally good for ocular health.

That’s because blood vessels in the eye are closely tied to the cardiovascular system. As a result, many conditions that affect the heart can often be detected in the eyes – sometimes even when symptoms haven’t manifested.

“Ophthalmologists can be the first ones to identify diabetes or high blood pressure in a patient,” says Niranjan Manoharan, MD, assistant professor of ophthalmology at the University of Colorado School of Medicine. “This happens in our clinic on a weekly basis.”

As a vitreoretinal disease expert at the Sue Anschutz-Rodgers Eye Center, Manoharan commonly treats patients who have diseases that can impact both the heart and the eyes.

Conditions that share the eye-heart connection

Just by looking at the eyes, ophthalmologists can observe blood vessel damage, diabetes, and high blood pressure.

“Many of these cardiovascular conditions don’t always come with obvious symptoms, even though they can be hazardous to overall health. A patient may not think there’s anything wrong, but there may clear signs in the eye because most cardiovascular diseases affect every blood vessel in the body, and that includes your eyes,” Manoharan explains.

Left untreated, diabetes may lead to diabetic retinopathy, which is often called a “silent disease” because it can lead to severe damage to the blood vessels in the eyes and body without any visual symptoms until advanced stages. In severe cases it can even lead to blindness. CU Department of Ophthalmology researchers emphasize the importance of screenings for people with diabetes or are at-risk of developing the disease to protect ocular health and vision.

Hypertension, commonly known as high blood pressure, is another condition ophthalmologists can identify during an exam by looking at the retinal arteries and veins. When blood pressure is too high, it can cause retinopathy, which may cause bleeding in the eye, nerve damage, swelling, and blurry vision.

Ophthalmologists can also see evidence of plaques in the arteries, which may signal that a patient is at higher risk for a stroke.

These cardiovascular conditions can lead to increased risk for ocular-specific diseases, too.

“High blood pressure and cholesterol are risk factors for worsening macular degeneration,” Manoharan explains. “While we know that there are some connections between these diseases, we don’t yet know the full extent.”

Healthy life, healthy eyes

Many behaviors and lifestyle habits that support heart health can also benefit ocular health, particularly keeping appropriate blood sugar and blood pressure levels in check, Manoharan says.

A balanced diet and exercise, both common recommendations for maintaining diabetes and hypertension, may aid eye health and reduce risk for ocular disease. Proper treatment and follow-up care are also crucial.

“At the end of the day, a lot of what is good for the heart carries over to the eyes and vision,” Manoharan says. “You want to prioritize seeing your preventative care providers and complete any recommended screenings, especially if you’re at-risk for diseases like diabetes. Early diagnosis can be vital for maintaining health, both in the heart and the eyes.”

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Niranjan Manoharan, MD