For many people, particularly younger patients or those who don’t wear glasses or contacts, it can be tempting to forgo regular eye exams. But a thorough check up by an optometrist or ophthalmologist is essential preventative care for more than just our eye health – it can provide critical insight into more serious underlying health issues affecting the body, including detection of a reoccurrence of cancers particularly cancers of the prostate, breast and colon, systemic disease including diabetes, and autoimmune or inflammatory disease including multiple sclerosis (MS).
“A lot of patients think about health care as pieces,” says Dr. Katherine Anderson, OD of Heritage Optical in Detroit. “They think, ‘You go to the eye doctor to get your eyes checked. You go to the heart doctor to get your heart checked,’ and so on. But what they don’t realize is there’s a significant tie between the eyes and the rest of the body.”
The most important part of an eye exam, according to Dr. Anderson, is the dilation. Using drops to dilate the pupils, doctors can check the health of the back of the eye. She points out that the optic nerve and the highly vascularized tissue of the eye can sometimes reveal issues that have not yet manifested in other parts of the body, or reveal symptoms that may have gone undetected. For patients with a history of cancer, diabetes, MS or other systemic, autoimmune or inflammatory diseases, an eye exam could be critical to early detection.
Diabetes and Other Systemic Diseases
According to Dr. Anderson, any systemic disease can manifest in the eye, but what she sees most commonly are issues connected to diabetes, which is one of the leading causes of blindness in the country.
The eye is among our most vascularized tissue and is the only place where living blood vessels can be observed without cutting into the body. This visibility can reveal systemic cardiovascular issues including hypertension and high blood pressure. For patients with a history of diabetes, early detection of these symptoms in the eye is an indication that there may be damage elsewhere in the body. Early detection is important to early treatment.
Many patients may not think of their eye exam as an opportunity for a cancer screening, but for patients with a history of cancer, particularly cancers of the breast, prostate or colon, it is not uncommon for a metastasis to occur in the eye.
For example, Dr. Anderson points out, it’s possible for someone with a history of breast cancer to get regular mammograms and still miss early detection of a recurrence because a metastasis in the eye won’t be caught through a mammogram alone. This is why dilation by an optometrist or ophthalmologist is essential, especially for these patients.
She points out that it’s also important for people with light skin or who have a family history of melanoma to get regular eye exams because skin cancer will often manifest in the back of the eye. It’s commonly the first place that it can be diagnosed.
Autoimmune and Inflammatory Disease
Dr. Anderson shares this scenario: a young woman comes in for an eye exam. She’s in her mid 20s, has never worn glasses but is experiencing issues with her vision in one of her eyes. It’s all kind of new to her and she just assumes she just needs glasses. Maybe she’s not feeling much urgency, just something she needs to get around to.
Through dilation, the doctor examines her optic nerve and finds indication of MS, a demyelinating disease. The presenting symptom often starts in the eye and leads to a formal diagnosis of MS, which affects the entire body.
“This is not uncommon,” says Dr. Anderson. “We send them off for an MRI and more testing and they’re diagnosed with MS. But the only symptom they were experiencing up to that point was some discomfort in the eye or a recent vision issue.”
MS is just one of the autoimmune diseases that can be detected through dilation. According to Dr. Anderson, rheumatoid arthritis is another common condition that can be revealed through an eye exam.
Silent and Asymptomatic
Dr. Anderson also stresses the importance of awareness about preventative measures that can be taken to protect our health and vision. A comprehensive eye exam will include screening for diseases that can be silent and asymptomatic for patients.
Most patients associate dilation with screenings for glaucoma, which is an eye disease where the pressure inside the eye is too high and damages the optic nerve. Left undetected, it can lead to permanent vision loss. But it doesn’t happen overnight. It can take up to decades for the damage to occur. Unfortunately, an asymptomatic patient who doesn’t wear glasses may go years without an eye exam and could miss an opportunity for early diagnosis. That means vision loss that could have been prevented.
Window to Health
The optic nerve and vascularized tissue of the eye can provide a wealth of insight to underlying health conditions. Whether it’s an older patient who’s experienced a stroke in the eye, or a younger patient with an undiagnosed infection, or any number of health issues in between, our eyes help us see in some unexpected ways.
“The body is one big functioning organism,” says Dr. Anderson. “It’s incredibly important to get regular eye exams. Our eye health is a reflection of our entire body.”