Home SEE WELL What Do Eye Doctors See When They Look In Your Eyes?

What Do Eye Doctors See When They Look In Your Eyes?

by Louise Wood
eye doctors

When eye doctors look into your eyes they are investigating more than just your eye color or glasses prescription.

A comprehensive eye examination can uncover many serious health conditions. In fact, your eye is one of the parts of the body that reveals a particularly large proportion of health issues.

Eye tissue is an extension of brain tissue and research is currently focused on the ability of the eye to uncover degeneration in the brain.

Your eye doctor may be the first one to recognize an issue with your general health. Check out some common diseases which might be detected at your routine eye examination.


The National Diabetes Statistics Report (2020) claimed 34.2 million Americans are living with diabetes. The number one cause for new cases of blindness in adults aged 20-74 in developed countries is diabetic retinopathy. Tiny blood vessels in the retina (capillaries) become stressed and leak blood or yellow fluid in the back of the eye.

In the early stages of the disease, these leaks can be seen by your eye doctor before they affect your vision. In more advanced stages of diabetic retinopathy, you get blurry vision and floaters. Poor diabetic control and chronically high blood sugar levels are linked to an increased risk of diabetic retinopathy.

In some cases, your eye doctor may notice signs of diabetic retinopathy before you are diagnosed with diabetes. Early detection allows patients to start making positive lifestyle changes and seek treatment before the condition progresses.

High blood pressure

Approximately 1.13 billion people suffer from hypertension (high blood pressure) worldwide, according to the World Health Organization. Though hypertension is common, it should not be ignored. Prolonged high blood pressure can have serious health repercussions: heart attack, heart failure, and stroke.

Hypertension can damage the blood vessels in the retina in your eye resulting in blurred vision or permanent vision loss. Narrowing, twisting, or leaking of the blood vessels are common signs of hypertension in your eye.

Elevated cholesterol

With age, you may develop gray deposits around your cornea. Sometimes the deposits can form a complete ring of white referred to as “arcus senilis.” The ring often correlates with high cholesterol and triglycerides which carry an increased risk for heart attack and stroke.

Most often this ring is simply a sign of aging. But if you’re not nearing retirement age you should get your cholesterol levels checked. Another ocular sign of elevated cholesterol is fatty yellowish bumps on your eyelids called “xanthelasma.”

Eye migraine

Are you experiencing bright dots or lines in your vision? You could have an ophthalmic (or eye) migraine—with or without a headache. Even if it occurs as an isolated event you should have it checked out by your eye doctor to eliminate more serious concerns such as a retinal tear or stroke.


Your eye doctor will perform a visual field examination and could detect a stroke if your central or peripheral vision has disappeared.

A transient ischaemic attack (TIA) occurs when oxygen is briefly lost in one particular part of your brain and can cause a sudden, temporary loss of vision. TIA’s are referred to as mini-strokes and can be predictive of a disabling stroke. If you have these vision symptoms your eye doctor will refer you immediately for a neurological assessment. You may have other symptoms such as weakness, numbness or tingling, difficulty speaking, dizziness, and loss of balance.

Autoimmune disorder

If you suffer from an autoimmune disease your immune system is starting to attack itself. Autoimmune diseases like rheumatoid arthritis, lupus, and Sjogren’s syndrome can cause ocular symptoms of dry eye. Your eye doctor will diagnose and treat your dry eye and ask a series of questions to rule out any systemic cause for your symptoms and refer you if they are concerned.

Thyroid eye disease

Your thyroid gland, at the base of your neck, is responsible for producing a hormone to regulate your metabolism. An autoimmune condition called “Graves’ disease” occurs when your thyroid is overactive and releases too many hormones. Common symptoms include weight loss, diarrhea, racing heartbeat, trouble sleeping, and shaking hands. Ocular symptoms include blurry vision, dry eye, double vision, pain with eye movement and exophthalmos (protruding eyes). Even without systemic symptoms, there could be signs of thyroid eye disease.

Myasthenia gravis

Do you have trouble opening your eyes? If you have droopy upper eyelids on both sides you may be suffering from myasthenia gravis, an autoimmune disease where your muscles weaken (including the muscles in your eyelids). Myasthenia gravis mainly affects your eye, face, and throat muscles making it difficult to chew, swallow or even speak.


Eye doctors can be the first ones to diagnose some cancers. Ocular melanoma is a rare form of melanoma that you won’t usually be able to see when you look in the mirror. It is often found in the uvea or wall of the eye. Symptoms can include blurry vision, eye pain, and visual disturbances like flashes of light or floaters.

Sometimes cancer that arises elsewhere in the body is diagnosed first in your eyes. The two most common cancers that spread to the eye are lung cancer in men and breast cancer in women. Some brain tumors can also be diagnosed at an eye examination.

Liver damage

When your skin and eyes look yellow or jaundice it can mean you have an issue with your liver. When your liver is under stress from inflammation or damage it produces more bilirubin which can discolor your skin and the white part of your eyes. In liver disease, you can also develop other issues such as dark urine and itchy skin. Bad diet, cancer, infection, and chronic alcohol abuse all cause damage to your liver.

Alzheimer’s disease

Alzheimer’s disease (AD) is the most common form of dementia and is characterized by a progressive decline in memory and learning. When Alzheimer’s disease develops, abnormal proteins build up in the retina.

Scientists have known these proteins have accumulated in the blood but now they are being found in the eye. Often these proteins are present in the retina many years before symptoms of the disease appear. An accurate, easy-to-administer diagnostic test for AD would enable current and future treatments to be more effective. Trials are underway for a world-first eye scan that uses colored light to look through the retina for these abnormal proteins before dementia symptoms occur.

Multiple sclerosis

Your eye doctor can play a very important role in the initial diagnosis and treatment of multiple sclerosis (MS). In 2010, there were around 300,000 people suffering from MS in the US. In up to 30 percent of patients, optic neuritis is the presenting sign of MS. Your eye doctor will use high-resolution scanning devices to image the back of your eye and detect early signs of MS.   

Parkinson’s disease

Parkinson’s disease is a progressive disorder of the central nervous system. Symptoms include tremors, muscle stiffness, and issues with balance. Currently, diagnosis often occurs late in the disease when there has already been significant damage. Research presented in November 2020 indicated that the progression of the disease can be determined by thinning of the walls of the retina. Essentially a photo taken of the retina may be able to predict the development of Parkinson’s disease in its early stages.

Who knew the window to the soul could be so informative?

You should now be convinced a regular eye examination is essential to monitor your general health. An annual eye examination is particularly beneficial if you have a family history of eye disease or other health conditions.

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